low shbg means high free E2 ?

[GreenMachineX]

Omg. I’ve been saying this to my wife for a while. I have move low e2 symptoms the high. And I’m a low shbg guy. My e2 is only a pont or 2 over the range. But I’m starting to think everything we thought we knew about shbg is the exact opposite. I’ve tried everything that low shbg guys are “supposed to do” and usually feel worse. I’m really thinking about raising my dose and going to less frequent injections like 2x a week or something.

Have you tried this? What's your shbg and what protocols haven't worked for you?

 

[GreenMachineX]

That’s some interesting info. Don’t think u have to think that deeply into it tho. But doesn’t hurt. The more u know and understand about something the better obv. What’s ur SHBG level?

Think u can just keep things fairly simple tho and just generally try to keep SHBG in a healthy range. Just like with everything else, SHBG is all about balance. But like with quite a few other hormones, like E2 and test, for example, low is much worse than high, at least imo. They’re finding out that SHBG isn’t just a protein that binds up add hormones, it’s actually needed to help get hormones into cells. At least from my understanding. And low SHBG causes hormones to fluctuate much more than someone with a normal SHBG, and it seems to cause more issues for these guys than men with normal, or even higher end SHBG levels. I would say u want to try and keep ur SHBG around 20-50, from what I’ve seen anecdotally.

How does one increase shbg?

 

[Systemlord]

How does one increase shbg?

Your diet can raise SHBG. Another way is cutting what amounts to starvation.

 

[Gman86]

How does one increase shbg?

Basically by increasing insulin sensitivity. Keto and carnivore diets are both notorious for raising SHBG

 

[Cataceous]

@Cataceous, would this possibly mean that low shbg guys would either need higher T levels, or lower estradiol levels than we previously thought? To make up for the skewed E/T ratio?
...

It was previously hypothesized that estradiol was a problem with low SHBG—as evidenced by this rule-of-thumb floating around that says that SHBG in nMol/L should match estradiol in pg/mL. I'd thought that idea could have a basis in relatively higher free estradiol as SHBG goes down, but that's shot down by this new thinking, and we have to look at other possible mechanisms. Regardless, if the issue is still reduced androgenic activity compared to estrogenic activity then it would be justification for AI use, because just increasing testosterone is also going to increase estradiol. I would still consider all of this to be too speculative to use for treatment decisions.

Regarding dosing frequency, here's some more speculation from "James": "I believe the fluctuations we see in low SHBG men that require 3x-7x weekly dosing are due to rapid and highly exaggerated changes in free estradiol due to the above phenomenon as peaks and troughs radically alter free hormone binding and metabolism in the absence of proportionate quantities of SHBG."

To determine the credibility of these ideas I'd like to see them fleshed out with some quantitative details and references.

 

[Systemlord]

Regarding dosing frequency, here's some more speculation from "James": "I believe the fluctuations we see in low SHBG men that require 3x-7x weekly dosing are due to rapid and highly exaggerated changes in free estradiol due to the above phenomenon as peaks and troughs radically alter free hormone binding and metabolism in the absence of proportionate quantities of SHBG."

I was able to see big fluctuations in Free T (25->15 pg/mL per Labcorp ranges) going from a Total T of 550-450 ng/dL. I can only imagine what the difference was in free estrogen.

Whenever my Total T is in the high 600's, my Free T is in the 30 pg/mL range which puts me in the supraphysiological ranges for Free T.

So with me peaking around 1000 on Jatenzo, I'm more than likely seeing a Free T peak in the 40-50 range which is why my hematocrit reached as high as 57%.

 

[JA Battle]

I was able to see big fluctuations in Free T (25->15 pg/mL per Labcorp ranges) going from a Total T of 550-450 ng/dL. I can only imagine what the difference was in free estrogen.

Whenever my Total T is in the high 600's, my Free T is in the 30 pg/mL range which puts me in the supraphysiological ranges for Free T.

How many calories do you eat in a day? Hold old? Height weight?

 

[Systemlord]

How many calories do you eat in a day? Hold old? Height weight?

Now I eat smaller meals, but I'm unsure about my calorie intake, but I know it's low do to my diet.

I have recently lost 7 pounds in 10 days. I'm 49 and weight 215 lbs and I'm 6 ft tall.

