High FREE T with Low. My TRT is not working and I need help !

[Atlaz]

*High FREE T with Low SHBG



Hey all,

here is my bloodwork to start.


BASELINE ( April 2015 ) :


Total Testosterone : 6.3 ( 6.1-27.1) nmol/L

Free T : 196 ( 110-660) pmol/L

Bio-available T : 4.4 ( 2.8-15.5) nmol/L

SHBG: 11 ( 13-84) nmol/L Low

Estradiol : 78 (40-160) pmol/L = 21 pg/ml



LH: 2 ( 1.0-9.0) IU/L

FSH: 2.1 ( 1.0-19.0) IU/L

Free T3: 5.4 (3.3-6.0) pmol/L

T4: 11.9 ( 9.0-19.1) pmol/L


----------------------------------------------

January 2016


Total Testosterone : 26.2 ( 6.1-27.1) nmol/L

Free T : 790 ( 110-660) pmol/L High

Estradiol : 112 (40-160) pmol/L = 30 pg/ml

-------------------------------

February 2016



Total Testosterone : 22.3 ( 6.1-27.1) nmol/L

Free T : 750 ( 110-660) pmol/L HIGH

Bio-available T : 17 ( 2.8-15.5) nmol/L

SHBG: 12 ( 13-84) nmol/L Still low as fuk

Estradiol : 116 (40-160) pmol/L = 31pg/lm



LH: 0.2 ( 1 -9.0) IU/L Low

FSH: 0.2 ( 1.0-19.0) IU/L Low

Free T3: 6 (3.3-6.0) pmol/L

T4: 13.9 ( 9.0-19.1) pmol/L

------------------------------------------------------------------------


Ok so according to my last bloods the obvious is that:

- Free T is high
- SHBG is Low
- E2 has not move. ( 30-31 pg/ml)


Current protocol:

- 60mg cypionate twice a week. (Total 120mg/week)
- 250iu HCG. (Total 500iu/week)
- No AI.
( DIM EOD)

Before getting on TRT I wish I had done more research on low SHBG. From what I read online, guys with low SHBG do not feel good any different on TRT or have a harder time getting dialed in. Please I need you guys to help me out here. So far TRT has given me more muscle (legs,arms) and a little more libido and thats it.


According to the internet these changes can potentially be helpful for a High Free T / low SHBG guy :


- Switch to multiple injections and smaller doses per week ( daily or 3-4x per week)

- SubQ

- Switch from Cypionate to Proponiate

- Get my E2 closer to 20pg/ml

- Fix thyroid Issue IF I have one.

- Insulin Issue

- Possible liver issue



================================


I also found this info:

SHBG is reduced by: high insulin (insulin resistance/diabetes), low thyroid, high testosterone, high DHEA, high growth hormone, low estrogens, low progesterone, high dihydrotestosterone

The hormone with the strongest effect on SHBG is insulin.

Low SHBG is most often strongly correlated with diabetes or insulin resistance.

 

[Megatron28]

So your blood work looks good and you have described positive effects from TRT. What is it that has you disappointed? Are there certain symptoms that have carried over from pre-TRT that you were hoping TRT would alleviate?

 

[Atlaz]

So your blood work looks good and you have described positive effects from TRT. What is it that has you disappointed? Are there certain symptoms that have carried over from pre-TRT that you were hoping TRT would alleviate?

Well at this point I was hoping to have motivation and drive. I got into TRT for the mood benefits. Its plaster all over the internet about the High free T and Low SHBG delimma. Im definitely not making this up.

 

[halfwit]

Well at this point I was hoping to have motivation and drive. I got into TRT for the mood benefits. Its plaster all over the internet about the High free T and Low SHBG delimma. Im definitely not making this up.

Nobody said you were making things up, but your thyroid looks great, your test and free test look great, and SHBG is going to be lower (I agree it was already low) on TRT. You have to understand that TRT takes time to bring everything back - two months cannot reverse what may have taken years to diminish.

