How often to test SHBG?

[Cataceous]

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E2 20.3: 6 months later > 12.3
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I'm interested in this result. Do you have measurements while on TRT but prior to hCG? I'm wondering if you used to have more aromatization. I'm trying to understand why stopping hCG has tanked my estradiol, even after three months.

 

[DragonBits]

I'm interested in this result. Do you have measurements while on TRT but prior to hCG? I'm wondering if you used to have more aromatization. I'm trying to understand why stopping hCG has tanked my estradiol, even after three months.

In the past, meaning for ~5 years on Nebido starting in 2009, I only tested total T and free T, a couple of PSA tests (2.28 – 2.78), a bunch of lipid tests, nothing else. So I could give you a couple of total T / Free T readings and lipid tests, but I am thinking that wouldn’t be useful to anyone.

To address your question:

I had one blood test in 7/ 2018 16 days after injecting Nebido but before HCG or anything else.

Total T 1389
Free T 28.4
E2 56.2
SHBG N/A

Then I had one test 9/2018 that was 109 days after Nebido, with HCG, but I was also probably using a T cream. At this point I am not sure about the cream, and I was supplementing DHEA/Preg.

Total T 690
Free T 20.7
E2 20.3
SHBG 41.1
PSA 3.9.

Since my PSA went up from a base of 2.4 before TRT/HCG to 3.9, I cut out everything outside of the Nebido.

I ordered a number of PSA/Hormone tests after 9/2018, but I changed up everything with the single goal of reducing my PSA while maintaining a high total T level.

Once my PSA got down to 3.2 on 4/2019, I went back to my new normal protocol.

Since that time I have gotten a number of blood tests (one total T / free T test) for my own reasons, I doubt they are related to TRT. Aldosterone, Omega 3 Index Complete (breakdown of all fatty acids in serum). Glucose Tolerance Test with Insulin (8 specimens), Progesterone, NMR LipoProfile®, today I got a blood draw for lipids / Vitamin D, 25-Hydroxyand and last but not least, a new calcium heart scan.

All interesting, but not pertinent to your question.

I was going to do a more complete hormone test sometime in August, but after that assuming noting is out of whack, I am thinking of moving to yearly blood tests, assuming I can do it my way.

If my Primary doctor or urologist wants me to take a test and writes the order in such a way that medicare pays for it, I am OK with doing it. Today's blood draw was for my primary doc.

 

[Cataceous]

... So I could give you a couple of total T / Free T readings and lipid tests, but I am thinking that wouldn’t be useful to anyone.
...

Thanks, I think this is what I was looking for. So you have a measurement before hCG, one during, and one after? And no AI use? If these are the conditions then they support the proposition that aromatase activity is reduced after being on and stopping hCG. It's not much data, but accumulating anecdotes is one way to come up with a testable hypothesis.

 

[DragonBits]

Thanks, I think this is what I was looking for. So you have a measurement before hCG, one during, and one after? And no AI use? If these are the conditions then they support the proposition that aromatase activity is reduced after being on and stopping hCG. It's not much data, but accumulating anecdotes is one way to come up with a testable hypothesis.

If aromatase activity is reduced after being on and stopping hCG, the key question would be for how long is aromatase activity reduced?

No AI during that time period, I only got some anastrozole in 2019 and only took a little, and by a little I mean ~0.625 twice in one week after a Nebido injection operating under the assumption that my E2 would be higher than I like. What typically would happen for a couple of week after Nebido my E2 would be higher than 50 and I gain water weight and my blood pressure would increase, then maybe 3 weeks later lose it.

I didn't gain any water weight, so it seemed to have worked, though I didn't bother with blood tests. I can't say I noticed water weight gain 9 years ago when I first started Nebido, but I do recall an unexplained rise in blood pressure which concerned me at the time.

