T Nation

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

When you do not have a “normal” case, you tend to spend a lot of time reading and wondering. Please note – my feelings are about MY case, MY situation – I am not suggesting they apply to anyone else.

I wrote in the beginning that I am using this forum to document my journey and allow others to see what I have worked through. That is the point of making posts like this showing my current thoughts.

The initial hypothesis, agreed to by “just about everyone” including Dr Crisler, was that I needed to “throw more Testosterone” at the SHBG to lower it. And that my “high testosterone numbers” were “inflated due to high SHBG”.

I am starting to believe that this may have been invalid. Here is why …

Total Testosterone:

From my Nov 2017 post:
My TT maxed out at 1351. My 8 year average is 1051. The High TT is another factor that has baffled the doctors when taken as a whole with the other blood results.

This was my NATURAL Testosterone. I was not on, nor had I ever been on TRT.

During that same time, my SHBG went as high as 120 nmol/L (ref: 20.6-76.7). In other words, my insanely high T levels had no effect on the insanely high SHBG. Yet “everyone”, including me, hypothesized that the Testosterone numbers were “artifically inflated” due to the high SHBG.

I am having a difficult time believing that now.

Under TRT, my testosterone climbed first to 1411 ng/dL, and then to 1441 ng/dL. SHBG did NOT decrease. In fact, it actually INCREASED. I have searched the internet and I RARELY see Testosterone go much higher. LabCorp for example, stops calculating at 1500, and shows the result as “>1500”. My doctor has stated that he doesn’t think Testosterone should be brought to a higher level than where I am now.

Here is where I think I may have made a mistake.

  1. My natural Testosterone levels were high. In hindsight, my T levels were not the problem.
  2. “Everyone” believed that throwing more Testosterone at the SHBG was the answer. I agree that is the best course of action for low T, but I am not sure now, whether it was the right course of action for High T.
  3. SHBG has always been the problem, not T. I wish the doctors would have suggested I take something to lower the SHBG FIRST. It wasn’t until we realized that increasing Testosterone wasn’t going to solve the problem did I get support on adding medicine (in my case Danazol from my US doctor; although my original doctors could have prescribed proviron because it is legal in my non-US location). But no one was talking about drugs to lower SHBG.

And contrary to posts on this thread, it wasn’t my Ambien, or my almonds, my cortisol, my food plan, or my BPA that was effecting my SHBG. As I eliminated these things and more, SHBG increased.

It wasn’t until the probiotics and the Danazol that my SHBG dropped dramatically. I list them both because I started them both at the same time and can’t rationally state that one or the other caused the SHBG to drop. (Later of course, I proved it was the Danazol without question).

I will be away from my BioTe doctor for a total of 4 months since my last booster insertion. I am really interested to see what my T levels do during this time – especially since my insertion “bump” feels almost non-existent after one month. I will be scheduling regular blood work.

After a few months, I will check LH/FSH to see if my T levels are still from the pellets or whether my testicles have begun producing again.

I can understand your confusion but you have missed something in your research. Naturally we produce a lot less testosterone on a weekly basis then we are injecting at any one time on TRT, so injecting (example) 140mg of testosterone at one time will cause your testosterone peak to be substantially higher then if you had naturally produce testosterone. It is this very large dose of testosterone then drive down overly high SHBG.

It’s the peaks themselves that are higher not the testosterone, this is what forces down SHBG.

Yet there are virtually NO blood results on this or other boards showing Testosterone numbers higher than I have mentioned. And unless you are juicing for bodybuilding, you will rarely read any suggestions to increase your T levels over 1500.

For the average male, 1000ng/dl corresponds to about 150mg to 200mg of supplemental testosterone per week, depending on the individual’s metabolizing ability. Source

At 1500 which for most people would be about 200 mg a week

So based on this information, your example of 140mg injection, would likely give you 1400 T levels at the PEAK of your injection, with much lower rates at the valley. My T is currently at 1441 ng/dL stable. My stable T is higher than the peak of the average injection.

High testosterone levels like this [>1500] could be ok if you have high SHBG/free T. Because if you can’t bring SHBG down you have to increase T high enough to compensate.

I’m actually not confused and can support what I am seeing with labs. The last quote has a very interesting comment – if you can’t bring down the SHBG, you have to increase T high enough. Comments like that reinforce my thought process that I should have tried Danazol or Proviron to lower SHBG before undertaking TRT.

Another forum poster commented “More T doesn’t mean lower SHBG for everyone.” And that is what I see. It wasn’t until my T levels were over 1400 that my doctor realized that something else needed to be done as T supplementation alone wasn’t working.

