Bloodwork Results: Elevated SHBG/Low Free T

@pushathlete236
Are you saying 200mg of testosterone a week or just HCG?

I had very similar numbers as you pre-TRT and using testosterone has helped immensely. I’m currently on 200mg/week total but you don’t want to start there. 150mg/week (preferably split twice weekly) is a good starting point. I plan on having kids as well and will use HCG when that time comes.

I was referencing my TRT dosage as no HCG will be administered until I’m dialed in with that. I’m going to start at 150 split twice weekly for now. I’ll re-evaluate labs then make adjustments if needed.

How were you feeling prior to exploring this option? Awesome to hear it helped you immensely!

No energy, fatigue, low motivation, somewhat overweight, my sense of well-being was crappy, depression, low sex drive, dick would get 70% hard, etc. There were a lot things I didn’t realize until after TRT weren’t ideal.

Make sure you do a lot of reading here because getting this shit right is key and there’s a lot of little things you have to learn that add up.

I wanted to update you on my results. Everything was going well for the most part until this recent change. I’ll explain below.

I also haven’t administered HCG as I’ve been still trying to dial in my current dosage as referenced by multiple of you.

Started with 75mg of test cyp x2 weekly. I came back higher then the range I wanted to be at knowing I was going to administer HCG at some point possibly increasing this amount further.

Total- 1481
Free- He only sent for total at this time (?)
Estrogen- 82

I lowered my dosage to 50mg x2 weekly. Basically cutting the dosage by 1/3. From doing enough research on these forums I should’ve known better then adding anything to help with estrogen, but I was advised I could use DIM To help “balance” the estrogen as well as lowering my dosage would help in itself. After seeing my results a month later I wish I would’ve just lowered the dosage as I’m reading DIM can act as an anti androgen inhibitor. My results came back as follows. Left me speechless seeing these results.

To be clear from the last set of labs until this one about (30) days apart the only thing changed was the lowered dose + added DIM.

Total- 126
Free- 22.8
Estrogen 59

I took my bloodwork on injection day but waited to do my injections until completed so it was consistent with the previous labs. I have dropped the DIM and continued my dosing of 50mg twice weekly. I’m thinking about retesting as it’s been almost two weeks since the lab was taken.

Any information would be greatly appreciated.

200mg of DIM* per day for 30 days.

I too have high SHBG, so your post title caught my eye. I’ve been dealing with this problem for years and have tried several ways of dealing with it. Some more successful than others. I see there’s a lot of responses to your original post and I haven’t had time to read through them. So some of this might be repeat.

First off, a problem with high SHBG is that it make diagnosis difficult if you do not test for SHBG. In your case your doc did, so kudos to him. High SHBG can drive up total T because bound T is protected from liver metabolism. However, just because you have normal amounts of Total T, your free or bioavailable T can be pathetically low, as yours was.

I’ve tried every available OTC product to lower SHBG and the only thing they lowered was the level of my wallet. In short, they don’t work for guys with excessively elevated SHBG like you and me (mine is actually higher than yours).

You can lower it with very small doses of certain anabolic hormones, but getting a doctor to prescribe them off label can be difficult. In my own experiments, I’ve found both stanozolol (Winstrol) and oxandrolone (Anavar) to be extremely effective at lowering SHBG. In my experience, stanozolol is more effective than oxandrolone. I need about 2.5mg of stanasolole twice per day to effectively lower my SHBG into the normal range. With oxandrolone, I need double that amount (5mg 2X per day). Keep in mind that these are very low doses of the synthetic hormones compared to what bodybuilders use (40-100mg/day). There is criticism of these products as being toxic to the liver, but in my experience these low doses put less of a strain on the liver than OTC analgesics. Ibuprofen for example pushes my liver enzymes way further up.

Lately, I’ve taken a different approach to treating my low Free T and that is by not fighting to lower SHBG but rather jacking up Total T to the point where it overwhelms the SHBG protein so that enough T spills over to get Free T into the normal range. Here’s a graph of an experiment I ran through much of 2019. I used various doses of T-cyp and tested for Free T after 6 weeks of treatment at each dose. As you can see, I’m closing in on an optimal dose of 110mg/week T-cyp (split into 47mg every 3 days). This keeps my Free T into the range of a healthy 20-50 year old guy. I’m still working on the experiment and plan to have two more doses to report in the middle of the graph over the next couple months. This might alter the slope of the regression line.