In a similar vein I was operating under the assumption that some herbs in LEF Prostate formula raised my SHBG from 41 > 66.2. But 4 weeks after stopping the prostate supplement, my SHBG continued to rise from 66.2 > 73.6. I then assumed it was just a longer lasting effect like a "half life" and at some point my SHBG would return to my natural level of 35-43 range.

I will find out next time I test shbg.

 

[Cataceous]

If aromatase activity is reduced after being on and stopping hCG, the key question would be for how long is aromatase activity reduced?
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If it's a real phenomenon then I've had it going on for three months now. If I weren't supplementing I'd still have undetectable estradiol.

 

[DragonBits]

If it's a real phenomenon then I've had it going on for three months now. If I weren't supplementing I'd still have undetectable estradiol.

I assume you are supplementing testosterone, either injection or cream? Is your total T above 600? Does raising T cause more E2? I also assume you aren't taking any supplements or other hormones that many cause lower E2.

IMO undetectable levels of E2 with normal levels of T is more than just a reduced aromatase activity.

I have had E2 below 5 when my total T was 350, I suppose if I got a lcms test they could have detected E2 at some level.

The only ill effects I had was my joints tended to be more sensitive to stress, now they aren't.

Now with E2 at 20-50, I have had allergic reactions to drugs that I tolerated before with no problems. Several eye drops and penicillin drugs. Not a big deal as I just avoid those drugs, but it was a surprise.

Try supplementing boron, in the past that raised both my free T and E2, 6 mg, you can tolerate a lot more than 6 mg, that is what I settled at. That raised my E2 from <5 to 11 with a total T of 350.

 

[Cataceous]

I assume you are supplementing testosterone, either injection or cream? Is your total T above 600? Does raising T cause more E2? I also assume you aren't taking any supplements or other hormones that many cause lower E2.

IMO undetectable levels of E2 with normal levels of T is more than just a reduced aromatase activity.
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Try supplementing boron, in the past that raised both my free T and E2, 6 mg, you can tolerate a lot more than 6 mg, that is what I settled at. That raised my E2 from <5 to 11 with a total T of 350.

Literally supplementing with estradiol in cream form, which after four previous undetectable results got me up to 12.5 pg/mL. Will be switching to injections of estradiol benzoate. I had previously been increasing my testosterone doses, now up to the most I've ever taken, which previously yielded 60 pg/mL of estradiol. So yes, "reduced aromatase activity" is an understatement. I have considered the possibility that some supplement is contaminated with an AI. But the only obvious candidate was started five days before a test that showed no adverse effects on estradiol.

I do already supplement with 3 mg of boron. I'm loathe to do a lot more experimenting before I restart hCG in less than three weeks. If that doesn't turn things around then I'll know there's more to it. If it does turn things around then it will support this idea that chronic hCG use might knock down extra-testicular aromatization.

 

[DragonBits]

Literally supplementing with estradiol in cream form, which after four previous undetectable results got me up to 12.5 pg/mL. Will be switching to injections of estradiol benzoate. I had previously been increasing my testosterone doses, now up to the most I've ever taken, which previously yielded 60 pg/mL of estradiol. So yes, "reduced aromatase activity" is an understatement. I have considered the possibility that some supplement is contaminated with an AI. But the only obvious candidate was started five days before a test that showed no adverse effects on estradiol.

I do already supplement with 3 mg of boron. I'm loathe to do a lot more experimenting before I restart hCG in less than three weeks. If that doesn't turn things around then I'll know there's more to it. If it does turn things around then it will support this idea that chronic hCG use might knock down extra-testicular aromatization.

Why did you stop HCG, how long were you taking it, meaning what is "chronic", and why did do you think HCG might have caused this?

If it did cause it, what is the mechanism that might have caused this, some kind of over stimulation, what is your theory about why HCG might have caused this?

I know aromatase activity is what causes the conversion of T > E2, but aromatase is present in many places like the bone and brain but there it is Paracrine action: the hormone acts locally. I am not sure about where the aromatase enzyme is that is responsible for serum levels of E2?