My labs: Sustained High T levels did NOT reduce my shbg.

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I actually like helping people on this forum. But I got to say it’s getting a little frustrating reading the INSTRUCTIONS SOME members give that should not be given based on a small picture.

I’ve said this before I hate when we tell guys in their 20s to go on trt without trying anything else.

You just stated fact before and summarized your own personal journey and were told you are confused?? That’s not helpful. There is no cookie cutter explanation on most things when it comes to trt. Esp taking .50 dex at time of a 50 mg injecting which appears to cause many to crash e2.

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Did you see this from @physioLojik not sure it applies to you …

Yea also high levels of cortisol drive shbg up. Don’t know if that was mentioned. That means not just life and emotional stress, but also environmental allergies and food intolerances.

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I can’t tell you how many times I have answered the question about “How much stress do you have in your life?”

“Well, other than my penis not wanting to jump to attention on my schedule, I’m pretty stress free”

Haha great answer. Have you ever had a food intolerance assay run? They’re extremely helpful.

We are not talking about testosterone levels, we are talking about testosterone peaks. If a guy starts out injecting 100mg once weekly and then starts injecting 150mg once weekly, his peaks will be higher, it’s this “momentary peak” that drives down SHBG and not the total testosterone level. Sustained high Total T levels do little to lower SHBG, it’s those peaks 24-48 hours after injection that lowers SHBG.

So you’re just going to invalidate everyone’s clinical experience dealing with high SHBG? Wow! I believe you’re letting your ego get the best of you thinking you know better than “everyone” including countless doctors clinical experience. Geez…

I told you from the beginning that pellet therapy wouldn’t be enough to lower your SHBG enough to matter, ideally you need to hit 3% on your free T and it’s never going to happen on pellets. The release of testosterone is slow and sustained great for a low SHBG guy, you need the impact or jolt of larger peaks and valleys that injections provide. When free T isn’t optimal erections will always take a back seat.

Yes, you also told me that Ambien was the source of ALL my problems and we have found that not to be true either.

You also told me you cannot “optimise dosages on pellets” and you must wait several months to adjust dosage, which I also proved is wrong.

And then you said it is the peak that drives down SHBG, not the T level. Where do you get that because every article says it is the T level.

From an online doctor site
When your testosterone level is the highest, is referred to as the “peak.” When your testosterone level is the lowest, is referred to as the “trough.”

But this is the part that I won’t sit back and take.

I started the post by saying this is based on MY experience with MY labs in MY situation. I didn’t attempt to invalidate anyone’s research. You are probably a very knowledgeable person, but you are offensive in your writing, and your personal attacks (“wrong move”, “you are confused”, and “letting your ego get the best of you”) make you less believable. I would think it makes people not want to post – especially anyone with pellet experience.

I am sharing my experience, my labs and my thought process on this journey. You have made your opinions clear. I am making all the wrong decisions. Move on.


I have not had a food intolerance assay run … nor did I take the test for leaky gut (both of which I would like to do).

Considering my stomach issues, I think both tests would be interesting.

Since I can’t see what is done to me during the pellet insertion, I went to YouTube and watched a BioTE pellet insertion. It is completely different than what it “feels” like. (Obviously, this is NOT me).

Wow…that was way more brutal than I thought it would be. Not sure why I expected rice grains into a small nick into the tissue.

It doesn’t feel like that; although that is probably indicative of the actual treatment I had, it doesn’t feel that “rough” when it is happening. My doctor described the pain as similar to someone kicking you in the ass with their knee. I would agree that is a good description. However, it didn’t effect my sitting in the car, or office, or other things I needed to do.

And yes, the pellets are just slightly larger than rice grains. One of the side effects is extrusion – when the pellets push out through the skin. Supposedly, the “hard pushing” you see is to make sure that the pellets don’t try to back out on their own.

I’m glad I didn’t watch the video before my first insertion. :slight_smile:

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Proviron is LEGAL where I am outside of the usa and I have switched to proviron from danazol today.

I found this article elsewhere and I thought it was so informative I would add it:

"Mesterolone is an orally active, 1-methylated DHT. Like Masteron , but then actually delivered in an oral fashion. DHT is the conversion product of testosterone at the 5-alpha-reductase enzyme, the result being a hormone that is 3 to 4 times as androgenic and is structurally incapable of forming estrogen. One would imagine then that mesterolone would be a perfect drug to enhance strength and add small but completely lean gains to the frame. Unfortunately there is a control mechanism for DHT in the human body. When levels get too high, the 3alpha hydroxysteroid dehydrogenase enzyme converts it to a mostly inactive compound known as 3-alpha (5-alpha-androstan-3alpha,17beta-diol), a prohormone if you will. It can equally convert back to DHT by way of the same enzyme when low levels of DHT are detected. But it means that unless one uses ridiculously high amounts, most of what is administered is quite useless at the height of the androgen receptor in muscle tissue and thus mesterolone is not particularly suited, if at all, to promote muscle hypertrophy.

