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High T, FSH, SHBG, Low E2 No Libido. My Lab Results (pellets)

looks like it has never been introduced in my country :frowning:

Hi TM whats your current TRT protocol If You dont mind me asking ?
I am also a suffering with the high shbg,

@j.lee
Read his log. 300+ posts ago he was high SHBG but if you scrolled up 15 posts he now has extremely low SHBG. If you want to spoil the whole story you can scroll up 2 posts.

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Quick catch-up … I had regular blood work in September; all was good. In October, I had a full range of Heart testing done and the blood work showed that my AST/ALT were out-of-whack; enough to “concern” the doctor. Re-tested same week different lab, and had different results, but one marker still high. Heart doctor requested a test 30 days later.

And, as he reviewed the re-tested blood results, sitting across from me in his office, he looked at me like I had three heads, and said “your AST/ALT is normal???”. I just said “Yup”. This is the craziness of blood tests. He is also the first person to tell me “don’t worry about low ALP; low ALP is good”.

ast-alt%20comparison

I also wrote previously that I purchased a FitBit in order to monitor sleep. I wouldn’t want to stake my life or my income on the accuracy of the watch, but it is interesting to monitor.

The first image shows my resting heart rate 48 hours after my pellet insertion.
The second image shows my resting hard rate this week.

I have decreased from 77-79, down to 62-63. Other than I am now on the treadmill EVERY day, I have no other changes in life. The watch makes it interesting to look at numbers such as these.

As to my sleep monitoring – there are more days that are accurate than those that aren’t. At least once per week it is unable to “get a consistent heart-rate while you slept” and only provides basic sleep details. For example, it reported like this last night, and included 90 minutes that I laid in the bed resting but not sleeping … as part of my sleep calculation.

Damn dude, your sleep is all over the map. And is that number on the right your RHR?

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Quick summary and update:

Pellet Insertion 9/23/19. On 10/1, I decided to cut my Danazol intake in half due to how low my SHBG was. My highest was 120 before Danazol; my lowest was 12. I thought was too low.

Two months later, my SHBG increased to 26.76 on 50mg Danazol, so only a slight increase; substantially less than what I was imagining I would see. Also surprising, as I found previously that dividing the danazol dose into twice daily works substantially better. With the reduced dosage, I am only taking it once per day.
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HCT and HCG still high. AST, ALT, ALP all normal, which makes me very happy to see.

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I will continue taking the lower dose of Danazol until my next insertion (around the end of March). I expected my T-level higher than it was - so I am curious as to how the next four months will play out.

Erections are good with help; but they continue to go away and come back in 5 minutes; something originally believed to be blood flow/heart related which has been debunked by all the heart tests I recently completed.

I did another consult with an andrology doctor and his diagnosis was that the erection issues were in my head. I would be ok with that diagnosis, if they could explain what was in my head causing me to “think down” an erection in the middle of intercourse, only to “think it back up” 5 minutes later.

Anorgasmia continues to get worse. I had a massage day before yesterday from a regular massage therapist that could get an ejaculation out of a dead man in a morgue. I had her stop before the ending could be happy, because I was exhausted and knew it wasn’t going to get there.

One out of two isn’t bad, I guess. I am still getting erections; and I feel better than I did 18 months ago at the beginning of this TRT journey.

@NH_Watts
Sorry, I misread your post. The number on the right is not “RHR” … it is the fitbit “sleep score”; a calculation of how your sleep rated on a 100 point scale.

One of the interesting thing about sleep monitoring (non scientific, using fitbit, garmen, etc.), is that you are forced to realize that you REALLY are sleeping at night. Yet, I am awake 1-2 hours during my sleep cycle; and I average being restless more than 20 times per night!

It further proved to me that I am only getting half to two-thirds of the necessary REM and DEEP sleep each night. That was the reason I always complained in the morning that I “wasn’t sleeping” because I didn’t awaken refreshed.

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Have you considered dropping the Danazol and just going straight more T to get your free T levels where you want them? It’s very not scientific but I saw another persons thread where they felt worse adding Danazol with a lower dose of T even though it worked out the same free T wise. They felt better without (or perhaps with less, I can’t exactly recall) danazol + higher doses of testosterone.

No idea why but it seems you’ve tried about everything so thought I would throw that out there since you seem to still be having issues

Been there, done that. Brought T over 3000. SHBG increased. Danazol is still the answer for me. Nothing has controlled my SHBG like it.

