Paradox TRT results, very low SHBG

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A few points to consider:

Your T is fake. No offense, but looks legit and seems reputable doesn’t make it so. It’s a risk with UGL and you lost this time. Even with low SHBG, 3x weekly would be enough to see a serum T increase.

Your PRL is a bit high.

Your SHBG was low before TRT. Very, very good indicator that you have insulin resistance. There really isn’t a better indicator. You aren’t going to be able to raise it (SHBG) being as low as it is without fixing that first. Check your fasting insulin)different from glucose). It is probably high. You don’t have to be overweight or have high glucose or A1c.
 
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@Jason Sypolt I agree about the fake T. I already bought pharma grade Sustanon from the pharmacy. This is my best bet for the moment.

Good point about the insulin resistance. I ran some tests in the beginning of February and levels were a touch high:

HbA1c 5.8% (4.8 - 5.9)
Blood Sugar Level 5.5 mmol/L (3.5 - 6.1)

Although my diet wasn't all that bad at this point, I started being even more strict with it and cut the sugar out as much as possible. Also I was prescribed 500mg Metformin a day by my endocrinologist. After a month a ran more tests:

HbA1c 5.0% (4.8 - 5.9)
Blood Sugar Level 3.9 mmol/L (3.5 - 6.1)
Insulin 8.3 uU/mL (3.0 - 25.0)

Also my cholesterol levels are quite good. I continue to watch my diet and continue taking 850 mg Metformin a day, so hopefully I won't have any more problems with insulin resistance (even if I had such). I also take a bunch of vitamins, minerals, fish oil and others - did a good research on that. Weight wise I am 91 kg / 182 cm (200 lbs / 6 feet). I am not very cleen, perhaps 20 something % body fat but I am quite muscular. Normally I am doing MMA and the workouts are long and super exhausting. I've always struggled to lose weight in the recent years, perhaps because of my hypogonadism. I normally eat about 2200 kcal which is really not that much considering my weight and intensity of training.
 
After essentially being on a light HCG mono-therapy for 4 weeks, I bought some Sustanon from the pharmacy and gave it a go. I've been doing 150 mg a week, divided Mon Wed Fri, for 4 weeks already. I noticed my skin got a bit oilier and a little bit of water retention (I gained about 1.5 KG / 3 lbs). Regarding positive effects, I think my mood is slightly better now and my libido is a bit better. I still have no morning wood though. I guess it might take some more time to get better results. Here is a summary of my bloodwork so far:

INITIAL READINGS
Total T: 216 ng/dL (250 - 870)
Free T (lab calculated): 6.4 ng/dL (9 - 30) 2.96%
Estradiol: 22 pg/mL (11 - 44) No idea what type of test they use for E2
LH: 2.9 mIU/mL (0.57 - 12.1)
FSH: 3.1 mIU/mL (0.95 - 12)
SHBG: 12.8 nmol/L (13.5 - 71.4)
Prolactin: 19.7 ng/mL (3.5 - 20)

AFTER 4W OF HCG - 1200 IU PER WEEK (MON WED FRI)
Total T: 245 ng/dL (250 - 870)
Free T (lab calculated): 7.3 ng/dL (9 - 30) 2.97%
Estradiol: 30 pg/mL (11 - 44) No idea what type of test they use for E2
LH: 0.6 mIU/mL (0.57 - 12.1)
FSH: 1.2 mIU/mL (0.95 - 12)
SHBG: 12.4 nmol/L (13.5 - 71.4)
Prolactin: 21.6 ng/mL (3.5 - 20)

AFTER ANOTHER 4W OF SUSTANON 150 mg/week + HCG 900 IU/week
Total T: 745 ng/dL (250 - 870)
Free T (lab calculated): 25.6 ng/dL (9 - 30) 3.44%
Estradiol: 62 pg/mL (11 - 44) No idea what type of test they use for E2
LH: 0.05 mIU/mL (0.57 - 12.1)
FSH: 0.05 mIU/mL (0.95 - 12)
SHBG: 10.1 nmol/L (13.5 - 71.4)
Prolactin: 30.6 ng/mL (3.5 - 20)

