TRT was going great!

[Nomad]

All in all I’ve been in doctor prescribed TRT for over two years now. I’ve been with defy for about a year now, the majority of the last year year has been fantastic since dealing with doctors that really know their shit. I went through a break up this spring and my doctor put me on Zoloft, I took it for two months and stopped because it affected my libido and I couldn’t ejaculate on it without tremendous effort. It’s been a few months now and libido is still lower than I’d like.

I’m on 80mg test c 2x weekly (160mg weekly)
.125 mg Arimidex 2x weekly
.5cc HCG 2x weekly
25mg DHEA daily
10,000 IU vitamin D daily
3mg boron daily

E2: 30.8
SHBG: 56.7
T Total: 960
Free T 21.3

I felt decent on these labs, but haven’t since the Zoloft. Going in for labs next week, appointment following week. Doctor wants me around 30 free T, can I ever get there with such a high SHBG count? What else can I do to try lowering SHBG?

Should I ask the doctor about increasing dose and switching to Aromasin instead of Arimidex?

34 years old.

 

[madman]

All in all I’ve been in doctor prescribed TRT for over two years now. I’ve been with defy for about a year now, the majority of the last year year has been fantastic since dealing with doctors that really know their shit. I went through a break up this spring and my doctor put me on Zoloft, I took it for two months and stopped because it affected my libido and I couldn’t ejaculate on it without tremendous effort. It’s been a few months now and libido is still lower than I’d like.

I’m on 80mg test c 2x weekly (160mg weekly)
.125 mg Arimidex 2x weekly
.5cc HCG 2x weekly
25mg DHEA daily
10,000 IU vitamin D daily
3mg boron daily

E2: 30.8
SHBG: 56.7
T Total: 960
Free T 21.3

I felt decent on these labs, but haven’t since the Zoloft. Going in for labs next week, appointment following week. Doctor wants me around 30 free T, can I ever get there with such a high SHBG count? What else can I do to try lowering SHBG?

Should I ask the doctor about increasing dose and switching to Aromasin instead of Arimidex?

34 years old.

Doctor wants me around 30 free T, can I ever get there with such a high SHBG count? What else can I do to try lowering SHBG?

Unfortunately the testing method you had done for free testosterone the piss poor direct immunoassay is inaccurate.....let alone tends to underestimate FT levels when compared to the gold standard Equilibrium Dialysis.

If you truly want to know where your FT levels sit on such protocol (T dose/injection frequency) than you would need to use the gold standard Equilibrium Dialysis or Ultrafiltration (next best) or simply use the newer calculated TruT method which has been shown to be on par with results obtained by the gold standard Equilibrium Dialysis.

It is available online to the general public for free....TruT Free Testosterone Calculator by FPT
Using the newer calculated TruT method.....if we take your TT 960 ng/dL, SHBG 56.7 nmol/L, Albumin 4.3 g/dL (mean) than your FT is 31.33 ng/dL (top of the reference range of 16-31 ng/dL)..

Your FT levels are already in the 30 ng/dL range and do understand that is at trough and seeing as you are injecting twice weekly (every 3.5 days) than your peak will be much higher.

As you can see even with having a higher SHBG of 56.7 nmol/L having a TT close to 1000 ng/dL puts your FT at the top end of the reference range and that is at trough.

Most still need to understand that due to the newer research/understanding of SHBG:T binding that even in cases of men with higher SHBG extremely high TT levels are not needed in order to achieve a healthy FT level.

Again your FT levels are much higher than you think!




*highlighted in blue- refer to the new Multi-step Dynamic Binding Model with Complex Allostery (TruT calculated)

* highlighted in green- refer to the linear law-of-mass-action model/equation Vermueulen (cFTV)


[0387] Relation between Percent FT with Total Testosterone and SHBG. Intra-dimer complex allostery suggests that SHBG can regulate FT fraction over a wide range of total testosterone concentrations without getting saturated. Indeed, it was found that percent FT calculated using the new model changed very modestly over a wide range of total testosterone concentrations. In contrast, the Vermeulen's equation suggests a negative relation between percent FT and total testosterone. Furthermore, as SHBG concentrations increase, percent FT calculated using our new model shows only a modest decline in contrast to the marked decline in percent FT calculated using Vermeulen's equation.

