Discountlabs ED panel, no SHBG?

[Nixter]

I was checking out this panel and didn't notice SHBG in the list of tests for this panel. Is that correct?
ED Panel

 

[Vince Carter]

SHBG wouldn't be an ED factor, directly.

 

[Nixter]

SHBG wouldn't be an ED factor, directly.

Could you explain why not? I've just been reading that its a prime factor in ED while on TRT. Is it because it's a secondary issue? I've been on trt for over a year now and to be honest ed problems have been worse since being on.

 

[Vince Carter]

Because if your Free T is in the lab range or higher you really don't need to know SHBG at that point, something to look at in follow on tests, sure. The inclusion or exclusion of certain tests in a "panel", if you will, is certainly debatable to why or why not. For instance in that ED panel the inclusion of Thyroid labs I would say aren't necessary.

 

[Nixter]

Makes sense. And my last SHBG was in range, 25.5 in a range of 16.5 - 55.9. Free test wasn't in my last panel unfortunately, just total which was 1274.0. range is 264.0-916.0 ng/dL but i had my draw at peak which i now know is wrong. Estradiol sensitive was 16.3, range 8.0-35.0 pg/mL. This was on 150mg test e split twice per week with 1mg adex.

I guess the first step is to find out free T. Is there not a way to calculate it from other panel numbers? Assuming i found my free T was low, what would be the first step in attempting to change that?

Thanks

 

[Vince Carter]

Given 150mg twice per week and your SHBG @ 25 Id be fairly certain that you don't have a Free T problem but stranger things have happened.

You'll need your albumin from a CBC:

Free & Bioavailable Testosterone calculator

 

[Vince Carter]

Too you've got to start getting the right labs and in the trough as makes things very hard to discern and the conversation difficult.

 

[Nixter]

I have albumin from the past test 4.4

That calculator give me a free test of 36.3/2.85% and bioavailable test 871/68.3 %

 

[Nelson Vergel]

All ED hormone-related studies link low total and free testosterone and/or high prolactin to ED. No SHGB.

You can always buy SHBG separately.

Sex Hormone Binding Globulin - SHBG

The more tests I add to a panel, the less affordable it becomes for most men. So, I try to be very careful about which ones I pick.

If you want the "kitchen sink approach" this is the panel to have:

Elite Male Blood Test Panel

 

[madman]

I have albumin from the past test 4.4

That calculator give me a free test of 36.3/2.85% and bioavailable test 871/68.3 %

When using the calculated Free T method (Vermulen) as long as you know your TT and SHBG it cab be done as even though albumin is also needed it is pre-set as a mean of 4.3 g/dL as an average of most men..... even if your albumin is within the mean it is not going to have a huge impact on your FT/BT values.

Only in cases of hypoalbuminemia (Interpret free testosterone results with caution
in presence of significant hypoalbuminemia) as in abnormally low.

 

[Nixter]

Sigh. I appreciate all your quick replies this morning guys. It seems *most of my markers are in range. What else could be possible issues? Prolactin? That wasnt in my last panel.

 

[Nelson Vergel]

Post number 2 here shows the factors involved in libido and ED. Hormones are only part of the story.

When Testosterone Doesn’t Lead to Better Erections

 

[Nixter]

Thanks Nelson, i am aware of those factors. My BP is upper normal for sure. This started when i started trt, it was lower before. My hematocrit tends to creep up as well. I'm donating today actually. I haven't really noticed previous donations having any effect on ED though, but i wasn't specifically making any mental note either

A new panel is the first step of course, but i have to drive down to the US for that. It's not that far from Vancouver but it requires taking time off work. I can also get blood work through the anti aging clinic that got me started but it's more expensive in Canada. At least id have the doc to help interpret the results. Even though it's just a naturopath, he treats a lot of local clients so he has experience.

I've been wondering for a while now if i might be better served finding the max T dose at which i don't require an AI and just go with that.

 

[Vince Carter]

Once you have what should be numbers that support erections and libido you have to consider the mind as what's holding you back. Erections/libido are always the things guys chase the most and have the least success with.

 

[fifty]

Charles Poliquin would say to boost libido, find a new sex partner

 

[Nixter]

I'm very aware of the mind connection and have experienced it in the past. The difference here is that in the past when temporary ED was psychological, "alone time" was never affected, only with partners. Now alone time is also affected so i suspect it's physiological. That and the issue has been chronic to varying degrees while on trt.

 

[Nixter]

As a bit of a "duh" moment, i realised my e2 is probably high. Last time i was tested, i was at 150mg t/wk plus 1mg adex and my e2 was right in the middle of reference. Now im at 200mg, I added HCG at 750iu/wk, but haven't increased adex so my e2 is probably high. I was still having ED issues last time i was tested but now they are worse with the increased T and added HCG. I really only added the HCG to see if it would make any difference to the ED. It did! ...worse lol. Likely due to the added conversion it creates. My next panel isn't until nov 28th but im going away this weekend with two girlfriends so Im going to add a bit of Aromasin I have on hand to hopefully lower e2. That and I'll be popping Cialis like pez lol. Anyways, i know throwing extra AI's in the mix without blood work isn't advisable but I'm kinda desperate here and I'm relatively sure I'm dealing with raised e2 that's making the problem worse.

 

[fifty]

Weekend getaway with 2 girlfriends. Excellent. Now where did I go wrong in life?

 

[Nixter]

Haha! Yeah, im poly which makes ED issues very concerning!

 

[Nixter]

So let's say i get blood work and the issue looks like something other than e2, like DHT or prolactin for example. What are my options then? For high/low e2 you'd adjust the amount of AI but how do you address other issues? I don't really want to add more drugs to the mix.

This is why I'm thinking to drop my test down to the amount where i don't require an AI. I've been reading cases where guys lose libido and have ED on higher trt doses, like anything above 100 or 120/wk