How can one increase SHBG when it is too low?

[James]

ERO & Vince Taylor - I'm struggling with understanding how it's beneficial for guys with low SHBG to actually take more and LARGER doses of test. Wouldn't the higher dose push SHBG down further resulting in even more E2 conversion? My SHBG is on the lower end of normal and Doc recommended 40 mg twice a week (80 total) vs. the 165 mg once a week that I was on. Forgive me if this theory is explained above.

 

[Gene Devine]

You got it correct James.

 

[ERO]

I don't actually have much of any E2 conversion. I had to stop Anastrozole entirely as a dose of 0.125 twice a week put my E2 at 5 on repeated ultra sensitive tests.

I have tried the lower doses for several months and my energy went completely to sh*t. Since about all I get out of TRT is a good energy level, I went back to larger doses. If I cant have a decent libido or build any muscle, at least I can have my energy back.

 

[James]

ERO - You have naturally low shbg, take a pretty good dose of test, and yet have very little E2 conversion? I'd think it'd be the opposite. Good that you got your energy I suppose.

 

[RoneTone]

Hey Ero - I've seen you mention in a couple posts that your libido is lower than it was previous to TRT. Do you mean your desire or erection quality? Or both? Are you using HCG?

Also, in this thread I see it recommend that HGH or other growth hormones/peptides can raise SHBG. In my expereince and also according to the study posted here HGH might lower SHBG: https://thinksteroids.com/community/threads/using-hgh-to-lower-shbg.134238499/

I think this was my case. I recently was on HGH 2iu per day for a month and my E2 exploded to 72 (from 30) on just my normal 45mg E03 cyp dose. I could feel the E2 surge and that's why I went and got tested.

My SHBG came back at 17. I did not do a baseline of for this prior but will test again here in 2 or 3 weeks to see if it rebounded and my E2 dropped back to 30 where it was previously.

Anyway - just some food for thought. I've seen some people say HGH can raise SHBG while others say it will tank it. Its seems there are studies that support both theories making it all the more confusing. I know now that I'll be very wary of using HGH again.

 

[ERO]

Hey Ero - I've seen you mention in a couple posts that your libido is lower than it was previous to TRT. Do you mean your desire or erection quality? Or both? Are you using HCG?

Also, in this thread I see it recommend that HGH or other growth hormones/peptides can raise SHBG. In my expereince and also according to the study posted here HGH might lower SHBG: https://thinksteroids.com/community/threads/using-hgh-to-lower-shbg.134238499/

I think this was my case. I recently was on HGH 2iu per day for a month and my E2 exploded to 72 (from 30) on just my normal 45mg E03 cyp dose. I could feel the E2 surge and that's why I went and got tested.

My SHBG came back at 17. I did not do a baseline of for this prior but will test again here in 2 or 3 weeks to see if it rebounded and my E2 dropped back to 30 where it was previously.

Anyway - just some food for thought. I've seen some people say HGH can raise SHBG while others say it will tank it. Its seems there are studies that support both theories making it all the more confusing. I know now that I'll be very wary of using HGH again.

Both desire and erection quality are lower on TRT than they were off, and they were low before - the loss of a previously strong libido and new ED is why I got tested and found out that I had low T. I also had low SHBG in that initial test before starting TRT.

I have gone both with and without HCG (human chorionic gonadotropin) and I honestly can feel no difference between with and without, and it does not seem to restore my testicle size, either. I also used doctor prescribed HCG (human growth hormone) for 6 months (this was 3 years ago) at 2IU per day, five days a week with weekends off. While that raised my IGF-1 on paper, it did nothing for me besides wasting a ton of money.

The thing with SHBG is that all of the few studies that exist are in "normal" people with a "normal" response, so that is why it is assumed that guys with low SHBG always convert to E2 at a higher than normal rate (many do, but some, like me, do not) and that low SHBG means you are pre-diabetic or diabetic (My fasting glucose is in the mid 80s and I have my own meter so I have tested for months at a time) and my A1C is 5.4 - the cut-off for diabetes is 6.5.

There are guys with low SHBG that feel awesome on TRT, but for each one of them there are probably ten other guys with low SHBG that feel next to nothing from TRT.

 

[RoneTone]

Thanks for the feedback.

