Ya I respect and understand that. It can be very costly and timely endeavor. I respect everyone’s individual journey.
Ya I respect and understand that. It can be very costly and timely endeavor. I respect everyone’s individual journey.
Vince Carter
Banned
save for one lingering problem I deal with, being low SHBG and having my trough E2 mirror my SHBG value, having my E2 in the single digits and monitoring Free Estrogen brought on most of the good stuff from TRT.
The 21-30 E2 is one of the biggest lies that's propogated in TRT.
The 21-30 E2 is one of the biggest lies that's propogated in TRT.
Charliebizz
Well-Known Member
That just proves how trt is still so trial and error. And even a lot of these so called top docs in the field are just guessing to a degree. We are all so different and all need wildly different approaches to our hormones. Sure guidelines are nice. But unfortunately a lot of us our out side of them.
I also feel like a lot of use younger guys that do not do well on trt can be adding fuel to the fire. Like for me it seems like what ever is going on with my health it’s my body’s way of slowing me down to address the real issue. What that is I have no clue. But every time I boost my t it brings on way more problems then good.
Or it could be what your saying Vince and I just never had my e2 low enough for me to feel ok. I’m most likely not done with trt forever because it’s an ever growing field. But for right now being a low shbg guy is hard to find what’s right for me
It's not exactly a lie, but it's based on averages. I think you're right to focus on free estradiol. If we assume the supposed optimal total estradiol range is based on normal SHBG of about 30 nMol/L, then the "optimal" calculated free estradiol is about 0.5-0.8 pg/mL. But these values are still above what works for you, yes? Maybe we also need to look at the ratio of free testosterone to free estradiol.
Bentiger07
Member
I once asked a knowledgible doc on TRT how can I raise SHBG. He advised its tough for guys to increase but he felt a low carb diet would help most. Low carb means low insulin. Insulin has a strong inverse relation to SHBG.
As I dont like limiting my dietary choices much since eating healthy is hard enough, and as I dont want my cholesterol to go thru the roof from low carb (I have/had ED which is correlated to the high cholesterol I have), I’m testing out another natural method first that keeps insulin low, intermittent fasting. Curious to see if it raises shbg. I already read some studies that show the inverse relationship between shbg and insulin.
P.S. I realized I made a big typo in the tips I gave in my 1st post here. If anyone read it, please disregard. I edited it and its correct now
As I dont like limiting my dietary choices much since eating healthy is hard enough, and as I dont want my cholesterol to go thru the roof from low carb (I have/had ED which is correlated to the high cholesterol I have), I’m testing out another natural method first that keeps insulin low, intermittent fasting. Curious to see if it raises shbg. I already read some studies that show the inverse relationship between shbg and insulin.
P.S. I realized I made a big typo in the tips I gave in my 1st post here. If anyone read it, please disregard. I edited it and its correct now
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Vince Carter
Banned
You think moving SHBG a few points as you put it is going to change anything? at all? (rhetorical)
My SHBG is in the 18-20 range consistently when I test. I think that I would be considered a "low SHBG guy". I inject 50mg of T cyp on Mondays and Thursdays. I use 300 ius of HCG M/W/F. I draw labs at nadir on the Thursdays prior to my injection. My total T is always in the 700 range and my free T is over top of the range. Why is it that low SHBG guys need to go to more frequent injections? Is it because their T is used up quicker and their total T and free T levels are lower unless more frequent injections are used? My t levels don't seem to indicate that. Do more frequent (lower amounts) of injection raise SHBG? Lower E (likely because of less spike)? Should I go to more frequent injections? Thanks for your thoughts.
No, but if you can move it 10 points and couple that with more frequent injections, one may feel the peaks and troughs less.
I'd consider SHBG of 18-20 nMol/L to be just borderline-low.
It's a misconception to think that low SHBG causes testosterone to be used up more quickly when on TRT. The rate of use is essentially controlled by the rate of absorption. One way to think of it is that the testosterone injections control the level of free testosterone, and the combination of free testosterone and SHBG determines where total testosterone ends up.
If conventional wisdom is correct—about more frequent injections being better for low-SHBG guys—then the likely reduction of peak estradiol may well be one of the reasons why. The idea is somewhat supported in theory by the decrease in the ratio of free testosterone to free estradiol as SHBG goes lower.
I don’t recommend anyone wasting time manipulating their SHBG, but taking thyroid medication, or just increasing thyroid levels in general, has been known to increase SHBG. It ended up being true for me. My SHBG is usually around 40. It went up to 63 when using 2.5 grains of NDT per day. So for anyone that does want to increase SHBG, you may be able to kill two birds with one stone by optimizing thyroid function with either NDT, T3, or a T3/T4 combo, and also increasing SHBG at the same time.
Vince Carter
Banned
I have documented labs that show I can wipe out the 6 day ester/half-life of Cyp in ~28hrs from a 16mg injection, SHBG is ~12.
Does that mean that your T levels are low after only 28 hours post injection?
Vince Carter
Banned
labs show my lowest point 8hrs post inj. I start to rise at 12hrs which carries thru to a presumed peak @ 28hrs, which is the first appt @ 8AM for a blood draw
I have a large drop-off at that point. I would have to stretch myself very thin to run labs after 28hrs, Id basically be skipping an injection at that point which isn't helpful to my treatment. BUt I have no problem extrapolating a conclusion based on that that I would be at my low T baseline around 36hrs.
The point being in all this is that my SHBG dominates the Cyp half-life.
Dr Crisler stated it well...the low SHBG guy pisses it out rather quickly but does NOT enjoy the same rate of clearance with the Estrogen.
isnt a low SHBG good? for example my labs
SHBG 22.6 [ref 13.3-89.5]
free test 2.6 [ ref 4.9-19]
total level 119 [ ref 175-981]
test bio available 65.7 [ ref 115-446]
albumin 4.7 [ref 3.2-4.8]
On 3/9/19
DHEA 220 [ref 106-464
prolactin 6.2
estradiol [ unsure if sensitive] 21 [ Ref male < 47]
Cortisol 18 [ ref<10 according to time it was taken]
SHBG 22.6 [ref 13.3-89.5]
free test 2.6 [ ref 4.9-19]
total level 119 [ ref 175-981]
test bio available 65.7 [ ref 115-446]
albumin 4.7 [ref 3.2-4.8]
On 3/9/19
DHEA 220 [ref 106-464
prolactin 6.2
estradiol [ unsure if sensitive] 21 [ Ref male < 47]
Cortisol 18 [ ref<10 according to time it was taken]
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You have yet to explain how your SHBG can possibly affect the slow absorption of the testosterone ester from an injected depot. Even if you can provide more than vague assertions that cypionate has an incredibly short half-life for you, that in no way shows causality in relation to your low-SHBG.
Kind of ridiculous if you think about it. You can't "piss it out" faster than you take it in. In any reasonable time period the average intake (absorption) and average excretion must match. Or maybe for once you can clarify what you think is happening?
Vince Carter
Banned
You should spend more time on PeakT policing that shit show of a forum.
Vince Carter
Banned
I think it's good, yes, you typically need less dosing to get excellent Free T but along with that can be the Estrogen management where the problem lies.
You did there have the wrong Estrogen test, one that is designed around females, overestimating levels in males. You need the LC/MS/MS sensitive tests. I tend in myself to like to see that E2 LC/MS/MS number closely mirror my SHBG value.
Versus here, where you express your disagreements with well-reasoned arguments. I can always hope.
SHBG doesn't affect absorption, but it DOES affect duration of action. Low SHBG guys will see great variance in peaks and troughs if injecting 1x per week than someone with higher SHBG.
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