It’s available on YouTube as a paid programme, but I’m not sure if it’s available outside of Australia.
Hi mate, I am in Australia too and am having similar problems. My SHBG was over range. I have seen a number of doctors here with no improvements. The problem is if your LH and FSH is low and you do not have pituitary issues TRT is unlikely to help.
I have been trying to gather a list of us guys having strange problems with testostererone so we can work together.
Cheers
Low vitamin D is associated with high SHBG. If you do an internet search some studies to this effect will come up.
So it is possible that addressing low vitamin D helped bring down your SHBG.
Latest bloodwork has come through. It was drawn yesterday, on 29th March.
Hormones
FSH: 6.6 IU/L (1.5 - 9.7)
LH: 6.4 UI/L (1.8 - 9.2)
Prolactin: 296 mIU/L (90 - 400)
E2: 50 pmol/L (14 pg/mL) (< 160)
TT: 14.2 nmol/L (= 409 ng/dL) (9.9 - 27.8)
SHBG: 42 nmol/L (15-56)
Free T (calculated): 249 pmol/L (= 7.2 ng/dL) (170 - 670)
TT seems to be sitting in the low-normal range. Free T is generally in the range 230 to 250 pmol/L (about 6.5 to 7 ng/dL). I think that that’s at or just above the hypogonadal range.
Thyroid
TSH: 3.26 mU/L (0.5 - 5.0)
FT4: 18.9 pmol/L (11.0 - 22.0)
FT3: 4.9 pmol/L (3.2 - 6.4)
@KSman will get excited about TSH, and this time I’m concerned. It’s risen from 1.26 mU/L in August, through 2.11 mU/L in December, and is now 3.26 mU/L. It might also explain why my weight jumped by nearly 10 kg / 20 lbs) in the last three or four months.
I want to dig up some older numbers for TSH. I have a suspicion that I could have been iodine deficient prior to arriving in Oz, and since bread here is baked with iodised salt, it might have been corrected, and that might have put me out of balance.
@vincentv if you’re desperate to get onto TRT then you can do it privately. For example, Dr Robin Wilcourt was willing to treat Sabour Bradley on Head First, whose TT was 16.7 nmol/L / 480 ng/dL at the time.
@seekonk my Vitamin D is now 112 nmol/L, and my SHBG is still fairly high!
Hey mate,
Thank you for the update.
I have been on TRT and it does not really work. That is the issue.
Even with high T i still have symptoms.
I do not have any ideas for now.
But want to keep working on this.
Just got an old value of TSH from the UK. It was 2.87 mU/L on 9/10/14.
It’s probably always been on the high side, rather than rising rapidly in the last few months. So scratch my theory about a bad reaction to increased iodine intake.
@vincentv Are you sure your problems are hormonal? The numbers on your old thread didn’t look too bad, so it could be something else. Depression and low T have pretty similar symptoms.
100 percent hormonal. I take testosterone and it wont grow muscles. I was deadlifting 200kg before all this happened. And I can not even gain muscle on TRT at 250mg a week.
I have no morning wood, libido and my hairloss has stopped. I also shave less. 100% hormonal. But we do not know what is effecting the endocrine system. It could be many things.
I cannot see that you have reported your oral body temperatures.
fT3 and fT4 should be delivering good temperatures.
But your hypothalamus appears to not seeing adequate thyroid hormone levels.
That would make sense if rT3 was elevated and then temperatures would be lower.
Iodine in bread. Works for people who are not:
- gluten intolerant
- dieting
- diabetics
High SHBG with low E2 is not right. Something else is going on as you are suspecting.
“”"
SHBG levels increase with estrogenic states (oral contraceptives), pregnancy, hyperthyroidism, cirrhosis, anorexia nervosa, and certain drugs. Long-term calorie restriction of more than 50 percent increases SHBG, while lowering free and total testosterone and estradiol.
“”"
See if there is anything here for you: shbg ssri - Google Search
Graemsay can you get in contact I am trying to get a bunch of guys together who are having troubles with T. Do you use facebook? Maybe I can send you a link to mine?
Firstly I picked up an old set of blood tests (dated 8th May 2015) last week. I didn’t have my hormones checked, however the following values are of interest:
TSH: 1.33 mIU/L (0.5 - 5.0)
Ferritin: 297 ug/L (20 -250)
My total cholesterol back then was 7.0 mmol/L, it’s now 6.2 mmol/L, so going in the right direction.
Ferritin was down a bit (282 ug/L) when I last had it checked. The bloodwork was done with a different lab, whose range is up to 500.
I had a look through the links from the Google search. The only thing that looked possible was a post at the ZRT Laboratory blog. The SSRI could have pushed prolactin up, which in turn would have increased SHBG.
I don’t have any bloodwork for prolactin when on the SSRI, but it was 266 and 296 mIU/L (range 90 to 400) after coming off.
I haven’t taken temperatures yet.
Man get in contact with me please.
Your ferritin is not good if it is always that high. Do some research and you will see that under 100 is optimal for long term health. There is a correlation between ferritin levels and whole body oxidative stress. What about transferrin saturation?