According to the experts, my issues are all in my head at this point. But, when you weigh it all out - life is good now; substantially different from 2 years ago when I started writing on T-forums.
:man_facepalming:

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Although I posted a while back that I am so much better than when I started this journey 2 years ago, and that I accept the problems I can not seem to “fix” (anorgasmia, losing/regaining erections) … it doesn’t mean I haven’t stopped thinking.

I realize that I never thought about “adrenaline”.

25 years ago, I was a first-responder type volunteer. When I would get hot calls (lights-siren), my body temperature would change to the chills, and I would need to run the heater on the way to the call. I would also find myself beginning to shake (especially my leg). I always felt I must have had some type of lack of control over adrenaline dumps.

What was always so confusing to me was that I was NOT afraid, or fearful, or panic-stricken about what was happening. There was anticipation of course, but I always felt in control.

I did some reading and found other people with similar occurrences, which has made me want to explore more.

People are also quick to point out “panic attacks” but I found a recurring theme that does not fit in my circumstances. People who suffered panic attacks all commented later that “they wanted to die” during the attack, and that is what set it apart. I have NEVER felt like this.

This HAS become worse as I age. Recently, I had a argument-by-text with a person who really angered me. I found myself shaking almost uncontrollably; my body temperature shifting to cold forcing me under the covers while fully dressed; and I could not control my hands and arms from shaking.

I want to point out that this was a text argument, and I was alone in the room, lying on the bed. I was in no physical danger and had no fear of being in danger - at that moment or later. The SUBJECT of the argument was about my step-kids and this person said things that set me off.

Why this is important now? I am realizing that part of my erection issues is due to the feeling I have described above.

Tonight I was sitting on the couch waiting for a regular FWB to arrive at my place. I was excited that she was coming over again as I haven’t seen her in a while, had taken Viagra shortly before, and had an erection while thinking about our last time together. (My “relaxation”, “meditation”, and “happy thoughts”!)

All of a sudden, without warning, my hands went cold, and my heart rate and breathing increased. The erection disappeared like a turtle’s head. There was nothing that I thought of to justify a “fight or flight” adrenaline rush.

There should be NO anxiety. And I AM thinking “happy, relaxing, thoughts” – I’m about to get laid. And no, there is no performance anxiety. She is not with me yet – performance anxiety would be more appropriate if she was here and I couldn’t perform.

Ten minutes later, she arrived, and my body began functioning again as it should, and all symptoms of the “rush” were gone … and we had a successful time together.

Sitting on the couch, feeling what I assume to be an adrenaline dump is what me think about writing this.

I am aware that adrenaline (aka epinephrine) is tied to adrenals and cortisol/cortisone, and also tied to the Pituitary. I already had an MRI of the pituitary, as well as multiple tests of cortisol.

Aldosterone, also a contributory factor, was tested and came in mid-scale acceptable.

The epinephrine blood test I took returned a “higher than normal” reading, but when combined as part of the catecholamines, the tests were considered normal. At the time, I was concentrating to Dopamine, thinking it might be causing my problems, without giving fair thought to epinephrine/adrenaline.

The tumors that could be involved all cause high-blood pressure along with other symptoms. I have low-blood pressure.

Every blood lab has different ranges, and that makes research on the internet frustrating. One major teaching hospital shows “normal” epinephrine" levels as being ONE-THIRD of my level; indicating that I have very high levels.

Also, adrenaline causes a release of glucose, which a fight-or-flight response would use. When no danger is present, that extra energy has no use, and this can leave the person feeling restless and irritable. Excessively high levels of the hormone due to stress without real danger can cause heart damage, insomnia, and a jittery, nervous feeling.

I have never relayed these occurrences to my doctors, nor considered their importance. I have NO rage issues; and generally, I can’t say I have any anxiety issues. And most of the time, there is no anger involved at all.

I plan to take a urine based catecholamines test in 1q20 and compare the results to my blood test. One doctor suggested that a urine test was more informative. I hope that it provides me with information to help me understand my situation.

It sounds like panic disorder. Are you a caffeine user? I realize its a simple question after your diatribe but it wasn’t mentioned. Do you have an endocrinologist you see?

Eliminated almost all caffeine (get some from dark chocolate and a diet coke) and all sugar about 3 years ago. Do not drink alcohol or smoke. Have submitted history and blood results to multiple specialists (perhaps 12), both in person and through online consults; and have seen two endocrinologists in person who waved the white flag.

