T still low, E crashed - follow up labs

[CoastWatcher]

I'm not sure it's crucial, though. Knowing your total T, free T, and your hematocrit would be crucial while on TRT. Knowing SHBG doesn't seem to be crucial. And it's not an inexpensive test.

If SHBG is low, particularly if it is dramatically low, you and your doctor will need to consider how many injections a week, and how much testosterone you need to inject, are necessary to reach success. SHBG indirectly impacts your estradiol. Not by direct action, but in terms of how quickly you are clearing/injecting testosterone and thus spiking E2. It's a vital measure to reference.

 

[Vince Carter]

I'm not sure it's crucial, though. Knowing your total T, free T, and your hematocrit would be crucial while on TRT. Knowing SHBG doesn't seem to be crucial. And it's not an inexpensive test.

It absolutely is. Pay for it or don't, it's been explained, now CoastWatcher mopped up on the topic.

 

[TMI]

It absolutely is. Pay for it or don't, it's been explained, now CoastWatcher mopped up on the topic.

At what SHBG level should TRT be administered daily? Please be specific if possible. Thank you.

 

[TMI]

If SHBG is low, particularly if it is dramatically low, you and your doctor will need to consider how many injections a week, and how much testosterone you need to inject, are necessary to reach success. SHBG indirectly impacts your estradiol. Not by direct action, but in terms of how quickly you are clearing/injecting testosterone and thus spiking E2. It's a vital measure to reference.

If SHBG is 17 (range 19 - 76) for a 50 year old hypogonadal male, should TRT be administered every 3.5 days, every other day, or every day? What if it is 20? Or 7? Do we know enough to select the appropriate TRT frequency of injection based on SHBG alone? Or will we have to still look at serum T, free T, and estradiol anyway? In other words, is SHBG really "crucial" or "vital" or just nice to have?

 

[TMI]

And I don't mean to be argumentative or disrespectful in any way with my line of questioning. But my doc never ordered SHBG, and I trust his judgment.

 

[Vince]

And I don't mean to be argumentative or disrespectful in any way with my line of questioning. But my doc never ordered SHBG, and I trust his judgment.

I've never had my SHBG tested either and I'm feeling really good.

 

[CoastWatcher]

And I don't mean to be argumentative or disrespectful in any way with my line of questioning. But my doc never ordered SHBG, and I trust his judgment.

If you trust his judgment why pose the question? If you're happy with your protocol then we are pleased for you and wish you the best. The vast majority of doctors who understand TRT use SHBG as a reliable measure in determining frequency and dosage. I happened to see my doctor this afternoon and posed the very question you raised - is SHBG crucial, vital or nice to have? She looked at me oddly and said it was "essential" - and then reminded me of the discussion I had with her over a year ago when I moved to daily injections. It was my (then) low SHBG that sealed the deal. Had it been on the high end I might have been a candidate for an AI.

I think ink we are all on the record and there's little more that can be added to the discussion.

 

[TMI]

If you trust his judgment why pose the question? If you're happy with your protocol then we are pleased for you and wish you the best. The vast majority of doctors who understand TRT use SHBG as a reliable measure in determining frequency and dosage. I happened to see my doctor this afternoon and posed the very question you raised - is SHBG crucial, vital or nice to have? She looked at me oddly and said it was "essential" - and then reminded me of the discussion I had with her over a year ago when I moved to daily injections. It was my (then) low SHBG that sealed the deal. Had it been on the high end I might have been a candidate for an AI.

I think ink we are all on the record and there's little more that can be added to the discussion.

Not so fast, CoastWatcher.

I trust my doc's judgment, but I question *your* judgment. We've gone from SHBG being "crucial" to "vital" to now being "essential".

I gave specifics regarding SHBG levels and asked how often one should inject based on those levels. You did not answer that question.

And your doctor looking at you oddly is not an answer to my question, either. In fact, you did not ask her my question at all (which involved specific numbers).

The fact of the matter is that SHBG cannot and will not ever direct the dosage and frequency of TRT.

 

[CoastWatcher]

I strongly disagree with your conclusions, but wish you success.

 

[Vince Carter]

I've never had my SHBG tested either and I'm feeling really good.

You're a patient of Dr Saya, you've had your SHBG tested, Vince, you're being very misleading on this subject that you apparently know little about inspite of your time here and questionable "moderator" label.

 

[Vince Carter]

Not so fast, CoastWatcher.

I trust my doc's judgment, but I question *your* judgment. We've gone from SHBG being "crucial" to "vital" to now being "essential".

I gave specifics regarding SHBG levels and asked how often one should inject based on those levels. You did not answer that question.

And your doctor looking at you oddly is not an answer to my question, either. In fact, you did not ask her my question at all (which involved specific numbers).

The fact of the matter is that SHBG cannot and will not ever direct the dosage and frequency of TRT.

Trolls gonna Troll.

 

[CoastWatcher]

As I noted, everyone has had an opportunity to express their views. The thread is closed.