Total / Free T are about where I expected them to be at 150 mg/week. I choose this as a good average starting point, from what I've seen here. Apart from feeling better and symptom resolution, I would like to get as much physical/recovery benefits from TRT as possible, since I am training seriously and intensively and muscle/joint recovery due to low T has been a big problem for me for years now. For this reason I would like to get my levels to around 1000 - 1200 ng/dL. That would hopefully give me the recovery benefits and won't result in too much negative side effects, since it's still within the normal physiological range, or slightly above it. Obviously I will be monitoring all health factors closely, not to do any harm and will drop the dose once things start getting out of whack. I am planning to increase my dose to 200 mg/week now, to try to boost the levels a bit more.

I am not quite happy that E2 sits at 62, while Total T is just 745. That gives T/E2 ratio of 12. If I want to increase my T to 1000-1200, E2 will probably also rise to some degree and that might come with its downsides. Even now with 62, I am not quite sure if it affects my libido in a negative way to a degree. I am not a big fan of AI in general and I'm trying to avoid taking such if possible.

Also I am not sure why my Prolactin jumped from 20 to 30 ng/mL after started taking testosterone. I've measured it multiple times the months before starting TRT and it was always around 16 - 20. I did a lot of reading on the topic, but still couldn't figure it out. I know that it shouldn't be tumour related, since the level is too low for that. But also I'm not sure if it is an actual problem - the level is not that much above the recommended range, in absolute units. I've never had problems with ED and I don't have such now. I don't know if it could be suppressing my libido though.

SHBG is still super low and even dropped down 2 units more since starting testosterone. There doesn't seem to be any reliable way to boost it significantly though, from what I've read. I've been taking 850 mg Metformin a day for a few months now, to increase my insulin sensitivity. I've also been taking 400 mg Berberine a day for a month now. None of this helps to rise my SHBG at all though. I've heard that low carb / Keto diet might help, but I really hate the idea for multiple reasons.

So, as I said, from next week I will be increasing the dose to 200 mg/week. I am also planning to add 200 mg/week of Nandrolone Decanoate for its joint healing properties and some additional performance benefits. I know Nandrolone doesn't aromatize as much as testosterone, so I hope it will not additionally elevate my E2 that much, considering it's already on the high side.

What do you guys think? @Vince @Nelson Vergel @Cataceous @madman @Systemlord @Jason Sypolt
 
After essentially being on a light HCG mono-therapy for 4 weeks, I bought some Sustanon from the pharmacy and gave it a go. I've been doing 150 mg a week, divided Mon Wed Fri, for 4 weeks already. I noticed my skin got a bit oilier and a little bit of water retention (I gained about 1.5 KG / 3 lbs). Regarding positive effects, I think my mood is slightly better now and my libido is a bit better. I still have no morning wood though. I guess it might take some more time to get better results. Here is a summary of my bloodwork so far:

INITIAL READINGS
Total T: 216 ng/dL (250 - 870)
Free T (lab calculated): 6.4 ng/dL (9 - 30) 2.96%
Estradiol: 22 pg/mL (11 - 44) No idea what type of test they use for E2
LH: 2.9 mIU/mL (0.57 - 12.1)
FSH: 3.1 mIU/mL (0.95 - 12)
SHBG: 12.8 nmol/L (13.5 - 71.4)
Prolactin: 19.7 ng/mL (3.5 - 20)

AFTER 4W OF HCG - 1200 IU PER WEEK (MON WED FRI)
Total T: 245 ng/dL (250 - 870)
Free T (lab calculated): 7.3 ng/dL (9 - 30) 2.97%
Estradiol: 30 pg/mL (11 - 44) No idea what type of test they use for E2
LH: 0.6 mIU/mL (0.57 - 12.1)
FSH: 1.2 mIU/mL (0.95 - 12)
SHBG: 12.4 nmol/L (13.5 - 71.4)
Prolactin: 21.6 ng/mL (3.5 - 20)