Proviron has four distinct uses in the world of bodybuilding. The first being the result of its structure. It is 5-alpha reduced and not capable of forming estrogen, yet it nonetheless has a much higher affinity for the aromatase enzyme (which converts testosterone to estrogen) than testosterone does. That means in administering it with testosterone or another aromatizable compound, it prevents estrogen build-up because it binds to the aromatase enzyme very strongly, thereby preventing these steroids from interacting with it and forming estrogen. So Mesterolone use has the extreme benefit of reducing estrogenic side-effects and water retention noted with other steroids, and as such still help to provide mostly lean gains. Its also been suggested that it may actually downgrade the actual estrogen receptor making it doubly effective at reducing circulating estrogen levels.

The second use is in enhancing the potency of testosterone. Testosterone in the body at normal physiological levels is mostly inactive. As much as 97 or 98 percent of testosterone in that amount is bound to sex hormone binding globulin (SHBG) and albumin, two proteins. In such a form testosterone is mostly inactive. But as with the aromatase enzyme, DHT has a higher affinity for these proteins than testosterone does, so when administered simultaneously the mesterolone will attach to the SHBG and albumin, leaving larger amounts of free testosterone to mediate anabolic activities such as protein synthesis. Another way in which it helps to increase gains. Its also another part of the equation that makes it ineffective on its own, as binding to these proteins too, would render it a non-issue at the androgen receptor.

Thirdly, mesterolone is added in pre-contest phases to increase a distinct hardness and muscle density. Probably due to its reduction in circulating estrogen, perhaps due to the downregulating of the estrogen receptor in muscle tissue, it decreases the total water build-up of the body giving its user a much leaner look, and a visual effect of possessing “harder” muscles with more cuts and striations. Proviron is often used as a last-minute secret by a lot of bodybuilders and both actors and models have used it time and again to deliver top shape day in day out, when needed. Like the other methylated DHT compound, drostanolone, mesterolone is particularly potent in achieving this feat.

Lastly Proviron is used during a cycle of certain hormones such as nandrolone , with a distinct lack of androgenic nature, or perhaps 5-alpha reduced hormones that don’t have the same affinities as DHT does. Such compounds, thinking of trenbolone , nandrolone and such in particular, have been known to decrease libido. Limiting the athlete to perform sexually being the logical result. DHT plays a key role in this process and is therefore administered in conjunction with such steroids to ease or relieve this annoying side-effect. Proviron is also commonly prescribed by doctors to people with low levels of testosterone , or patients with chronic impotence. Its not perceived as a powerful anabolic, but it gets the job done equally well if not better than other anabolic steroids making it a favorite in medical practices due to its lower chance of abuse.

Mesterolone is generally well liked nonetheless as it delivers very few side-effects in men. In high doses it can cause some virilization symptoms in women. But because of the high level of deactivation and pre-destination in the system (albumin, SHBG, 3bHSD, aromatase) quite a lot of it, if not all simply never reaches the androgen receptor where it would cause anabolic effects, but also side-effects. So its relatively safe. Doses between 25 and 250 mg per day are used with no adverse effects. 50 mg per day is usually sufficient to be effective in each of the four cases we mentioned up above, so going higher really isn’t necessary. Unlike what some suggest or believe, its not advised that Proviron be used when not used in conjunction with another steroid , as it too is quite suppressive of natural testosterone, leading to all sorts of future complications upon discontinuation. Ranging from loss of libido or erectile dysfunction all the way up to infertility. One would not be aware of such dangers because Proviron fulfills most of the functions of normal levels of testosterone.

Stacking and Use:

Mesterolone is an oral alkylated steroid. If used primarily as an anti-aromatase drug, using it throughout a longer cycle (10-12 weeks) of injectables may elevate liver values a little bit, though much, much less than one would expect with a 17-alpha-alkylated steroid. Eventhough instead of inhibiting gains, mesterolone may actually contribute to gains. So that’s a bit of a shame. Its not quite as toxic since its not alkylated in the same fashion, but at the 1 position, which reduces hepatic breakdown, but not like 17-alpha alkylation. The reason for the change of position I assume, is because alkylating at the 17-alpha position has been shown to reduce affinity for sex hormone binding proteins. This would in turn decrease its ability to free testosterone. Nonetheless the delivery rate is quite good. Its taken daily in 50-100 mg doses.