A bit of thread necromancy here, but it’s probably best to keep everything in one place.
I’d gone along to a male health clinic in Melbourne’s CBD last year to have a chat with their doctor. I’d been having various symptoms, and figured a second opinion wouldn’t hurt. However, he told me that no-one would put me on TRT with my hormonal levels.
I’ve seen a few threads here where people claim their problems are hormonal, but the root cause could be depression. Normally they’ve been through all the local doctors and endocrinologists, and told that there’s nothing wrong, but they persist. I didn’t want to be that guy, and decided to stop looking into TRT.
Late last year I’d had a discussion with my PT about hormonal levels, and it prompted me to take another look. I saw a few references on forums to Dr Z, who’s based in Perth, but has monthly clinics in Melbourne and Sydney. I made an appointment for January, but had to cancel due to work commitments, and the need to get a fresh set of blood tests.
Anyway, I had a draw at the start of the week, and managed to get a very last minute appointment with Dr Z this morning. I don’t have all the values here, but from memory:
FT (calculated): 250 pmol/L (=7.2 ng/dL)
SHBG: 70 nmol/L
TSH: 1.4 mU/L
FSH and LH were around 7 to 9 IU/L. I think that one was flagged as being high.
I’ll pick up (and post) full labs in a day or two from my usual GP.
Dr Z looked at the numbers, and said that I’d not qualify for TRT under the usual guidelines, however my FSH and LH should be around 1 to 2 IU/L at my age, which indicates that my pituitary is screaming at my testes, and they’re not responding, so he thought that I needed it.
He gave me a choice of injections, nebido or creams, and I went for the former. So he sent me off to the local pharmacy with a script for Sustanon 250. After which he showed me how to inject it, and I went off on my way.
My initial protocol is one pre-loaded vial of Sustanon 250 per fortnight, with an Anastrozole tablet per week, split in half. I suspect that I’m going to be told to split the dose, inject subcutaneously, and all that, but I’m not messing around with it at this stage.
I asked about HCG, and Dr Z didn’t think that it’s important. He’s open to introducing it in future, but considers it largely cosmetic, and doesn’t want to make too many changes too fast.
I’m a bit surprised that I got started on TRT today, as I was really trying to find the cause of my gynecomastia. I’ll give it a trial for a few months and see how I feel.
Incidentally, my TSH levels have returned to 1.4 mU/L without any intervention. So that’s one less thing to worry about.
This is a follow up to a post in @flash74’s thread. I don’t want to hijack it, so I’m moving it here.
I wrote:
And the indefatigable @KSman replied:
I agree that it sounds like I’m primary. My body has eunuchoid proportions (upper to lower segment ratio is 0.9, arm span is about 10 cm / 4" greater than my height), which suggests it’s something that’s not been entirely right for a long time.
I don’t know what the cause is, and I’d like to find out. Healthline has a list, but I’m not sure if any really apply.
My testes were not checked. Would it be worth arranging an examination? If so, what tests? Ultrasound?
If I stick on TRT (as per the protocol above), how long is it likely to be for natural testosterone levels and fertility to be impacted? I was considering getting the latter checked as a baseline.
Lastly, my experiences so far.
I had my first injection on Thursday 16th February, and took my first dose of Anastrozole on the Friday.
I was quite bloated on Saturday and Sunday. I suspect that this might have been water retention.
Libido picked up over the first few days, which surprised me. I’d expected there to have been a bit of a lag. But it’s been a bit like a badly tuned radio, in that sometimes it’s there, and sometimes it’s not. However it dropped off sharply on Friday, about a week after the shot.
Appetite is up a lot. I’ve been spending a lot of time at the gym, so that might be the cause.
Mood was down for the first few days, I felt very irritable, but then improved. It’s also tailed off a bit since Friday. I don’t expect TRT to cure depression, but any little helps.
I feel really sore the day after taking a dose of Anastrozole. I’m not sure if this is gym or E2 related.
You should inject T twice a week and dose anastrozole at that time.
The half life of anastrozole means that it take around a week for a given dose to build up to final serum levels.
Anastrozole can make joints ache if dosed too high, but not muscles.
The problem is that my prescription is for pre-loaded syringes, rather than a vial. I know that other people have emptied these out, and then split the dose, but I haven’t looked into it, nor do I know where to buy the necessary supplies.
I don’t know if it’s possible to get syringes with a lower dose. Something to ask my doctor when I next see him in about six weeks.
The aching was probably exercise related. I’ll keep an eye out for it.
I’ve been running TRT for nearly two months now, and am due to see Dr Zentner in about a week for my first check-up.
I didn’t have blood tests back when I last posted, so here are my pre-TRT numbers.
Hormones
Testosterone: 17.7 nmol/L (= 510 ng/dL) (9.9 - 27.8)
SHBG: 59 nmol/L HIGH (17 - 56)
Free Testosterone (calculated): 251 pmol/L (= 7.23 ng/dL) (170 - 670)
E2: 87 pmol/L (= 24 pg/mL) (<160)
Prolactin: 212 mIU/L (90 - 400)
FSH: 7.9 IU/L (1.5 - 9.7)
LH: 9.5 IU/L HIGH (1.8 - 9.2)
TT seems to bounce between about 12 and 18 nmol/L, whereas FT is more consistent at 230 to 250 pmol/L.
