T Nation

5 Months into TRT. Possible Gyno, SHBG and Bloodwork Questions

Hi all I’m a first time poster and hope to get some answers to questions I have :). I’m 46 years old, 200 lbs waist size 35’. In Jan 2019 my Test levels were below normal (under 8 nmol/L) and my doctor felt I would benefit from TRT.

I am now on month 5 of TRT, using 1.62% Test Gel, applied daily, for a total of 110mg Test per week. Here is some blood work below from May and from last week so you can get a fuller picture. The blood work from last week was due to pain in my right breast which I thought may be early symptoms of Gyno and I went to see my doctor. I have therefore started Arimidex with the permission of my doctor (0.25mg per day) and the breast pain has eased after 7 days (16 July to today) of treatment. I will now slow down to 0.25mg twice per week now that my E2 levels will definitely have dropped. I had my blood work after 1 day on Arimidex (0.25mg) on 17 July.

02 May 2019
Total Testosterone – 25.4 nmol/L (range 8-30)
Free Testosterone – 403 pmol/L (range 180-739)
SHBG – 55.6 nmol/L (range 18.3-54.1)

17 July 2019
Estradiol (E2) – 57 pmol/L
Total Testosterone – 20.1 nmol/L range 8-30)
Free Testosterone – 296 pmol/L (range 180-739)
SHBG – 57.7 nmol/L (range 18.3-54.1)

My questions are as follows:

  1. Was my estradiol high enough to get gyno symptoms? My breast and nipple was noticeably uncomfortable and has now eased up. I haven’t gone for the scan yet to confirm.
  2. Going forward now, I will dose with Arimidex 0.25mg twice a week per research I’ve done, and will follow up with more blood work in 3-4 weeks. Will my free test increase during this time?
  3. Why has my total and free test dropped from May to July? I noticed that in May my libido was higher and would like to keep my test levels up for this purpose.
  4. Can you comment on my high (just out of range) SHBG levels and how to reduce them?
  5. Any other comments to make given my blood work above?

Your lower SHBG with excess androgens, you’ll need a Total T 1000> to ever have enough Free T and injectable Test will get you to where you need to be. As it stands now your Free T hasn’t really been optimal which needs to be at the top of the ranges.

Your doctor is slacking off not really optimising your levels, any doctors prescribing androgel is clueless. High SHBG can be because of starvation diets/cutting, excess alcohol consumption and partly to do genetics.

The reason your levels have declined is because you on T-gel which is common to see men absorb less as time goes on because men generally absorb gels poorly, women absorb gels much better than men.

Highly doubt that you had gyno issues with SHBG that high.

What other symptoms were you having? Or was it just the lump?

Usually gyno starts out as itching in the nipples, signifying that there is growth.

EDIT: OH YEA, big thing I forgot to say. With your SHBG that high, you shouldn’t be messing with an AI, you will find yourself in a very bad place, very quickly if you keep doing what your doing.