T Nation

53, Hoping to Start SQ T

Eager to get some input on trying T for fatigue and what feels like onset on andropause. Currently 53 years old with drop in my free T 47.3 range: 47-244. TT is mid range at 656 reference range: 390-890. SHBG is high at 118 with range of 17-66. I do have osteopenia in femurs and lumbar spine. My T labs two years ago and always have been high, above reference range with NO steroid usage ever. Only thing I have taken for years is 50 mg of DHEA per day.

Feeling like last year my tolerance for exercise is nil. I’ve had a tough time with most activities related to movement such as pilates and walking/hiking, sex drive is notably decreased. Usual obvious stuff.
I am 5’6" and 128 lbs. Do not bodybuild! Just looking for some experienced perspective as I study mu options. Thinking about 50 mg SQ twice a week to see if some life will come back. Thanks guys!

When scanning your FT and TT I knew what was coming next, we see guys coming in here everyday with excellent TT numbers wrecked by high SHBG. TRT is only treatment able to lower SHBG enough to start feeling close to great, I doubt you’ll hit much resistance getting on TRT. Stay away from doctor’s who try to have you inject once every two weeks, your are going to need large weekly injections, 150mg weekly would be a good starting point. SO will be important since you’re going to require larger than average doses to get over the top of that SHBG and increase your FT to make a difference. The one thing that increases the effectiveness of TRT is lifting weights, no doubt about it!

Thanks, Systemlord. So even with my low height and weight you still think I’ll need 150 mg per week? I was thinking 50 mg every 3.5 days at first. I’d like to avoid need for AI or clomid and keep it simple. From what I read and listened to from Dr. John Crisler seems like 50 mg twice a week, total of 100 mg per week, would be ideal. Less chance of needing AI this way especially if done SQ. I don’t think my doc will give a problem when I see her next week. She seemed eager to get labs going hoping shed be able to get me on T. I do need to run my PSA, estradiol, dht and maybe LH before I start this to get baselines. I’m psyched just wish I’d found out sooner. Its a drag having to wait till after Christmas!

SHBG needs to be addressed, even if you do get on TRT. Are you on any medications? in the past?

I have had bad issues with SHBG being high (up to 70 at one point). Its made in the liver, so any damage or scarring will increase it.

I have tried just about everything to try and lower it (OTC) but have not had good results.

Actually though, I just posted about it as well, I was able to get my SHBG from 54 to 37, and the only change I made was Calcium D Glucarate (which helps the liver get rid of toxins).

Cant say 100% for certain if that is what helped with the SHBG, but it was my only change.

No 50mg twice weekly is for someone who has either SHBG middle to lower end of the range, I’ve seen guys with high SHBG go on the standard doses with mediocre results because you’ll need more androgens to push down SHBG to where it will matter.


As for the Calcium D Glucarate I don’t believe your case is typical, otherwise everyone would be doing it and we’d hear about it more often.

Thanks guys. I think my liver is part of the shbg issue because I am very autoimmune and sensitive to chemicals, fragrances etc. My liver enzymes are normal and no history of alcohol or other drug abuse. I have zero tolerance for alcohol, always been like that. i take 125 mcg levithyroxine for low thyroid function, about ten years.
I guess I’m thinking on 150 mg testosterone per week that need for AI and hcg will be unavoidable but if that is what’s needed to regulate I’m open to it.
Incidentally I have been inadvertently taking all the stuff that helps low free test such as boron, vitamin d, magnesium. I think stress brought my free T down. It was high at 313 two years ago. Now it’s 47.3. Pretty crazy.
I have heard some people get great libido improvement with D-glucarate so it makes some sense It may be helpful to head off estradiol. Btw I’m a clinical nutritionist, with MS in human nutrition, but much of the trt ideas are a bit out of my scope. So I’m assimilating a lot quickly. Really appreciate the in put!

Thyroid meds increase SHBG.

This is from another site. Maybe there is some information that you can use in here related to adjusting your thyroid meds… I haven’t had to go into thyroid issue just yet and hopefully never.

"Since being on heavy dosages of thyroid for over 6 years at heavy dosage dealing with lab numbers all over the place esp SHBG, finally after dealing with SHBG issues for 2-3 years they are resolved. In just 8 weeks off being off thyroid cold turkey my SHBG has gone from 69 down to 30! This is great news as I no longer have to worry about using danazol or other forms to manipulate shbg. I am know now recommending t4 and NP thyroid in place of T-3 when working on Dr’s case where this is a huge rise in SHBG if on t-3 is involved. I am chopping away one thing at a time getting off meds such as HC (cortef), hcg, thyroid, Next and finally is testosterone If on T-3 and elevated SHBG you may want to think about getting off it (Dr’s supervision) and making transition to NT or adjusting t-4 up and working on increasing factors converting t4 to t3. Under no circumstance do not stop meds on own, but be under a very knowledgeable health professionals. Transition can be incredible tricky and there will be alot of bumps in the road, but people who have done them are glad they did. Many of them had good T levels to begin just thyroid bounded free levels all up. The end result many of them did not need TRT in the end, just proper adjustments of thyroid. The question why this occurs in some people not in others remains a mystery. The only hypothesis (supported by one study) is when thyroid (t-3) is given and SHBG rises this may be an indication of not being thyroid resistance. "

I don’t believe the results are standard at all. I do however want to put out any information I can regarding lowering SHBG because of the prevalence of high SHBG in the community.

I’ve tried stinging nettle, boron, vitamin d, magnesium, tongkat ali, and something called Unleashed. Nothing worked.

If CDG helps me, then possibly it will help others who abused benzos/alcohol in the past.

I know I was starving for info when I was researching how to lower SHBG.

Thanks @anon10035199. I had read this about T3 meds increasing shbg but I take levothyroxine which is T4 only and my free T3 lab levels are mid low range consistently so I don’t think the levothyroxine is the culprit for me. I do think it is liver related and aging. My suspicion for many men like myself where there are no obvious drug or other liver stressors is that a major contributor is likely heavy metal related, particularly mercury.
Ironically before this recent lab work with low Free T I had backed my routine use of boron from 10 mg each day to about 2 mg per day for perhaps the few weeks prior to draw. Since I added back born at 10 mg per day my libido and ejaculate is noticeably improved. I may try CDL next.

Boron was the only other one that gave me passing results. I would feel a surge in libido, then it would be gone. So I do think it helps, but maybe not for long? Boron also helps with inflammation, so maybe that is where it helps the liver to lower shbg? not sure.

I suspect I get better than passing results with boron for my libido but I think the bar is just dropping over time so there is only so much it can bring me back. Definitely helps my knees and other inflamed areas. I just need to get more labs and get started with some T. My PCP is a woman and she is great but think I’m gonna see another doc who does trt and sports medicine an hour away. i suspect he will be more tuned into possible need for higher dosage T, AI and hcg etc…