AFTER ANOTHER 4W OF SUSTANON 150 mg/week + HCG 900 IU/week
Total T: 745 ng/dL (250 - 870)
Free T (lab calculated): 25.6 ng/dL (9 - 30) 3.44%
Estradiol: 62 pg/mL (11 - 44) No idea what type of test they use for E2
LH: 0.05 mIU/mL (0.57 - 12.1)
FSH: 0.05 mIU/mL (0.95 - 12)
SHBG: 10.1 nmol/L (13.5 - 71.4)
Prolactin: 30.6 ng/mL (3.5 - 20)

Total / Free T are about where I expected them to be at 150 mg/week. I choose this as a good average starting point, from what I've seen here. Apart from feeling better and symptom resolution, I would like to get as much physical/recovery benefits from TRT as possible, since I am training seriously and intensively and muscle/joint recovery due to low T has been a big problem for me for years now. For this reason I would like to get my levels to around 1000 - 1200 ng/dL. That would hopefully give me the recovery benefits and won't result in too much negative side effects, since it's still within the normal physiological range, or slightly above it. Obviously I will be monitoring all health factors closely, not to do any harm and will drop the dose once things start getting out of whack. I am planning to increase my dose to 200 mg/week now, to try to boost the levels a bit more.

I am not quite happy that E2 sits at 62, while Total T is just 745. That gives T/E2 ratio of 12. If I want to increase my T to 1000-1200, E2 will probably also rise to some degree and that might come with its downsides. Even now with 62, I am not quite sure if it affects my libido in a negative way to a degree. I am not a big fan of AI in general and I'm trying to avoid taking such if possible.

Also I am not sure why my Prolactin jumped from 20 to 30 ng/mL after started taking testosterone. I've measured it multiple times the months before starting TRT and it was always around 16 - 20. I did a lot of reading on the topic, but still couldn't figure it out. I know that it shouldn't be tumour related, since the level is too low for that. But also I'm not sure if it is an actual problem - the level is not that much above the recommended range, in absolute units. I've never had problems with ED and I don't have such now. I don't know if it could be suppressing my libido though.

SHBG is still super low and even dropped down 2 units more since starting testosterone. There doesn't seem to be any reliable way to boost it significantly though, from what I've read. I've been taking 850 mg Metformin a day for a few months now, to increase my insulin sensitivity. I've also been taking 400 mg Berberine a day for a month now. None of this helps to rise my SHBG at all though. I've heard that low carb / Keto diet might help, but I really hate the idea for multiple reasons.

So, as I said, from next week I will be increasing the dose to 200 mg/week. I am also planning to add 200 mg/week of Nandrolone Decanoate for its joint healing properties and some additional performance benefits. I know Nandrolone doesn't aromatize as much as testosterone, so I hope it will not additionally elevate my E2 that much, considering it's already on the high side.

What do you guys think? @Vince @Nelson Vergel @Cataceous @madman @Systemlord @Jason Sypolt
The half-life of sustanon is between 15-18 days, you need 5 half life cycles to get serum saturation, testing would be at a minimum after 75 days or 10-11 weeks.
 
Your dose of Metformin is too low. I would use 1500 mg daily. Metformin ER (slow-release)

 
Your dose of Metformin is too low. I would use 1500 mg daily. Metformin ER (slow-release)

Has anyone seen any benefits of adding metformin to their medication list? I am prediabetic. It runs in our family. Wondering if it helps to stay active and fit?
 
Has anyone seen any benefits of adding metformin to their medication list? I am prediabetic. It runs in our family. Wondering if it helps to stay active and fit?
I'm insulin resistance. Even though my a1c, fasting glucose and pancreas numbers all look good. I still use metformin.
 