The best thing to stack it with is testosterone of course. Its most easily bound to SHBG and albumin, and deactivated for up to 98%. Since the DHT can compete for these structures with higher affinity it would naturally lead to a higher yield of whatever testosterone product you stacked it with. Since DHT levels are notably higher now there is also more stimulation of the androgen receptor causing more strength gains, and because of its affinity for aromatase the overall estrogen level decreases as well. This has as a result that gains are leaner, and once again the overall testosterone yield is increased as less I converted at the aromatase enzyme.

It’s of course used in other stacks with products such as methandrostenolone , boldenone and nandrolone to reduce estrogenic activity and increase muscle hardness. The addition of proviron makes boldenone a dead lock for a cutting stack and for some may even make it possible to use nandrolone while cutting, although the use of Winstrol or a receptor antagonist in conjunction is wishful as well. The benefit of adding it to a nandrolone stack is that it may also help you reduce the decrease in libido suffered from nandrolone, since the latter is mostly deactivated by 5-alpha reductase, an enzyme that makes other hormones more androgenic."

I have blood work and will post it shortly.

PS: proviron … "Originally developed as a drug for treating depression in men, " … !!

I stopped Danazol and started Proviron 25mg today. Based on all the reading, it looks like I should take 25mg am and 25mg pm. For at least the first week, I plan on 25mg per day only.

Blood Work 5-28-18
Albumin 4.83 g/dL (3.5-5.2)
Testosterone 1093 ng/dL (193-740)
Free Testosterone 15.4 ng/dL (5.33-12.59)
SHBG 69.34 nmol/L (20.6-76.7)
Free Testosterone Percent: 1.4% (1.23-2.59)

I am away from the doctor for three or more months. I know my T will continue to drop, but am willing to experiment to get a feel for how much I lose each month. My body is absorbing the BioTE pellets like they were tictacs.

Quick Summary:
March 3, pellet insertion

3-29-18 (?) blood work: T at 1411; shbg at 97.2; free t at 1.13%
4-13-18 booster pellet insertion; 4-15-18 started danazol
4-28-18 blood work: T at 1441; shbg 60.4; free t at 1.74%
5-28-18 blood work: T at 1093; shbg 69.34; free t at 1.4% (25% drop in T at 2 months)
shbg increased.

Libido and an attentive penis have not returned.

My appetite has gone berserk. I want to eat huge meals multiple times per day, which is both unusual, and not what I wanted.

Quick Summary:

3-3-18 pellet insertion
3-29-18 (?) blood work: T at 1411; shbg at 97.2; free t at 1.13%
4-13-18 booster pellet insertion; 4-15-18 started danazol
4-28-18 blood work: T at 1441; shbg 60.4; free t at 1.74%
5-28-18 blood work: T at 1093; shbg 69.34; free t at 1.4% (25% drop in T at 2 months)
shbg increased. Started proviron; stopped danazol.
6-25-18 blood work: T at 762; shbg 101.1; free t at .9% (50% drop in T at 3 months)
shbg increased. Stopped proviron; started danazol at 2 caps per day.

I knew I would feel like shit during this experiment. And I do … (just in case that makes anyone happy!). Plus … 100mg Viagra does NOTHING.

I haven’t given up on Proviron, but I think my overall SHBG is too high for it. I think guys with elevated (but lower) SHBG might do well. The reviews of it were outstanding.

I have decided to restart danazol at an increased dosage. I will start with 2 caps, although I read where “serious” cases should start at 3 caps for 90 days.

I wondered about proviron and danazol at the same time, but I did not find ANY references to the two drugs being used simultaneously.

Blood Work 6-25-18
Albumin 4.79 g/dL (3.5-5.2)
Testosterone 762 ng/dL (193-740)
Free Testosterone 7.15 ng/dL (5.33-12.59)
SHBG 101.1 nmol/L (20.6-76.7)
Free Testosterone Percent: 0.9% (1.23-2.59)
Estradiol (NON-sensitive): 28.8 pg/mL (25.8-60.7)

I expected my SHBG to rise, but not THAT much. Proviron supposedly doesn’t lower the actual number, but opens a binding site to free Testosterone. That didn’t work for me. My highest ever SHBG was 104, and that was NO meds, NO Test, NO supplements or vitamins, NOTHING.

This is my second highest SHBG EVER, and I’m still taking a ridiculous amount of medicine and supplements. Seeing the SHBG climb this high was a real disappointment. It appears that 1 danazol capsule brought SHBG down during the first trial by 30 points (I was at 97.2 immediately before Danazol). Now I will test 2 capsules daily and see if I made any progress.

