T Nation

ADHD Guy. Low T, High SHBG. Considering TRT+HCG+AI

Hi all,
first off all please let me say thank you to everyone here on T-Nation for providing invaluable information!

Trying to keep this short, I’m 32, I have been for years rather depressed, low libido, struggle with internet-addiction, brain fog, low energy and have developed social anxiety as a result of not getting anything done and repeatedly starting new projects that I don’t finish. The latter can be attributed to my ADHD (mixed type, but more PI, while as a kid I was PH). I’m on Ritalin, and it helps focussing, but it doesn’t really make a big difference. There are a few anecdotal reports (including on T-Nation) that TRT either increased/decreased ADHD symptoms. I wouldn’t be surprised if symptoms overlap, and that some people who are diagnosed for ADHD actually have low T (or thyroid problems) as well.

Anyways, I have an appointment next week with a doctor who specializes on low T and hope he knows his stuff. What I’m thinking about is TRT, in combination with HcG and AI, as I want to preserve my fertility (just in case I find a girlfriend) and it probably makes it easier to get off in case it makes ADHD much worse. I know dialing in is not that easy. From my understanding, high SHBG means I need higher TRT and two shots per week!? What’s important to know about HcG and AI(anastrozole?)? Anything else I need to ask the doctor about? I would also love to hear from others who have ADHD, and if/how TRT affected them. Thanks for taking your time and good luck to you all!

My results are (sadly not tested for E2):

TSH: 1.32 mU/l
Hematocrit: 44%
AST: 41 U/l
ALT: 26 U/l
Cholesterol: 212 mg/dl
HDL: 53 mg/dl
LDL: 148 mg/dl

T: 3.63 ng/mg
SHBG: 67 nmol/l
Albumin: 48.8 g/l
fT: 1.11%
bioavailable T: 3.70 nmol/l

I was diagnosed with ADHD and Tourette Syndrome and at very young age, TRT turned me into a multitasker which was never my strong suit and it started to feel like I didn’t even have ADHD anymore. I was able to stop all ADHD medication as a result.

Tourette Syndrome is no more, high cortisol increases symptoms of Tourette Syndrome and TRT lowers my cortisol which makes me calmer. ADHD can be triggered by an inability to remain calm, TRT makes me calmer and able to focus better.

Your high SHBG is binding up most of your testosterone, I would expect Free T to be low. You can start TRT in isolation and revisit HCG and FSH injections when looking to have kids, you can also add micro doses of clomid to increase sperm production.

TSH looks optimal, TSH is a stimulating hormone and not an actual thyroid hormone. Free T3 is the master thyroid hormone that affects change within the body, but most doctors ignore it and focus on the lowest common denominator TSH and Free T4.

You need to provide reference ranges for all lab values.

How would one go about correcting this or optimizing your injections around high SHBG and low free T?

You don’t affect changes in SHBG by a large margin without TRT, excess androgens lowers SHBG and you can’t produce enough naturally. Test cypionate creates unnatural testosterone and estrogen spikes, this lowers SHBG is just about everyone.

One or two injections per week will be optimal, unless having difficulty keeping estrogen under control, then more frequent smaller injections would be necessary. Anastrozole should only be used once all other options have been exhausted, like increasing injection frequencies.

It may or may not help your ADHD. I was diagnosed as a child with ADHD, and was on Ritalin. My mother pulled me off, because she was afraid it would stunt my growth.

I think the ADHD led to low testosterone. I can be up all night with my mind racing from thought to thought. I think the lack of sleep is what caused low levels. Pair that with heavy training, and my body was likely not recovering well.

I kinda think I need to be on ADHD medication as an adult even with the TRT. I have better energy, but I am not that focused.

I was diagnosed as an adult. Looking back, the ADD was pretty obvious except that I have never been hyper-active. I also was low T for a long time and didn’t know it, I have old labs that say so but neither me or my doc knew what we were looking at. I can tell you this, on the last two shot days I got the feeling of being over-amped. I have never had this feeling before in my life. Not on 180 mg of Adderall, not on mucuna pruriens, not on anything. I only knew what it was because of how other people describe it. I think it’s finally having enough free testosterone to form catecholamines correctly.