@Vince Sustanon is a mix of 4 esters as you know, I'm sure. Here is a list of their half-lifes:

Propionate 2d (30 mg/ml)
Phenylpropionate 2.5d (60 mg/ml)
Isocaproate 4.5 (60 mg/ml)
Decanoate 7d (100 mg/ml)

I couldn't find many sources about the half-life of Testosterone Decanoate, but even if it's longer than 7 days it won't be much longer I guess. I used the following calculator to estimate the blood saturation of Sustanon, while admitted 3 times a week as in my case:


I've attached a screenshot. You can see that it takes about 5 weeks to achieve relative saturation (~95% of the final level). However, to achieve saturation faster, during the first week I injected 200 mg instead of 150 mg. That brings the levels up quite a bit quicker. That is demonstrated on my second screenshot. The saturation in this case is reached in only 2 weeks. Even if those estimations are not quite right and we take some uncertainty into account, I am pretty sure that I will get fairly close to saturation with this method in 4 weeks time.

Regarding insulin sensitivity, my blood levels (fasting blood sugar, HbA1c) got a lot better once I started a proper diet + Metformin a few months ago. However, as I said that didn't help with SHBG at all, it even got lower. I am a bit sceptical that 1500 mg a day instead of 850 mg will change things much to be honest. Also I am a bit cautious not to start experiencing some side effects on such a dose.

@AdamYoung I've read quite a bit about Metformin from many good sources and all people say that it's really good for insulin sensitivity and general health and longevity. Especially in your case it might really help you. I was pre-diabetic myself a few months ago and I have a family history of type 2 diabetes. Now my blood levels are perfect.
 

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Looks like I was wrong.
Sustanon 250 half-life – It has different half-life since it is made up of four different esterified Testosterone compound. Its half-life falls in different categories. After injecting Sustanon 250, it usually has a half-life of 4 days. The level may fall into the quarter by the 10th, and the level goes down to one-eighth by the sixteenth day, and then it shoots down to one-sixteenth by the 23rd day.


How do different esterified compounds help in making Testosterone so beneficial?
Since sustanon-250 is composed of four different esterified testosterone compound having different half-lives, it makes it easy for the drug to be more stable in the system. It gives sustanon-250 enough time to impact the body and showcase its results. At the same time, because of the stability, there is no need to inject sustanon-250 multiple times.
These esterified compounds undergo hydrolysis as soon as it is injected in the body. Since some of them have a longer half-life, they start performing, as soon as the shorter half-life hormone shoots down.

The half-life of different Sustanon Compounds
Testosterone Propionate
– It has the shortest half-life of 2-3 days. It starts showing its effect within 24 hours of injection.
Testosterone phenylpropionate – It is also known as propionic acid phenyl ester. This has a longer half-life as compared to Testosterone propionate and isocaproate. It has a half-life of 4-5 days and thus is longer lasting and more impactful.
Testosterone isocaproate – Also known as isohexane,4-methylvaleric acid, and isocaproic acid. The half-life if this compound is 7-9 days. If it is used as a single testosterone supplement, then you need t to inject it after every week. This compound is also found in Aratest and Omnadren.
Testosterone decanoate – The fourth compound of Sustanon 250 has the longest half-life and is thus the most powerful one. Its half-life extends for more than two weeks. It may also have an active life of a month thus you may need to inject it after a month. But, this only happens in the case of hormone replacement therapy.
Because of the variegated half-life of different esters in Sustatone 250, the compound continues to prove lasting effects since there is a sustained supply of testosterone in the bloodstream.

Leave your questions. Professional bodybuilders are ready to reply!

Mark - Reply

How to inject sustanon 250?


Paul Morris INBF/WNBF member:

Sustanon 250 injection, also known as the depot injection, is injected into a deep muscle, such as buttock, upper arm or thigh. At the injection site, it accumulates testosterone hormone that is released into the individual’s bloodstream gradually. Ideally, a person is given one injection once in a period of 3 weeks for maximum results. However, the dosage may vary from one individual to the other.


Ben - Reply

How often to take sustanon 250?


Paul Morris INBF/WNBF member:

Sustanon 250 can be taken as per the dosage limit and if t you are new just go with the one injection of 1 ml two weeks to one injection of one ml of all four weeks. On following this dosage limit as safe, then you can simply get out from the major side effect to the body during the usage f the sustanon.