My issue is with the term “panic disorder” … because it applies to periods of “intense fear” and/or a “fear that something bad is going to happen”. Neither condition applies. Even anxiety is defined as “worry, distress, or fear” — none of which I experience as part of my problems. I don’t have OCD (to the best of my knowledge); I don’t have PTSD; and I don’t have “social phobia”. I enjoy speaking in front of people on topics that interest me.

I know that intense anger can trigger it. However, other than the ONE instance of anger I expressed, I can’t tell you another instance in the past year involving intense anger. I can be angry because you drank all the milk and put the empty container back in the refrigerator, but that won’t trigger any of the feelings I mentioned.
:slight_smile:

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@traveling-man - I read your previous post about adrenaline, etc and found that very interesting as I’ve had something similar happen too.

I posted this almost 1.5 years ago looking for some relief.

His response -

I did try what he recommended… It did help me relax quite a bit actually, almost too much. I was very tired.

I don’t take either if those things anymore though. As I’ve increased my dose and time has passed, I’ve become more confident in my performance and have less issues now. If it’s been a while and I’m going to try to have sex, I might take 1/4 of a 20mg lavitra and that usually helps me mind and body.

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Hi travelling-man,

(Excuse my english). I’m 40 years old and i measured 90 shbg in my last blood test. I msnaged to be on 800 total testosterone just taking zinc, magnesium, boron and exercising. But feeling no improvement at all. So I started taking 50mg danazol daily and been doing that for a month. As a result I didnt felt any change in my feelings. Unfortunately I didnt had a blood test after this try.

But in my case danazol alone, at least with that dosage , was still not enough. Now starting trt with 200mg week and still not feeling nothing, though I understand I need 5 more weeks to tell.

Regards

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Time for another update. I had a pellet insertion in September, 2019 (ahead of schedule) since I was flying out of the country.

I wrote previously that I still have problems that no one can address. Erections (my sexual arousal) still require Viagra to perform. And in previous posts I described my LIBIDO (my sexual desire) as the friendly dog who tries to hump the leg of every visitor to his house.

dog humping r

Yes, that was me — in my mind. In my mind, I was humping legs at every opportunity. Granted, I might not have been erect during all this mental humping, but my brain WANTED to hump; my libido was great and had not changed over the course of my life. I have always had libido (being horny).

The results of the blood work just before my pellet insertion showed my SHBG at 12; down from 104. I felt that was too low, and cut down on my danazol from 100 to 50 per day. I had no issues for more than two months.

In early December, I ran out of Armour thyroid medicine that the doctor was having me test; and decided to start my Iodine supplements when the armour was finished. I was very low on Iodine in a previous test.

Just after the middle of December, my libido tanked. I do not ever remember the feeling of having “no interest” in sex … I felt blasé; something in my brain wasn’t firing correctly and interest in sex was gone.

During this time, nocturnal erections continued as well as morning wood, yet I had no interest in a shaking of the sheets, or even a quick wank. It was brutal.

Fast forward to mid January 2020: My doctor requested I add thyroid tests to my schedule blood test to see if anything has changed.

Libido is still tanked. Blood results in the next post.

I was adjusting to the need for Viagra for every encounter, as well as the loss of erections in mid stroke – only to get it back 5-15 minutes later. It sucked, but I was doing my best to accept.

Losing Libido though? OMG. “Want to fuck?” … “oh, not really.” WHO SAYS STUPID THINGS LIKE THAT?? Yet that is what happens when your libido is gone.

Blood results … Testosterone is at normal levels for this stage of my cycle. Yes, I know it appears high to many of you but read my history before you comment.

SHBG levels. Considering I started this journey at 104, these levels are amazing. But what is TOO low?

January levels of free testosterone is at 2.53%

Thyroid levels

And now, Estradiol

Important takeaways – Sensitive Estradiol didn’t change since September 2019. Yet, in 2019, I had libido at full scale. Another important point is that for many years before I started this TRT-train, I had EXCEPTIONALLY low Estradiol. I wanted to allow it to free-flow for a while and see what happend.

Whether the Estradiol is behind my problems or not is something I can’t determine, however I have started taking my DIM supplements again.

As of right now, Jan 21, 2020, my libido is still in the toilet. I started DIM again and am debating whether to return to my full dose of Danazol, even though I don’t know how “low” low-shbg is.

Remember that it is usually LOW-SHBG PLUS LOW-TESTOSTERONE that creates erection/libido issues. Having one low, and one high alters the equation and makes case studies difficult to find.