I will continue to update on this journey.

Nothing has changed in the past two weeks. As of today, I have not noticed any changes due to the increased dosage of Danazol.

However, because of the change in dosage, I am running out of Danazol. Surprisingly, I can’t buy it anywhere but the hospital, so that required me to meet a new doctor to obtain a prescription.

I was very impressed with her answers and her willingness to both listen and read the results I have provided. Whether she can help me in any way is yet to be seen – but it is nice to find a doctor that you feel comfortable speaking with and seems excited to take on cases that are slightly out of the ordinary.

She has requested a four-day-part Saliva test. I completed this test in early 2017 but agreed to take it again if she thinks it will help her to diagnose. She is intrigued at what “inflammation” in my body is stimulating the SHBG. She wants to have another look at the Adrenals.

She also refilled my Danazol as I requested. I still won’t see my main US doctor for one month.

I continue to use this thread as a “diary” of my journey. When there are any changes, I add them to the thread with as much information as I have at the time.

Quick Summary:

3-3-18 pellet insertion
3-29-18 (?) blood work: T at 1411; shbg at 97.2; free t at 1.13%
4-13-18 booster pellet insertion; 4-15-18 started danazol
4-28-18 blood work: T at 1441; shbg 60.4; free t at 1.74%
5-28-18 blood work: T at 1093; shbg 69.34; free t at 1.4% (25% drop in T at 2 months) shbg increased. Started proviron; stopped danazol.
6-25-18 blood work: T at 762; shbg 101.1; free t at .9% (50% drop in T at 3 months) shbg increased. Stopped proviron; started danazol at 2 caps per day.
7-30-18 blood work: T at 444; shbg 33.2; free t at 1.9; (70% drop in T at 4 months)

Another way to look at this: Each month I have dropped 25-40% in testosterone from previous month) using pellets.

This month’s blood results are the most puzzling so far.

To keep everything documented here, I underwent a “hemorrhoid sclerotherapy”. It was 66% effective, but I will need to repeat it in a few months. There is no documented tie between hemorrhoids and SHBG, but I list it anyway.

After last month’s “failure” of proviron, I have been taking 100mg per day of Danazol after speaking with my USA doctor.

However, I decided to try something else, but didn’t inform my doctor. For the past three weeks, I have been adding an additional 50mg Danazol every other day, plus proviron EVERY day.

I was quite horny, especially for the first few days. But it still took a 100mg Viagra to run the race. In the last 4-5 days before the blood work was done, I was taking 150mg Viagra to get the job done. That is the strangest part of the experiment.

Blood Work 7-30-18
Albumin 4.88 g/dL (3.5-5.2)
Testosterone 444 ng/dL (193-740)
Free Testosterone 8.55 ng/dL (5.33-12.59)
SHBG 33.20 nmol/L (20.6-76.7)
Free Testosterone Percent: 1.9% (1.23-2.59)
(I forgot to test Estrogen)

My SHBG dropped to 33.2 from 101.1! That is amazing.

My T-level of 444 is the lowest T-level in my life - and I feel it.

I am equally shocked at the Free T Percentage of 1.9%. That is the highest since I have been testing (10 years). That should have provided lots of spontaneous erections, but it didn’t. I would have anticipated much better erections without Viagra with this level of free t %.

Orgasms were elusive. Sex ended out of exhaustion rather than climax.

What is my next step?

I have stopped taking danazol and will stay off for 30 days. I want to know if it returns to my insane levels as before or not.

I will be visiting my doctor for a pellet insertion. I don’t know if he will agree, but what I think needs to happen is this:

  • I felt my best when my t-level was over 1400. To account for the monthly drop of T, I would need to start off with a mega boost … how high he will let me go is still to be discussed.

  • BTW: discussion of ultra high TRT: http://compassionateoncology.org/pdfs/HDTRT9.pdf

  • After the 30 days is over, and my blood is tested again, I will return to 100-150mg of Danazol per day to reduce the SHBG. I will not be using Proviron since I am in the USA. The second month will give me a chance to see what the higher dose of Danazol (ALONE) does for my shbg. This should tell me if the addition of Proviron played a part in the lowered SHBG or not.

I am really curious what my results would be when my T levels are higher – combined with the higher Dananzol dosage. That is what I hope to watch for and test.

At the end of 3 months, I will return to the doctor for another pellet boost. I think we agree that 3 months is the longest I can go without a boost.

Whether we can control the monthly drop is yet to be seen.

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Update posted. Tagged as requested.