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@Vince Sustanon is a mix of 4 esters as you know, I'm sure. Here is a list of their half-lifes:

Propionate 2d (30 mg/ml)
Phenylpropionate 2.5d (60 mg/ml)
Isocaproate 4.5 (60 mg/ml)
Decanoate 7d (100 mg/ml)

I couldn't find many sources about the half-life of Testosterone Decanoate, but even if it's longer than 7 days it won't be much longer I guess. I used the following calculator to estimate the blood saturation of Sustanon, while admitted 3 times a week as in my case:


I've attached a screenshot. You can see that it takes about 5 weeks to achieve relative saturation (~95% of the final level). However, to achieve saturation faster, during the first week I injected 200 mg instead of 150 mg. That brings the levels up quite a bit quicker. That is demonstrated on my second screenshot. The saturation in this case is reached in only 2 weeks. Even if those estimations are not quite right and we take some uncertainty into account, I am pretty sure that I will get fairly close to saturation with this method in 4 weeks time.

Regarding insulin sensitivity, my blood levels (fasting blood sugar, HbA1c) got a lot better once I started a proper diet + Metformin a few months ago. However, as I said that didn't help with SHBG at all, it even got lower. I am a bit sceptical that 1500 mg a day instead of 850 mg will change things much to be honest. Also I am a bit cautious not to start experiencing some side effects on such a dose.

@AdamYoung I've read quite a bit about Metformin from many good sources and all people say that it's really good for insulin sensitivity and general health and longevity. Especially in your case it might really help you. I was pre-diabetic myself a few months ago and I have a family history of type 2 diabetes. Now my blood levels are perfect.
 
After essentially being on a light HCG mono-therapy for 4 weeks, I bought some Sustanon from the pharmacy and gave it a go. I've been doing 150 mg a week, divided Mon Wed Fri, for 4 weeks already. I noticed my skin got a bit oilier and a little bit of water retention (I gained about 1.5 KG / 3 lbs). Regarding positive effects, I think my mood is slightly better now and my libido is a bit better. I still have no morning wood though. I guess it might take some more time to get better results. Here is a summary of my bloodwork so far:

INITIAL READINGS
Total T: 216 ng/dL (250 - 870)
Free T (lab calculated): 6.4 ng/dL (9 - 30) 2.96%
Estradiol: 22 pg/mL (11 - 44) No idea what type of test they use for E2
LH: 2.9 mIU/mL (0.57 - 12.1)
FSH: 3.1 mIU/mL (0.95 - 12)
SHBG: 12.8 nmol/L (13.5 - 71.4)
Prolactin: 19.7 ng/mL (3.5 - 20)

AFTER 4W OF HCG - 1200 IU PER WEEK (MON WED FRI)
Total T: 245 ng/dL (250 - 870)
Free T (lab calculated): 7.3 ng/dL (9 - 30) 2.97%
Estradiol: 30 pg/mL (11 - 44) No idea what type of test they use for E2
LH: 0.6 mIU/mL (0.57 - 12.1)
FSH: 1.2 mIU/mL (0.95 - 12)
SHBG: 12.4 nmol/L (13.5 - 71.4)
Prolactin: 21.6 ng/mL (3.5 - 20)

AFTER ANOTHER 4W OF SUSTANON 150 mg/week + HCG 900 IU/week
Total T: 745 ng/dL (250 - 870)
Free T (lab calculated): 25.6 ng/dL (9 - 30) 3.44%
Estradiol: 62 pg/mL (11 - 44) No idea what type of test they use for E2
LH: 0.05 mIU/mL (0.57 - 12.1)
FSH: 0.05 mIU/mL (0.95 - 12)
SHBG: 10.1 nmol/L (13.5 - 71.4)
Prolactin: 30.6 ng/mL (3.5 - 20)

Total / Free T are about where I expected them to be at 150 mg/week. I choose this as a good average starting point, from what I've seen here. Apart from feeling better and symptom resolution, I would like to get as much physical/recovery benefits from TRT as possible, since I am training seriously and intensively and muscle/joint recovery due to low T has been a big problem for me for years now. For this reason I would like to get my levels to around 1000 - 1200 ng/dL. That would hopefully give me the recovery benefits and won't result in too much negative side effects, since it's still within the normal physiological range, or slightly above it. Obviously I will be monitoring all health factors closely, not to do any harm and will drop the dose once things start getting out of whack. I am planning to increase my dose to 200 mg/week now, to try to boost the levels a bit more.

