HRT to Treat Adrenal Burnout & Low T - Advice?

[quote]James 21 wrote:
KSMan, you are very… very mistaken.

You misunderstand the phrase “tightly bound.” Studies show that SHBG retains its binding with testosterone for less than one hour.

The idea that SHBG “stealz ur tee” is so utterly moronic that I can’t be bothered to argue. SHBG prolongs the action of testosterone in the body and protects testosterone from early excretion or metabolization.

If you were correct, that the binding of testosterone to SHBG was irreversible, then you are asserting that the male body eradicates 98% of the testosterone that it creates, leaving only 2% to perform its function. This assertion reaches a mystifyingly and headache-inducing level of stupid that I just… I don’t know what to say.

[For the sake of accuracy, only ~60% of T is strongly bound, while ~%2 remains free and the remainder is weakly bound, which (according to studies) preserves it for an average of 18 minutes.]


The reality is that SHBG’s primary role is to transport testosterone. You will see this assertion within the first paragraph that you read about SHBG within any modern book on male endocrinology. It mediates the free to bound ratio of multiple hormones, has its own signaling pathways through SHBG-R, is sometimes absolutely required to signal the androgen receptors in certain tissues (yes, SHBG-T completes a signaling pathway) and most importantly – SHBG is the primary buffer (just like a testosterone ester) that prolongs the action of testosterone in the body, temporarily protecting it from metabolization and excretion, which is necessary due to the pulsatile nature of testosterone release.

SHBG does not steal, remove, eat, destroy, metabolize, or block testosterone. It protects it. It releases T back to the free form over time and/or through diffusion within certain target tissues. End of discussion.

Greetings from the other other board you mentioned. :wink:

Hi James, Only now I see your reply, damn me.
Have you seen my other topics on Meso? My god, Dr. Jim is the ultimate mf!
My Free Cortisol is below range, transcortin skyhigh, shbg bottom low, yet he implies my condition is purely mental and does so in an unspeakably insulting manner. This guy needs to have his attitude re-assessed, eventhough he might be one of the board’s main posters.

As for relating to both our conditions, I have read through practically all your posts.
There is a significant difference between you and me.
You have clinically low SHBG from youth with low T, small build, … .
I don’t. I was doing fine, building muscle quite easily, until I started messing up my life by using steroids, working night shifts, overtraining at the gym, high stress levels, … . The combination of these factors is what got me where I am now.

Regarding the SHBG, have you ever looked at CBG (transcortin)? The other binding protein, which mainly binds cortisol? My ratio is so fucked up it implies I must be suffering from adrenal induced hypothyroidism at a cellular/liver level, combined with a nice touch of adrenal fatigue (low DHEA/Pregnenolone). I therefore think that T3 (and not Armour/T4) will downregulate my CBG and upregulate my SHBG, or at least it should, if administered correctly.
Also, I need to detoxify my liver, will do so using regular coffee enema’s, milk thistle and possibly some Calcium-D-Glucarate, although I am suspicious about the last one reducing SHBG even further due to estrogen depletion.

I hear you have been doing some T3 experiments yourself?
Any luck on those yet?

Regards from Belgium.

Apologies for starting up this thread after many years of being dead, but there are many similar blood results to mine and I was wondering if you ever got to the bottom of the issues? I also have low am cortisol and high transcortin, plus a number of of other similar blood results. I started trt back in March but not doing so great at the moment and think I’m crashing due to adrenal and thyroid struggling.

Did you ever get this sorted? What meds/supplements worked for you???


TRT alone might not cut it. I use 15mg hydrocortisone and very low dose T3 alongside TRT every day and feel much better now, living a pretty busy life.
However, do not rely too much on blood results, supplements and medication.

Good resting, low intensity workouts, no excessive drinking/smoking, taking joy in what you do and choosing to not let stress or external influences get to you (!) will create more willpower and strength than any pill can. Named elements are the main contributors to good health, you are stronger than you might think.

Good luck.

Thanks for getting back to me with the update. Really appreciate that… Glad you managed to get back on track and am feeling better. I think you are right to a point about lifestyle and keeping stress as low as possible being more important to popping pills and taking loads of supplements. Stress does some crazy crap to our bodies and minds.

I have ordered some hydrocortisone tablets already as I think my low cortisol is definitely putting strain on my system and causing a lot of fatigue. These are my cortisol results.

Cortisol (8h) 19.6 ug/dL (7-25)
Transcortine + 74 mg/L (20-50)
Cortisol Free (8am) - 6.4 ug/L (10-30)

I found it interesting that your cholesterol results were similar to mine. My good cholesterol was low and bad high. And Triglycerides and CRP were also above range. My SHBG was very similar to yours too.

I also have the tinitus you mentioned you had. Did that ever get better for you?

I’m gonna try and follow your lead and see if I can get my adrenals functioning better and also thyroid. And also try and find the best TRT dosing and protocol that works for me.

Thanks again, and all the best!