To further complicate the issue, I imagine that serum levels of E2 are not always reflective of bone, brain levels of E2 and does serum levels of E2 affect bone / brain levels?

I have never had a whole lot of serum E2, when totally off external hormones my E2 was <5 with ~350 total T. Only when my total T got up to 1300 was my E2 over range at 56 pg/ml. But I didn't have any seriously noticeable effects of low E2 even though it must have been low for 10 years before TRT, my joints seemed to be more sensitive to stress, however that is somewhat subjective and depends on how much stress I have applied.

Clomid really caused a big increase in E2, you might try that. On clomid (no TRT) I had an E2 of 27 with a total T of 478. I was taking 50 mg every other day. Clomid blocks the hormone estrogen from interacting with the pituitary gland, however, I am not sure Clomid would be effective while on TRT as CLomid increases LH/FSH, which should be near zero on TRT.

One assumption I had, E2 conversions isn't linear, meaning double your total T and at some point you get more than double E2. Does anyone think that is true?

Here is another blood test taken in 6-2019, that is a year after stopping HCG while still on TRT, but I have no idea what my SHBG was.

Testosterone,Free and Total
Testosterone, Serum 612 ng/dL 264 - 916 01
Free Testosterone(Direct) 10.0 pg/mL 6.6 - 18.1 02

Estradiol, Sensitive 17.3 pg/mL 8.0 - 35.0 02
Methodology: Liquid chromatography tandem mass spectrometry(LC/MS/MS)

 

[Cataceous]

Why did you stop HCG, how long were you taking it, meaning what is "chronic", and why did do you think HCG might have caused this?
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I stopped hCG at the behest of a clinic giving me some joint injections, because they claim to have data showing that hCG "lowers total nucleated cell counts." I'd been on it for four years. The estradiol crash happened after stopping hCG, which is why I speculated that hCG use had suppressed extra-testicular estradiol production. I expected a reduction in estradiol due to loss of intra-testicular production, but that's only 15-25% of the total according to Wiki's references. The rest does come from the peripheral tissues.

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If it did cause it, what is the mechanism that might have caused this, some kind of over stimulation, what is your theory about why HCG might have caused this?
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I don't know enough about what stimulates or suppresses aromatase to state a plausible mechanism.

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Clomid really caused a big increase in E2, you might try that. ... I am not sure Clomid would be effective while on TRT as CLomid increases LH/FSH, which should be near zero on TRT.
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I did try enclomiphene for a period and it was insufficient to overcome the suppression of TRT.

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One assumption I had, E2 conversions isn't linear, meaning double your total T and at some point you get more than double E2. Does anyone think that is true?
...

It's nonlinear, but in the opposite direction. The aromatase enzymes start to saturate with additional testosterone, so the rate of increase in estradiol decreases with increasing testosterone.

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Here is another blood test taken in 6-2019, that is a year after stopping HCG while still on TRT, but I have no idea what my SHBG was.
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Testosterone, Serum 612 ng/dL 264 - 916 01
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Estradiol, Sensitive 17.3 pg/mL 8.0 - 35.0 02
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Hard to say, but this could be showing a recovery in aromatase as times goes on. Or it could just be random fluctuations.

 

[DragonBits]

Hard to say, but this could be showing a recovery in aromatase as times goes on. Or it could just be random fluctuations.

I had assumed E2 went down because of lower Free T and something in the prostate formula, but it's equally plausible it went down from quitting HCG.

I was only on HCG for ~ 2 months, ~ 500 IU every 2 or 3 days a week.

 

[Nelson Vergel]

I never test for SHBG. Free T tells me the story.

 

[Nashtide]

I never test for SHBG. Free T tells me the story.

Okay, but isn’t there the idea that blood tests for FT are very in accurate? And you can’t calculate FT without SHBG. Are you using a different FT test?