I feel my libido is not as good as it was before TRT. I'm just not as excited about sex. It's not horrible, but I think it's a bit worse than before.

It could be that my E2 was just at 72 2 weeks ago and I'm letting it come down. It seemed much better my first 3 or 4 months on TRT.

I've been reading quite a bit about guys with low SHBG. I'll get tested next week to see if my SHBG rebouned after the HGH, but I'm worried I fall into this group.

I'm in the upper range of FBS when I test it and unless my E2 drops again I seem to convert T to E at a high level.

Ero, it seems you've read quite a bit about low SHBG. Does it seem like most guys with low SHBG convert T to E at a high rate and must take AIs to cope with it? Since we have high Free T it seems the E2 would be high as well. I switched to E02 injects from E03, lowered my dose and dropped the HCG/HGH in hopes of it dropping naturally.

Any other guys with low SHBG that is causing your T to covert to E please chime in!

 

[ERO]

Personally, I convert at a very low rate and do not need an AI even at a dose of 200 mgs of Testosterone a week (split into one, 100mg dose every 3.5 days). Even the very smallest doses of Anastrozole tank my E2 to low single digits. Some guys do convert at a higher rate, but my advice after fighting this for over 4 years is to test everything and assume nothing. Remember too that many if not most of the low SHBG advice is based upon guys with a "normal" SHBG system, not on guys that had low SHBG before they ever started TRT like myself. Also I would caution against some doctors that worry about our free T being high and so they want to move us to a very, very low dose of Testosterone to get the free T down - at which point we may be back at or near Low-T levels. I tried that and it was awful, but again, some guys may find that works for them. Also some doctors still do not understand that low SHBG is a bad thing, in fact, they assume that the lower, the better. Trust me, lower is NOT a good thing when you are below the usual range, most often shown at between 20 and 70.

 

[LowT2014]

I suffer from Low SHBG issues as well, being on TRT nebido protocol IM for 35 weeks, high E2 and low shbg, no sexual desire at all, my doctor here in Australia don't even believe in AI. So I am have decided to stop TRT as I am not benefiting from it, My E2 sky rocketting and as I suffer from having low shbg prior to starting TRT, i am getting nipple sore as well.

At least you guys are in USA, lucky for you, you can engage other means or doctors who knows and believe in AI and how important it is to control E2 while someone put on TRT. I loathe these doctors in Australia who blatantly refuse somone AI even with sore nipples and lab work which show high E2. Sadly I am quitting my TRT as this fail doctor refuse to treat my high E2.

Cheers
P.S I am fgn SAD.

 

[CoastWatcher]

I suffer from Low SHBG issues as well, being on TRT nebido protocol IM for 35 weeks, high E2 and low shbg, no sexual desire at all, my doctor here in Australia don't even believe in AI. So I am have decided to stop TRT as I am not benefiting from it, My E2 sky rocketting and as I suffer from having low shbg prior to starting TRT, i am getting nipple sore as well.

At least you guys are in USA, lucky for you, you can engage other means or doctors who knows and believe in AI and how important it is to control E2 while someone put on TRT. I loathe these doctors in Australia who blatantly refuse somone AI even with sore nipples and lab work which show high E2. Sadly I am quitting my TRT as this fail doctor refuse to treat my high E2.

Cheers
P.S I am fgn SAD.

Any my chance your doctor would consider a change to twice weekly injections? That may permit you to bring your values into a comfortable range.

 

[LowT2014]

Any my chance your doctor would consider a change to twice weekly injections? That may permit you to bring your values into a comfortable range.

The only T available in Australia for IM is Nebido Testosterone Undecanoate and Testosterone Enthanate (primiston depot) rest are transdermal and under the skin solutions.

He totally refused testosterone Enthanate and told me its more anabolic and put me on this huge 4ml injection of nebido that creates huge E2 boost every 12 weeks. The problem i have got is high e2 and trt didn't benefit me at all other than first 4 weeks when i started freshly. My shbg was always low even without trt and stayed low and didn't move at all after trt.

Cheers
Ps i will post and keep this updated.