You mentioned E2 and DIM. I’m not aware of any data that says T can interfere with T levels. This seems odd, particularly if you are on TRT. Instead, i suspect there was something odd with the lab itself. You might want to rerun it before making any drastic changes. A total T of 126 for a guy on TRT seems like an anomaly of the test.

Also, make sure you are using the correct E2 lab! Many doctors get this wrong and order the female test which will always come back high for guys because we are below the sensitivity of the assay and it reports anomalous high measurements. I STRONGLY suggest the LC/MS/MS test method rather than a direct antibody based test. There can be a lot of cross-reactivity with the direct method, even if it is designed as a sensitive test for men. The Endocrine society published a position paper on test methods and they recommend the LC/MS/MS test method (which is what I always use).

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I don’t trust your labs, redo labs again. If you look at your estrogen, it dropped expectedly, but the testosterone numbers are suspect, you can’t have estrogen this high without amortization and you need testosterone for this process to occur.

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Truly appreciate the in-depth response. I’d like to stay connected to you through this forum as you continue to find the optimal dosage as we come from the same side of things having high SHBG. I’ve been running only two injections a week but about 10mg less then you in total. Would’ve liked to know what my free testosterone was on the original test when I was at 1400 before lowering my dosage since this last test seems like an error as mentioned. I feel I haven’t even gotten this number since starting and it’s the main reason I even started it.

With your current dosage and getting your free testosterone in the range your looking for, what is your total testosterone at? My only concern was having my total at a very high number to finally get my free testosterone in line. I know our body uses based of our free meaning it’s not as much as a concern, but you know how lab results can be interpreted.

With throwing larger amount of testosterone to your SHBG. You mentioned you inject x3 times a week compared to my x2 weekly dosages. Is this impacted better by one weekly larger dosage or just the total per week dosage no matter how stable you look to make your blood levels through more frequent dosages if that makes sense. Are you doing IM? And with three dosages a week I’d like to hear your protocol for injecting as I know frequent injections are being done differently then users only doing it once or twice a week.

Appreciate the info once again!

Thank you for getting back to me as always.

I can schedule this immediately to get done. I could get in as soon as tomorrow latest Wednesday if needed but I was testing the exact same previous (on injection day- running bloodwork before injections) to keep my test numbers stable. I already injected today meaning if I were to honor this protocol I’d have to wait until Thursday. I don’t know if it matters or not.

When I just run total I could have results back in 1-2 days. Adding free testosterone it takes about a week. Are you looking to just see a rise in the total knowing the lab was off or do I need to run labs for both?

How often do you hear or see labs being wrong? As this would be a first, just curious to know if this happens more then I would have been expected.

Thanks again for the guidance!

Regarding my Total T during this experiment, they varied and some levels I’ll never know because they exceeded the upper end of the lab range. The Table below provides more information. I use the direct method which has an upper end of 1500 ng/dL. Anything above that get’s reported as >1500. i could have used the more expensive LC/MS/MS assay to get the exact number, but I saw no reason to spend the extra money, as I knew the values would be excessively high and I was just doing this to complete the experiment. I’m more interested in optimizing Free T.

Also, come clarification. My standard (current) protocol is every 3 days (E3D) not 3 times per week. Also, as you can see from the table below, When I used the higher levels of T-cyp in my experiment, I changed the frequency of dosing to avoid huge spikes in T in the hopes of minimizing E2 and DHT conversion problems. Also there is some older data in the table (and graph) where I was experimenting with daily dosing.

I typically use shallow IM injections in my upper quadriceps muscle. I typically use a 28D 1/2 inch needle one-piece insulin syringe.

Jesus Christ… 1482 + FT of 24 on 93mg weekly… you lucky bastard

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A couple of things to note about that data point.

  1. It is old data from several years ago and I did not test SHBG at the same time. My SHBG has increased with time, so it may have been lower back then. Since I did not test, we’ll never know.

  2. I was experimenting with daily dosing at the time (0.07mL/day). Actually I now see an error in the table. 200 X 0.07mL = 98 (not 93mg/day).