 

[murrayhewitt]

Hello all,

I have seen this idea thrown around on trt and steroids forums that low SHBG causes high free E2 and that the use of DHT derivatives like Proviron, Anavar can cause gyno by lowering shbg = > high free Test => more aromatization.

But as per this study SHBG preferentially binds to DHT with affinity 5 times more than Testosterone and 20 times more than Estradiol. So if a person has low SHBG they should have way more free DHT available than free E2 (ratio is 20:1 as per the affinities) which implies that the balance of DHT to E2 is skewed towards DHT and the said user should be feeling low E2 sides even when the blood work shows normal E2 levels.

Is this plausible or am I missing something. Anyone can shed light on this, that would be great.

This has to be what I am dealing with. I have constantly battled with low e2 symptoms my entire TRT journey and have never been able to figure out why when my e2 on labwork is always realtively normal. It is finally making sense why I feel better with lower total T numbers but like super low which has my free T sit towards the top of the range. It's as if the higher I push my T the worse low e2 symptoms I get and I attribute it to high DHT as I have the symptoms of high DHT. I've started berberine to try and adjust my insulin sensitivity in hopes that will raise my SHBG but I dont know how else to attack it. Do I stick with super low T doses (15-20mg EOD) or is there another way to attack this? I've even tried estrogen cream from amazon with not much luck. It's so frustrating as I want to get the benefits of TRT but some days I just feel worse. My SHBG has never been higher than 22 and as low as 12. My thoughts are
1. Add low dose clomid 12.5 mg EOD or E3D for the SHBG raising effects
2. DHT blocker? I know its highly frowned upon but I have taken it in the past for a short period with no lasting effects.
3. Just keeping really low doses like 15mg EOD, which seems like I wont get the full benefit of TRT but I guess better than feeling like crap.

Thanks for any insight or discussion.

 

[Charliebizz]

This has to be what I am dealing with. I have constantly battled with low e2 symptoms my entire TRT journey and have never been able to figure out why when my e2 on labwork is always realtively normal. It is finally making sense why I feel better with lower total T numbers but like super low which has my free T sit towards the top of the range. It's as if the higher I push my T the worse low e2 symptoms I get and I attribute it to high DHT as I have the symptoms of high DHT. I've started berberine to try and adjust my insulin sensitivity in hopes that will raise my SHBG but I dont know how else to attack it. Do I stick with super low T doses (15-20mg EOD) or is there another way to attack this? I've even tried estrogen cream from amazon with not much luck. It's so frustrating as I want to get the benefits of TRT but some days I just feel worse. My SHBG has never been higher than 22 and as low as 12. My thoughts are
1. Add low dose clomid 12.5 mg EOD or E3D for the SHBG raising effects
2. DHT blocker? I know its highly frowned upon but I have taken it in the past for a short period with no lasting effects.
3. Just keeping really low doses like 15mg EOD, which seems like I wont get the full benefit of TRT but I guess better than feeling like crap.

Thanks for any insight or discussion.

Have you ever tried less frequent injections.? I have low shbg and the more I increase the frequency the worse I feel. I’m going to switch to 2x a week and see how that goes for me. 3x a week has been alright. Just tried daily’s for the 3-4th time and just feel bad overall.

 

[GreenMachineX]

Have you ever tried less frequent injections.? I have low shbg and the more I increase the frequency the worse I feel. I’m going to switch to 2x a week and see how that goes for me. 3x a week has been alright. Just tried daily’s for the 3-4th time and just feel bad overall.

How long did you try daily for? I'm in this boat now, but can't go back to EOD because any increase in dose I think will drive anxiety again. Unsure what to do.

 

[Charliebizz]

How long did you try daily for? I'm in this boat now, but can't go back to EOD because any increase in dose I think will drive anxiety again. Unsure what to do.

Probably my 3rd or fourth time trying daily. I’ve done it for like 2 months in the past. Right now I’m on two weeks and same old bullshit happening again. I’ve seen plenty of low shbg guys do ok with less frequent injections. Do daily’s don’t work for everyone

 

[TRicker]

My SHBG has never been higher than 22 and as low as 12.