 

[ERO]

Perhaps the transdermals would work better for you if you have not already tried them? A lot of guys here started on them and later switched to injections, but transdermals do work well for some folks. With a small daily dose you may have less E2 conversion and/or you may be able to control E2 with DIM as an over the counter supplement. This one works well for a few guys that I know. http://www.amazon.com/Natures-Way-D...pebp=1435813845194&perid=0XZYB7X4JK0GJP229AGP

 

[Vestpocket]

James,

The reason for taking HIGHER doses of testosterone with low SHBG is that the leading theory for why SHBG is so vital is that it acts as a promoter of signaling at the androgen receptor and is vital for update of T in certain tissues. If you can't get proper AR signaling because you lack SHBG, the only current workaround is to oversaturate your tissues with testosterone.

The only people who do well with low SHBG are the people taking too much exogenous T, as far as I've seen.

 

[Vestpocket]

Here's a better explanation of the problem:

I cross the FT threshold even at a tiny, tiny dose of testosterone:



If anyone thinks this is "awesome," I think you need to turn in your bro card.

 

[ERO]

Here's a better explanation of the problem:

I cross the FT threshold even at a tiny, tiny dose of testosterone:



If anyone thinks this is "awesome," I think you need to turn in your bro card.

Agreed 100%. It may look awesome on paper to have that much free T, but as someone that has fought low SHBG for over 5 years, it most assuredly is not.

 

[Vestpocket]

I keep hearing people say that there are medications that can increase SHBG. When questioned, they back down.

Are there actually any medications that reliably increase SHBG?

- Estrogen is out of the question, because all of us with low SHBG already have high estrogen to begin with. The liver doesn't care.
- T3 is supposed to increase it, but if you believe the studies, you need to achieve hyperthyroid doses ~50 mcg per day to see a boost. Also, the studies are in people that start with normal SHBG, not impaired SHBG.

Capesaris is on the way as a drug to increase SHBG. It's a SERM that works at the liver.

Has anyone heard of anything else that might work?

 

[CoastWatcher]

I keep hearing people say that there are medications that can increase SHBG. When questioned, they back down.

Are there actually any medications that reliably increase SHBG?

- Estrogen is out of the question, because all of us with low SHBG already have high estrogen to begin with. The liver doesn't care.
- T3 is supposed to increase it, but if you believe the studies, you need to achieve hyperthyroid doses ~50 mcg per day to see a boost. Also, the studies are in people that start with normal SHBG, not impaired SHBG.

Capesaris is on the way as a drug to increase SHBG. It's a SERM that works at the liver.

Has anyone heard of anything else that might work?

Capesaris, from what I have read, also lowers free testosterone. A double-effect not particularly welcome.

 

[JIMO]

I've been on SERM treatment for the past 7 months and it has not effected SHBG at all. Its been 15 the whole time. First 3 months was on clomid then I switch after experiencing the typical clomid mood swings and low libido to Tamoxifen.

 

[ERO]

It is a sad fact, but there seems to be nothing out there (for now, anyway) that can raise SHBG in guys with abnormally low levels. I get next to nothing out of TRT because of my low SHBG, so if anything new comes out that shows promise in raising SHBG levels (and doesn't have too many or too serious of a side effect profile) I am going to be all over it.

 

[RoneTone]

James,

The reason for taking HIGHER doses of testosterone with low SHBG is that the leading theory for why SHBG is so vital is that it acts as a promoter of signaling at the androgen receptor and is vital for update of T in certain tissues. If you can't get proper AR signaling because you lack SHBG, the only current workaround is to oversaturate your tissues with testosterone.

The only people who do well with low SHBG are the people taking too much exogenous T, as far as I've seen.

From what I've seen on the boards most recommend that low SHBG guys do more frequent dosing. Can you provide a link or study that sites what you're suggesting? I'm low SHBG (17) and interested in this topic. I'm not doubting you, just curious because your position doesn't lineup with my experience.

I inject EOD and have had pretty good results with it. I think injecting 100mg+ at once might give me a panic attack and my E2 would skyrocket lol, though I've never tried so maybe I'm completely wrong. I have to mange E2 on 95mg a T a week on EOD shots with .125mg of AI for each inject.

Dr John in his new book says as much - basically low SHBG guys can have lots of 'free' E2 circulating and they seem to be more susceptible to conversion, though ERO seems to contradict this. That would seem to indicate a large dose of T would add large amounts of freely circulating E2 as well. Wouldn't that make guys feel horrible for part of the week?

I'm going to start working wit Defy and Dr John next week so I will ask him more on this topic.