  3. If you look at the last row, you see the low end of the experiment (81.7mg/week) using an E3D protocol only got me 994 Total T and a mediocre 14.4pg Free T.

  4. My current protocol is 46.7mg E3D = ~109mg/week. I’ve got about another 2 weeks on this protocol before I run a new set of labs. I suspect I’ll be near my goal range for Free T.

The amount of time and effort put into your testing is amazon to see. Awesome to see the different ranges and the data you have backing it up over the past to see how your personal response is.

I feel you and I are in a very similar dosing phase now as I mentioned running .25 (50mg) x2 a week. If I alternated from doing it during the morning both times I could be at a perfect 3.5 days, but ultimately it’s landing around 3 days per one shot, 4 days for the other.

This is why I had to drop an updated response after dropping the dosage from the first labs of 1482 (150mg total a week split x2) to the current protocol seeing these results. Only thing that changed was the added DIM and lowered dosage. To see levels cut by 85-90% means the DIM truly was blocking androgens or it was a botched lab test as you both mentioned. Hopefully things pan out on the next lab keeping the dosage the same but with the removal of DIM as I feel lowering the dosage in it self would’ve handled the estrogen ratio.

What’s your thoughts on use of HCG?

And I see your hemoglobin bouncing around. Is the changes to your dosages altering it, or are you doing anything outside of testing to bring it manage it?

^^^^^ missed pressing the reply to you as this was a response to your last messages sent . My apologies!

This is one of the main reasons why I prefer an E3D protocol over 2X per week. With E3D, the interval between injections is always constant so you can test on any injection day.

E2: Per prior comment, make sure you are using the LS/MS/MS lab and not the sensitive ‘direct’ method. Here’s an article from this site that discusses testing E2 in men. Scroll down past the median levels by age and you will find a discussion on methods. The author recommends LS/MS methodology.

HCG: I use it in my protocol. It’s more of a cosmetic thing. I have small testicles to begin with and they shrink to almond size after a few months without HCG. However, I also like maintaining testicular function. Since our problem is high SHBG it means that we are not primary hypogonadotropic. As such, we should respond well to HCG. Guys that don’t notice a change in testicular size are probably primary to begin with and their testicles shrunk to their smallest size long ago.

Hemoglobin: Yes it bounces around because in the past I’ve donated blood to keep the level in check. According to my original hormone doc (very knowledgeable) and a recent paper I found, it’s DHT more than T that drives hemoglobin production. This is why I’ve incorporated finasteride into my protocol last year. According to the article, guys on TRT who also take finasteride have statistically lower hemoglobin levels. The downside with finasteride is that it is on the forbidden drug list for donating blood, so if you take it you have to go through 1 month withdrawal before donating. Currently I’m monitoring hemoglobin closely to see if I can get by without having to donate blood. The verdict is still out.

If I’m currently running around 100mg a week split into two dosages I could either alternate morning to night correct? or go E3D as you mentioned. What would the dosage be roughly going this route?

Regarding HCG. That’s great to hear that high SHBG respond better implementing it. I have a couple questions for you regarding it.

I bought mine end of December but held of using it until I was dialed in with my testosterone dosing as mentioned above. I’ve basically kept it in the fridge for a month and a half now (3 month supply) Would you get another bottle before adding it in my protocol or would it be good to use for the entire length of the bottle. I’ve heard it can lose potential potency quickly.

What is the amount and frequency you using personally? Are you able to run your protocol using HCG with no AI? And how much of an increase has it added to your total testosterone and free?

Would you hold off any longer on it if you were me? I was planning to get it in obviously over a month ago and keep pushing it back due to my lab results but would really like to get it for the reasons you mentioned. Thanks for the previous input!!

Regarding Hemoglobin reason being I ask is I’ve seen an increase in my number as well. Hematocrit has continued to be in range but Hemoglobin is the number creeping up.

(17.8) & (18.1) readings in the past. I’m also looking for an alternative route then constantly donating blood as there is countless mixed reviews regarding feedback and results.

100mg/7days = 14.29mg/day

14.29 X 3 = 42.9 or about 43mg E3D

43mg / 200mg/mL = 0.22 mL per injection E3D