T Nation

44 Y/O First Labs


#1

Test = 649
Estradiol = 23.6
TSH= 1.85
LH = 4.2
SHBG = 72.7

Doc is talking about starting with 200mg a week.


#2

Why do you need trt? Do you have units and ranges? What symptoms do you have? Are these all of your labs? What do you expect anyone to derive from your post? At first glance it doesn’t at all look like you should go down the road of trt. Do you want to shut down your hpta axis, potentially for the rest of tour life? Do you know what that means?


#3

Please, when posting lab results add units and lab reference ranges. Some labs also put the description of a method used for testing - post those as well.

So:

  • total T looks is fine and doesnt warrant TRT per se.
  • SHGB level is very high, and I’m sure your free T is on low end of the range. This will cause low T symptoms that you probably having.
    -TSH is rather high, i would advise you to check thyroid function by measuring body temperatures.
  • Read the stickies in this forum section, that is a goldmine of information although there is a lot of reading to be done.

With a limited information, we can only guess what’s happening. Since SHGB is out of range, l would focus on that first. There is many factors that be cause of high SHGB, like medication, alcohol, wit D defficiency, diet…
Get it in range and you free T will rise to a satisfactory level without any exogenous T.


#4

I’d be happy with 649 on ANY scale. 200mg a week at 649? I’m moving to your location! E2 is near perfect too.

Sign me up.


#5

Sorry this took so long


#6

ALT is high. From recent training or sore muscles - or a liver problem.

SHBG is made in the liver, E2 increases, FT lowers.

SHBG lowers FT, SHBG+T is not bio-available.
SHBG+T inflates TT
So your labs make sense.

Free T, FT should be tested, but it should be low.

TRT will lower SHBG if E2 is actively managed with E2 to be near E2=22pg/ml and FT is high.

E2 is already there with low FT, so TRT will increase it and E2 management with anastrozole needs to be started with first dose of T, not after weeks to see how bad the labs are.

TSH should be closer to 1.0, the ranges are stupid.
See the last paragraph in this post to eval overall thyroid function.

If you have not been using iodized salt, that is probably cause of thyroid issues.

200mg T per week is wrong

TRT:

  • self inject T cyp SC/SQ, not IM, with #29, 1/2", 0.5ml insulin syringes
  • 0.5mg anastrozole at time of T injections - see stickies re over-responders
  • 250iu hCG SC EOD to preserve testes/fertility

At age 44, with your high SHBG, TRT makes sense, only if done as I suggest.
You need to look at liver to see if SHBG is driven by disease.

Please read the stickies found here: About the T Replacement Category

  • advice for new guys
  • things that damage your hormones
  • protocol for injections
  • finding a TRT doc

Evaluate your overall thyroid function by checking oral body temperatures as per the thyroid basics sticky. Thyroid hormone fT3 is what gets the job done and it regulates mitochondrial activity, the source of ATP which is the universal currency of cellular energy. This is part of the body’s temperature control loop. This can get messed up if you are iodine deficient. In many countries, you need to be using iodized salt. Other countries add iodine to dairy or bread.


#7

I do Lift heavy 2 to 3 times a week and I do BJJ 2 times a week.
I just started taking 6mg of Boron to help with the SHBG.

Only salt I use is himalayan salt.

I Just started last week with : 1ml every 7days of T Cyp/Anastrozole compounded and 0.5ml HCG twice a week.