I would look at actually dropping the DIM, as a slightly higher circulating estradiol may be beneficial in your case. DIM doesn't reduce estradiol from a generation standpoint, but it does help you excrete it faster.

Other than that, just let the hormones do their thing. It took me about a year on TRT to fully appreciate all the benefits. For the record, most guys with crazy low SHBG have values much lower than yours, but it's honestly so rare (I know of two guys in that boat) that I don't have a huge pool of samples to draw from.

My .02c

 

[Megatron28]

Well at this point I was hoping to have motivation and drive. I got into TRT for the mood benefits. Its plaster all over the internet about the High free T and Low SHBG delimma. Im definitely not making this up.

I agree with Halfwit!!!

Also I would like to add that motivation and drive aren't necessarily tied to Testosterone levels. They are intrinsic. If you said you felt exhausted all the time and couldn't recover after exercising/playing sports and had zero libido because you would rather sleep, that would be different. But if you just don't feel like excelling in your job or doing work around your house or hanging out with friends you may be dealing with a mental illness like depression. When is the last time you felt motivated and driven? Have you asked yourself, you family and friends if you might be depressed?

 

[cybrsage]

As others have said, it takes time for TRT to kick in. I expected instant results from the increase because I get instant bad results from a decrease. Anyway, here is what a medical study says to expect. I reformatted it for easier reading.

RESULTS:

Effects on sexual interest appear after 3 weeks plateauing at 6 weeks, with no further increments expected beyond.
Changes in erections/ejaculations may require up to 6 months.
Effects on quality of life manifest within 3-4 weeks, but maximum benefits take longer.
Effects on depressive mood become detectable after 3-6 weeks with a maximum after 18-30 weeks.
Effects on erythropoiesis are evident at 3 months, peaking at 9-12 months.
Prostate-specific antigen and volume rise, marginally, plateauing at 12 months; further increase should be related to aging rather than therapy.
Effects on lipids appear after 4 weeks, maximal after 6-12 months.
Insulin sensitivity may improve within few days, but effects on glycemic control become evident only after 3-12 months.
Changes in fat mass, lean body mass, and muscle strength occur within 12-16 weeks, stabilize at 6-12 months, but can marginally continue over years.
Effects on inflammation occur within 3-12 weeks.
Effects on bone are detectable already after 6 months while continuing at least for 3 years.

Onset of effects of testosterone treatment and time span until maximum effects are achieved. - PubMed - NCBI

 

[Atlaz]

Thanks guys for all the insight and tips. I will let the therapy work and drop the DIM for a while.

 

[Alpin]

Your labs look great...
What b.F. % are you at?

 

[IMT staff]

Sometimes Clomid will raise SHBG

How long have you been on TRT?

 

[Atlaz]

Sometimes Clomid will raise SHBG

How long have you been on TRT?

Since November 25. About 3 months.

 

[Atlaz]

Your labs look great...
What b.F. % are you at?

Im pretty high at the moment. 23-24%.

I have a torn meniscus and four months ago the pain has increased. Im waiting for surgery but meanwhile my lifestyle has taken a hit and became more sedentary. ( fat has accumulated on belly only) My workouts are limited and I had to stop putting weight on my left knee or standing for too long.

Im looking into stem cells injections to maybe one day be able to run again.

 

[Atlaz]

I agree with Halfwit!!!

Also I would like to add that motivation and drive aren't necessarily tied to Testosterone levels. They are intrinsic. If you said you felt exhausted all the time and couldn't recover after exercising/playing sports and had zero libido because you would rather sleep, that would be different. But if you just don't feel like excelling in your job or doing work around your house or hanging out with friends you may be dealing with a mental illness like depression. When is the last time you felt motivated and driven? Have you asked yourself, you family and friends if you might be depressed?

I dont have a full on depression but a more mild version of it. Im moving next week to another province ( State ) in Canada and this change can definitely bring a new outlook. A couple of years ago I did try medication and therapy but with limited results. Allot of low T guys feel " depress " and TRT helps them no? Whether situational or biological im tackling this on all fronts.