Latest Blood Work - 18 months on testosterone replacement therapy (TRT) with no effect - Low SHBG

[newtohrt]

Latest Blood Work - 18 months on TRT with no effect - Low SHBG

Hi All-

I have been on HRT for 18 months now with no results what so ever. My libido is completely gone, and I have been unable to loose any fat or make any progress in the gym. I don't smoke, drink only rarely and eat a decent diet with lots of protein. I have low SHBG and after researching this on the Internet and in talking with IMT, I now understand that it makes it impossible, or next to impossible for HRT to have any effect. So, my question is - Has anyone ever enjoyed successful HRT with low SHBG? (My first HRT Dr was elated that I had low SHBG...not realizing that that made me not feel anything from treatment)

By successful, I mean the usual criterion. Get your energy back, resolve low or no libido and ED, make some gains in the gym and loose a bit of fat - the usual 3 things that HRT 'promises' to everyone. My low pre-HRT libido dropped to zero both times within a week of me starting or re-starting HRT.

I have my most recent blood work attached and would be most grateful for feedback and/or constructive suggestions. I am currently pinning Test Cyp 50mg E3D, HCG 500 IU E3D and no Aromatase inhibitor (AI), as I normally don't aromatise much although in this test it is elevated a bit. Over the past 18 months, I have tried Test cream as well, along with several different dosages of Test cyp injections, all to no effect. In fact, I feel slightly better off HRT than I do on. I have stopped twice and restarted.

I originally started HRT for the usual reasons. Brain fog, low to no libido, I work out hard, but it no longer does any good, cannot loose any fat or gain any muscle, etc...I am now seriously considering stopping for good. I started for a reason, but no treatment to-date has helped so I may as well save the money.

Thanks in advance for any insight - I value the opinions of the experienced folks on this board!

 

[methos]

That's interesting about SHBG causing your symptoms by being low. I seemed to have reacted the opposite way. When I started testosterone replacement therapy (TRT) my SHBG was 56 and Total estrogens at 128 and I felt like hell. I have slowly lowered these numbers over the course of a year and libido, strength, all of the above are perfect. I feel the best with SHBG around mid twenties and same with estradiol.

Have you ever tried more than 90mg of test per week? I have to take about 225mg per week to achieve Total Test levels of about 1200. That's when I feel the best.

 

[newtohrt]

Tried many dosages

That's interesting about SHBG causing your symptoms by being low. I seemed to have reacted the opposite way. When I started testosterone replacement therapy (TRT) my SHBG was 56 and Total estrogens at 128 and I felt like hell. I have slowly lowered these numbers over the course of a year and libido, strength, all of the above are perfect. I feel the best with SHBG around mid twenties and same with estradiol.

Have you ever tried more than 90mg of test per week? I have to take about 225mg per week to achieve Total Test levels of about 1200. That's when I feel the best.

I have experimented with doses as high as 300mg per week and as low as 50mg per week. Sadly, I can tell no difference between the two.

 

[ccpowers]

Okay, first: I think you are hypothryoid. Low SHGB is either usually caused by hypothyroidism and/or insulin resistance. Based on your labs: high TSH, low free T hormones, you are hypothryoid based on my understanding. I have low SHGB and am on testosterone replacement therapy (TRT) as well, with little to no effect. My GP explained that if your SHGB is low, your testosterone could be 10,000 but it wouldn't matter because it has no where to go. I am on liquid research T-3 right now but either it's fake or I am just not having a response to T-3 because it's doing absolutely nothing. I am seeing my doctor soon, going to get bloods done and go from there. (t-3 increases shgb)

Also, you may have high reverse T-3 so make sure you test that. Reason being, your free T-3 is high but coupled with high TSH means your body is sensing that it is hypothyroid but your free T-3 is high as well which doesn't make sense. High free t-3 would suggest hyperthyroid but that is not the case here. I've read reverse T-3 comes up as free t-3 on blood test so you have to get both tested to differentiate them. High reverse t-3 is not good and renders real t-3 useless. The treatment would be to supplement with cytomel for a few months to lower it, then switch over to synthroid or armor.

 

[newtohrt]

Thyroid

Okay, first: I think you are hypothryoid. Low SHGB is either usually caused by hypothyroidism and/or insulin resistance. Based on your labs: high TSH, low free T hormones, you are hypothryoid based on my understanding. I have low SHGB and am on testosterone replacement therapy (TRT) as well, with little to no effect. My GP explained that if your SHGB is low, your testosterone could be 10,000 but it wouldn't matter because it has no where to go. I am on liquid research T-3 right now but either it's fake or I am just not having a response to T-3 because it's doing absolutely nothing. I am seeing my doctor soon, going to get bloods done and go from there. (t-3 increases shgb)

Also, you may have high reverse T-3 so make sure you test that. Reason being, your free T-3 is high but coupled with high TSH means your body is sensing that it is hypothyroid but your free T-3 is high as well which doesn't make sense. High free t-3 would suggest hyperthyroid but that is not the case here. I've read reverse T-3 comes up as free t-3 on blood test so you have to get both tested to differentiate them. High reverse t-3 is not good and renders real t-3 useless. The treatment would be to supplement with cytomel for a few months to lower it, then switch over to synthroid or armor.

I should have mentioned that I have been taking Liothyronine at 25 mcg a day for 2 months and it has not done anything. My previous thyroid labs looked very much like my current ones, which is why I started the Liothyronine. It sounds like perhaps I do have the reverse T-3 thing going on though, since my SHBG has not increased after 60 days dosing with Liothyronine, nor have the thyroid test results changed much, if any. I am having a consult with a thyroid specialist next week and I have my fingers crossed!

Thanks man - this is great information!