I have low shbg as well...it usually hovers around 17 on TRT. Have you ever considered that what you think are low E2 symptoms, are actually high E2 symptoms? I battle the same thing, and have heard/read that guys with low shbg can have high E2 symptoms despite the numbers looking good on labs. Higher free testosterone means higher free E2.
Many of the times that I have hit the "sweet spot", it was always while lowering E2 with anastrozole...until it goes too low. I have never hit the sweet spot trying to let E2 climb. I believe estrogen management is much more difficult for low shbg guys.

 

[murrayhewitt]

I have low shbg as well...it usually hovers around 17 on TRT. Have you ever considered that what you think are low E2 symptoms, are actually high E2 symptoms? I battle the same thing, and have heard/read that guys with low shbg can have high E2 symptoms despite the numbers looking good on labs. Higher free testosterone means higher free E2.
Many of the times that I have hit the "sweet spot", it was always while lowering E2 with anastrozole...until it goes too low. I have never hit the sweet spot trying to let E2 climb. I believe estrogen management is much more difficult for low shbg guys.

That has been the conventional wisdom but I'm certain mine are low e2. Constant joint pains, extreme fatigue coupled with the fact that taking cialis which is known to lower e2 makes me feel even worse, like complete garbage for days. Like this study said that the original poster linked with the DHT affinity made perfect sense to me. I've always had high DHT symptoms even on really low doses. I tried anaztrozole years ago and felt horrendous. I mean there is a thought to it but the joint pains and fatigue, dry skin are pretty specific to low e2. I know everyone will say look at the labwork but I feel like that is what we are discussing here is the unknowns of what the correlation between what labwork looks like and what is actually going on due to the low SHBG.

 

[TRicker]

I know everyone will say look at the labwork but I feel like that is what we are discussing here is the unknowns of what the correlation between what labwork looks like and what is actually going on due to the low SHBG.

Very true! With low shbg, it seems like a guessing game, as symptoms don't always match the labs.

As a note, when I started TRT 8 years ago, I was put on 200mg/week in one shot, hcg, and .5mg of anastrozole 2x/week (of course I would sometimes forget to take the AI consistently)...and I felt better than I do now. I guess ignorance was bliss, because I had lower shbg then as well, but just didn't know any better. I may go back to that protocol, after I address my high RT3.

 

[murrayhewitt]

Very true! With low shbg, it seems like a guessing game, as symptoms don't always match the labs.

As a note, when I started TRT 8 years ago, I was put on 200mg/week in one shot, hcg, and .5mg of anastrozole 2x/week (of course I would sometimes forget to take the AI consistently)...and I felt better than I do now. I guess ignorance was bliss, because I had lower shbg then as well, but just didn't know any better. I may go back to that protocol, after I address my high RT3.

I have a similar story with starting on a high dose and remember feeling great as well. It could partly be due to the honeymoon period, but also my thoughts are the high doses allowed my E2 to at least be in such a high range that it would alleviate the symptoms. I did not feel comfortable with such high doses from a health perspective however. Im in my early 30's and just running those kind of T numbers for 40 years did not seem like an intelligent health decision. There is some correlation here to SHBG and I think that SHBG does more than we think as far as just "binding" to the hormones.

 

[GreenMachineX]

Probably my 3rd or fourth time trying daily. I’ve done it for like 2 months in the past. Right now I’m on two weeks and same old bullshit happening again. I’ve seen plenty of low shbg guys do ok with less frequent injections. Do daily’s don’t work for everyone

What symptoms do you have on daily?

 

[Charliebizz]

What symptoms do you have on daily?

I get this strange pressure headache and my mood just takes a big hit. 3x a week wasn’t perfect but I’d have more good days then bad. On daily’s I just feel very flat and blah about everything. I’m going to switch to 2x a week to see if I can improve on how I felt doing 3x a week.

 

[GreenMachineX]

I get this strange pressure headache and my mood just takes a big hit. 3x a week wasn’t perfect but I’d have more good days then bad. On daily’s I just feel very flat and blah about everything. I’m going to switch to 2x a week to see if I can improve on how I felt doing 3x a week.

Do you have issues with hematocrit/hemoglobin with either protocol?

Any issues switching back to eod from daily? I think daily has made me super sensitive to any adjustment in dose.

 

[Charliebizz]

Do you have issues with hematocrit/hemoglobin with either protocol?

Any issues switching back to eod from daily? I think daily has made me super sensitive to any adjustment in dose.

I don’t luckily. All my blood markers are great.and no real issues switching back.