Low SHBG high Free T Injection Protocol

[optimizely]

Hello,

Long time reader of this forum. First time actually posting. I’ve been on TRT for 2 years due to steroidal induced hypogonadism. I’m 25. Total T was low 200’s and never came back.

After two years of TRT i’ve finally come to the conclusion and realization that I have low SHBG and thus higher estrogen conversion and high free T. All of which I learned about from this forum and Dr. Crisler. I’ve always focused on having my total T number in the upper physiological range (as you will see in my blood work) and ignored SHBG, Free T, and Bioavailable T. I’ve felt good on TRT but not great. Libido has always been trash after starting TRT 2 years ago which is frustrating.

My current protocol is 200mg/week of test Cyp injected IM Monday and Wednesday with 1mg anastrozole on injection days.

My plan is to switch to SQ injections EOD with anastrozole EOD. I guess my question to the board is what testosterone and anastrozole dose should I switch to EOD knowing that I am a low SHBG. Last couple blood panels I was 10 and 11 SHBG.

Injecting 200mg/week had my free T and bioavailable T numbers double the highest upper limit number of free T. Things that I wonder now is if it’s better to base your labs off you free T numbers and disregard total testosterone number. Everyday I’m learning and try to get better. Appreciate any input! Last blood panel is below:

Total T: 1126 ng/dl
Free T: 496.8 pg/mL
Bioavailable T: 1,021.7 ng/dl
Estradiol sensitive assay: 35 pg/mL
SHBG: 11 nmol/L

 

[Systemlord]

You should reconsider and inject everyday as your SHBG is super low, you're estrogen will be better controlled injecting ED vs. EOD.

That is what you want to be able to do, manage estrogen right? Smaller injections, smaller peak's and lower estrogen is how its works.

 

[optimizely]

I’m open to everyday injections. My goal is to better control estrogen and get my free T number back into physiologic range. Would it make sense to lower dosage to achieve this? And what total T and free T number should I aim for?

 

[Joey786]

Have you ran thyroid labs? Hypothyroidism can lower SHBG.

 

[madman]

I’m open to everyday injections. My goal is to better control estrogen and get my free T number back into physiologic range. Would it make sense to lower dosage to achieve this? And what total T and free T number should I aim for?

Moving to daily or EOD injections would be beneficial due to your low SHBG and seeing as your FT is so high it can easily come down and whether that is mid-normal or high-normal of the physiological range is any ones guess as each individual is different.

Most men need their FT in the 2-3% range of TT.

TT is good to know but you should be concentrating on your FT levels as it is the unbound active fraction of testosterone responsible for the positive effects.

You will need to lower your overall weekly dose in order to bring your FT down.

If we take your TT 1126 ng/dl and SHBG 11 nmol/L and use the Free & Bioavailable Testosterone calculator your FT is really high 3.58% and your BT is really high 83.9%

 

[Systemlord]

I target symptom resolution, I never aim for a number. When I feel awesome I want to see what that looks like on paper, when I'm desiring sex several time a day that's when I want to see what that looks like on my labs.

 

[optimizely]

I’m going to start daily injections. What is a good starting dose for my testosterone cyp and anastrozole keeping in mind i’m Low SHBG and sensentive to estrogen conversion. I see 16mg/day as a common starting dose. But, is that too high? And how much arimidex?