I am not quite happy that E2 sits at 62, while Total T is just 745. That gives T/E2 ratio of 12. If I want to increase my T to 1000-1200, E2 will probably also rise to some degree and that might come with its downsides. Even now with 62, I am not quite sure if it affects my libido in a negative way to a degree. I am not a big fan of AI in general and I'm trying to avoid taking such if possible.

Also I am not sure why my Prolactin jumped from 20 to 30 ng/mL after started taking testosterone. I've measured it multiple times the months before starting TRT and it was always around 16 - 20. I did a lot of reading on the topic, but still couldn't figure it out. I know that it shouldn't be tumour related, since the level is too low for that. But also I'm not sure if it is an actual problem - the level is not that much above the recommended range, in absolute units. I've never had problems with ED and I don't have such now. I don't know if it could be suppressing my libido though.

O SHBG ainda está super baixo e até caiu 2 unidades a mais desde o início da testosterona. Não parece haver nenhuma maneira confiável de aumentá-lo significativamente, pelo que li. Estou tomando 850 mg de metformina por dia há alguns meses, para aumentar minha sensibilidade à insulina. Também tomo 400 mg de berberina por dia há um mês. Nada disso ajuda a aumentar meu SHBG. Ouvi dizer que a dieta baixa em carboidratos / Ceto pode ajudar, mas realmente odeio a ideia por vários motivos.

Então, como eu disse, a partir da semana que vem vou aumentar a dose para 200 mg/semana. Também estou planejando adicionar 200 mg/semana de Decanoato de Nandrolona por suas propriedades de cura das articulações e alguns benefícios adicionais de desempenho. Eu sei que a nandrolona não aromatiza tanto quanto a testosterona, então espero que não aumente tanto meu E2, considerando que já está no lado alto.

O que é que vocês acham? @Vince @Nelson Vergel @Cataceous @madman @Systemlord @Jason Sypolt
did you manage to increase the shbg?
 
All androgens decrease SHBG. There is no way around it and it’s actually a good thing since your free T goes up. I would not worry about it. Your prolactin is high though.
 
Beyond Testosterone Book by Nelson Vergel
it’s actually a good thing since your free T goes up.

Seems this has been posted to death on here thanks to @Cataceous 's heroic efforts.

How would decreasing SHBG increase or "free" up more T after the initial transient and the patient reaches new stable operating point?

See here for exhaustive posts I shared with you.




Are you invoking a hypothesis that involves SHBG providing feedback to the HPTA control loop? Simply stating SHBG frees up more T appears handwaving once you understand..


TT = f(FT,SHBG,HSA)

not

FT = f(TT,SHBG,HSA) like the calculator paradigm tht is a result of evolution of measurement methods over time.

Testes produce FT not TT. Substrate for aromatization is FT not TT. Body eliminates FT not TT.

Hence reducing SHBG would have to increase the signal to produce more FT in order to free up more absolute T. For a given FT production rate, it is correct to state that lowering SHBG would result in a higher percentage of FT (FT/TT). That is very different picture than more absolute FT. See exhaustive commentary and posts linked above.

At some point we need to have one thread to cover pro/con on this debate so we can put this to bed to help guys and avoid confusing the crap out of most laypeople. Otherwise the same myths keep getting repeated over and over again. I posted my experiment using oxandrolone. Oxandrolone dropped SHBG but reducing SHBG did not increase absolute FT. It stayed constant. TT dropped as expected. Hence, FT/TT increased (relative fraction of FT went up).
 
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