 

[Nomad]

Doctor wants me around 30 free T, can I ever get there with such a high SHBG count? What else can I do to try lowering SHBG?

Unfortunately the testing method you had done for free testosterone the piss poor direct immunoassay is inaccurate.....let alone tends to underestimate FT levels when compared to the gold standard Equilibrium Dialysis.

If you truly want to know where your FT levels sit on such protocol (T dose/injection frequency) than you would need to use the gold standard Equilibrium Dialysis or Ultrafiltration (next best) or simply use the newer calculated TruT method which has been shown to be on par with results obtained by the gold standard Equilibrium Dialysis.

It is available online to the general public for free....TruT Free Testosterone Calculator by FPT
Using the newer calculated TruT method.....if we take your TT 960 ng/dL, SHBG 56.7 nmol/L, Albumin 4.3 g/dL (mean) than your FT is 31.33 ng/dL (top of the reference range of 16-31 ng/dL)..View attachment 8202


Your FT levels are already in the 30 ng/dL range and do understand that is at trough and seeing as you are injecting twice weekly (every 3.5 days) than your peak will be much higher.

As you can see even with having a higher SHBG of 56.7 nmol/L having a TT close to 1000 ng/dL puts your FT at the top end of the reference range and that is at trough.

Most still need to understand that due to the newer research/understanding of SHBG:T binding that even in cases of men with higher SHBG extremely high TT levels are not needed in order to achieve a healthy FT level.

Again your FT levels are much higher than you think!




*highlighted in blue- refer to the new Multi-step Dynamic Binding Model with Complex Allostery (TruT calculated)

* highlighted in green- refer to the linear law-of-mass-action model/equation Vermueulen (cFTV)


[0387] Relation between Percent FT with Total Testosterone and SHBG. Intra-dimer complex allostery suggests that SHBG can regulate FT fraction over a wide range of total testosterone concentrations without getting saturated. Indeed, it was found that percent FT calculated using the new model changed very modestly over a wide range of total testosterone concentrations. In contrast, the Vermeulen's equation suggests a negative relation between percent FT and total testosterone. Furthermore, as SHBG concentrations increase, percent FT calculated using our new model shows only a modest decline in contrast to the marked decline in percent FT calculated using Vermeulen's equation.

That’s very informative, thank you! Do you know if the doctors at Defy know about this? My last appointment was in March.

 

[Systemlord]

TRT or excess androgens is how you deal with high SHBG, but there aren't many other effective means of lowering it to a significant degree.

 

[Nomad]

Do I actually need HCG if I’m not worried about nuts shrinking, or fertility? I have a vasectomy.

 

[Gman86]

Do I actually need HCG if I’m not worried about nuts shrinking, or fertility? I have a vasectomy.

No. HCG definitely isn’t necessary for most men. There’s tons of guys that feel great without it. Was just listening to a great video last night and they actually discussed HCG quite a bit and how it’s not necessary, but for some, they feel better with it. The guys that feel better with it seem to be in the minority though.

 

[SilverSurfer]

I think you’re looking in the wrong place. It’s not your TRT. It’s not your hormones. It’s not an after effect of Zoloft. It’s you, yourself. You just suffered an emotional trauma a few short months ago. A big portion of libido is in the brain vs biology. You are a person, not a machine. You haven’t had time to grieve and heal emotionally yet, and that’s ok. I’m sure your libido is fine and will bounce back once you’ve moved on or found a new relationship.

 

[Miironleg]

It's the arimadex, stop that and you'll be fine