It was the high FSH and LH that was used to diagnose me as being hypogonadal. It sounds like compensated or subclinical hypogonadism in my case.
Thyroid
TSH: 1.4 mU/L (0.5 - 5.0)
FT3: 4.8 pmol/L (3.2 - 6.4)
FT4: 18.9 pmol/L (11.0 - 22.0)
TSH was 3.26 mU/L last time, but has dropped back to a decent level with no effort from me.
Other
PSA: 1.32 ug/L (0.25 - 2.2)
Albumin: 43 g/L (36 - 47)
Globulin: 26 umol/L (5 - 30)
ALT: 16 U/L (5 - 40)
AST: 16 U/L (10 - 40)
GGT: 14 U/L (5 - 50)
Protocol
I’ve been following the initial protocol for two months: 250 mg Primoteston Depot as an intramuscular injection every two weeks, with one tablet of Anastrozole per week, split into two doses.
I know it’s not optimal, but I wanted to see where it got me before I started adjusting things.
Results
The main things that I’ve noticed has been an increase in libido, or, more accurately, I now tend to have one. Before it felt rather theoretical.
My mood has improved a bit. I’d probably characterise TRT as being equivalent to a 50 mg per day dose of Sertraline / Zoloft, but without the side effects.
However, it’s not been a consistent benefit. For the first four shots, this is what I felt:
- I felt good the first week, and back to normal on the second.
- I felt good both weeks.
- The injection didn’t feel as though it had an effect, and I felt more-or-less back to my old self both weeks.
- I felt good the first week, and back to normal on the second.
My suspicion is that the second injection shut me down, which is why things weren’t so good for the third shot.
I’ve been running the injections every other Thursday, and if the effects wear off, I tend to feel them slipping on the following Thursday or Friday.
This week I had a depressive episode on Monday and Tuesday, and I think that I’m still feeling the tail-end of that now. I’m not sure if this is down to brain chemistry or crashing my hormones.
I’ve not noticed any significant muscle gain or fat loss. I thought that my traps might be looking a little bigger, but that’s it. Weight has been pretty stable, around 98 to 100 kg (215 to 220 lbs) over the last couple of months, and that’s including being away on holiday for a few weeks.
Side Effects
Other than a bit of bloating, the odd extra spot, and body hair thickening slightly in a few places.
The injection site can be a bit sore for a few days.
I’ve had a few joint issues. There’s a bursitis on my left elbow that’s slowly clearing, and my left knee and ankle have been clicking a bit. I don’t know if these are injuries or from crashing my E2.
I had gynecomastia before I started, despite my E2 being low normal. There was an article posted in another thread suggesting that LH could be a cause, which I suspect might be the case with me.
My nipples have been a bit tender in the last week, and there was a bit of soreness a day or two ago, but I haven’t noticed any changes.
Adjustments
I’m not really feeling the benefits in the same way that a lot of people seem to be. I don’t feel a significantly better, so there’s a consideration of stopping TRT.
Before I do, I’d like to try making some adjustments:
- Increase the frequency of injections. I’ve heard that weekly is better than biweekly for those with high SHBG.
- Bump up the dose.
- Add HCG to the mix.
I’m currently using preloaded syringes that contain 250 mg of Testosterone Ethanoate, which makes splitting a bit more difficult. An easy way of achieving the first two would be to inject once per week. That would put me at the very high end of the scale, which is generally frowned on around here.
I want to add HCG, particularly as fertility is likely to be a problem for me before TRT is thrown into the mix.
I’ve been along to see the doctor for the first follow-up today, and these are my latest numbers. These were taken a week after a shot.
Testosterone: 47.4 nmol/L HIGH (= 1366 ng/dL) (9.9 - 27.8)
SHBG: 38 nmol/L (17 - 56)
Free Testosterone (calculated): 1173 pmol/L HIGH (= 338 pg/mL) (170 - 670)
E2: <44 pmol/L (<12 pg/mL) (<160)
My current protocol is:
- 250 mg of Testosterone Ethanoate every fortnight.
- One Anastrozole tablet per week, split in half.
I was quite surprised by the numbers, as I felt as felt things were dropping off about seven or eight days after the injection.
So what’s the plan?
Dr Zentner said to reduce the Anastrozole dose by half. I think that the dosing equation (which I can’t find) is pretty linear, so that should get my E2 around the optimum 85 pmol/L / 22 pg/mL level.
He wasn’t keen to up to dose, but suggested splitting it on a weekly basis. I’m using preloaded syringes, so would inject half of the contents (125 mg) each time.
If that doesn’t work, then he said to try injecting a whole 250 mg syringe every ten days. A third option, which wasn’t suggested, would be 125 mg every five days.
I’m probably going to experiment with all three protocols and see how I get one. I’ll post updates in the next month or two.
@trtnoob in the end I ran 250 mg every ten days. I tried every five, but preferred the less frequent, bigger doses.
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Did you notice much drop off at all at any point through the 10 days?