T Nation

Injection Protocol for People with Low SHBG


#1

Few words about me :

-age - 25
-5' 7.5'' 163 lbs
-slightly bald
-rare beard
-a bit of fat at the low belly
-been using drugs and AAS 5-7 years ago
-in the last 3-4 years had a diet of 80% protein + 20%carbs most of the time!
-currently - Hipogonadism - TRT from 3 months/Testim gel(1 tube/day)

Latest lab tests :
Estradiol : 102.2 pmol/L (28-156)
FSH : 0.321 mUI/mL
Total T : 15.98 nmol/L (9.9-27.8)
SHBG : 6.95 nmol/L (14.5-48.4) LOW
Free T : 0.068 nmol/L (0.015-0.145)

Since starting TRT,improvements only in sleeping(no more insomnia) and libido!
Still feel fatigued,brain fog,anxiety,panic attacks,depression,headaches..

Next week I will switch from gels to injections! I need your help please!

Which protocol do you think it will suit me for a SHBG of 6.95 nmol/L ?

-15mg ED (105mg/week) ?
-25mg E2D (100mg/week) ?
-35mg E3D (105mg/week) ?
-50mg E3.5D (100mg/week) ?

Anyone with Low SHBG injecting with success??

Next week I will go for a scan for adrenals and soon I will make a Full Thyroid Panel as well!


#2

I’ve read recently (little bit on here, mostly elsewhere) that Test Prop could possibly be better for those with low SHBG- so you may want to consider that. if anything- it will be just as good, it won’t be worse than Cyp. in the case of Prop, 100mg per week in ED or EOD dosing seems to work for most. ED would then be ~15mg/day, EOD would be ~30mg.

from what I’ve read, I don’t get the ED or EOD injections of Cyp


#3

[quote]dez6485 wrote:
I’ve read recently (little bit on here, mostly elsewhere) that Test Prop could possibly be better for those with low SHBG- so you may want to consider that. if anything- it will be just as good, it won’t be worse than Cyp. in the case of Prop, 100mg per week in ED or EOD dosing seems to work for most. ED would then be ~15mg/day, EOD would be ~30mg.

from what I’ve read, I don’t get the ED or EOD injections of Cyp[/quote]

Thank you for your reply!
So,Test Prop would be fast ester, and Test Cyp looong ester? I think my doc already ordered Test Cyp, so I will have to use the first dose as Test Cyp and after I will switch on Test Prop! Let’s see how it goes …I guess I will have to experiment…


#4

Any T ester is converted to bio-identical T in your body. Long esters have slower release curves, but if you inject frequently, T cyp will provided quite steady levels. So no need to worry about other T products that might be more costly.

Your FT will go high, but more FT should increase FT–>E2 and SHBG may increase. You can only start with a protocol and keep it steady so you know what labs represent then refine from there.

If you were not absorbing gels, that might be indicating a thyroid problem. See these stickies:

  • advice for new guys
  • thyroid basics
    – check your body temperatures, these can be more important than lab work
    – have you been using iodized salt for years?

#5

[quote]KSman wrote:
Any T ester is converted to bio-identical T in your body. Long esters have slower release curves, but if you inject frequently, T cyp will provided quite steady levels. So no need to worry about other T products that might be more costly.

Your FT will go high, but more FT should increase FT–>E2 and SHBG may increase. You can only start with a protocol and keep it steady so you know what labs represent then refine from there.

If you were not absorbing gels, that might be indicating a thyroid problem. See these stickies:

  • advice for new guys
  • thyroid basics
    – check your body temperatures, these can be more important than lab work
    – have you been using iodized salt for years?
    [/quote]

Thanks KSman,that is very valuable information!

I have done a thyroid scan 3 months ago,doc said nothing`s wrong,TSH tested twice : 4 months ago : 1.50 mIU/L (0.27-4.20 mIU/L ) , 3 months ago : 1.05 uUI/ml (0.27-4.2 uUI/ml), somehow I do not trust that scan and I know TSH it is a pituitary hormone,that stimulates the thyroid gland…so for more info I know I need a full Thyroid Panel. I have checked my body temp just now : 96.62 degrees Fahrenheit, I will do again tomorrow morning as well! Regarding the iodized salt,to be honest I haven’t used that much in the last few years! I have bought a 12% Iodine solution,which contains (Iodine,Potassium Iodide,distilled water). Should I use it or not? It says that : DO NOT USE IF YOU HAVE THYROID/RENAL problems…

Regarding the injections,I will consult my doc as well for a 30mg E2D protocol(120mg/week) and make test again after 6 weeks on Total T, Free T,Estradiol right? and adjusting from there… thanks a lot for your help! I really appreciate!


#6

The issue with iodine is the perception that is can create new cases of thyroid autoimmune diseases. But in reality, it uncovers pre-existing cases. With a selenium deficiency, normal thyroid function creates free radicals that damage normal thyroid tissues and sometimes the body has an autoimmune response to the damaged tissues. So it is recommended that one have an identifiable source of selenium which can be had in a good quality multi-vit that contains other trace elements and iodine.

In any case, you do not want to be iodine deficient.

Labs:
TT
FT
E2
PSA if older


#7

Thanks KSman , Just got my results for 24 hour urine Cortisol : 388.8 nmol/24h ( 100 - 379 )

ACTH : 49.48 pg/mL (7.2- 63.3) -was tested one week before ‘’ 24 h urine Cortisol ‘’

Now what should I do next?


#8

I would be concerned with the low body temperatures [more readings?]. You will feel better if you do something that restores thyroid function and metabolic rate that would restore body temperatures. So you can try IR or a lifetime of Rx thyroid drugs.

If one has known/proven thyroid auto-immune antibody issues, then taking iodine can be an issue, but perhaps not with ample selenium.

Need to see the thyroid labs: to see if fT3 is good which then suggests that rT3 is leading to the low body temperatures and that would connect to cortisol and adrenal issues.


#9

[quote]KSman wrote:
I would be concerned with the low body temperatures [more readings?]. You will feel better if you do something that restores thyroid function and metabolic rate that would restore body temperatures. So you can try IR or a lifetime of Rx thyroid drugs.

If one has known/proven thyroid auto-immune antibody issues, then taking iodine can be an issue, but perhaps not with ample selenium.

Need to see the thyroid labs: to see if fT3 is good which then suggests that rT3 is leading to the low body temperatures and that would connect to cortisol and adrenal issues.[/quote]

Low body temperatures :
10.30 - 96.44 F
12.30 - 97.52 F
14.30 - 97.7 F
16.30 - 97.52 F
18.30 - 97.34 F
21.00 - 96.98 F
22.30 - 96.26 F
00.30 - 97.52 F

Ok,so correct me if I am wrong,please, the ROOT cause of this hormonal imbalances(high cortisol,low t,low shbg,etc) may be THYROID. Once I will treat THYROID everything may go back to normal? I have read that symptoms of HYPOTHYROIDISM are almost the same in HIPOGONADISM!

‘’ Hypothyroidism is one of the most under diagnosed and under treated conditions in our society today.

You should know that Hypothyroidism has many of the same symptoms as low Testosterone and can cause Hypogonadism as well. ‘’

Thanks man.


#10

Sorry to but in,

But why is low SGBH a bad thing when on TRT? Surely it just equates to better bioavailable free T levels?


#11
    I have done a scan for adrenal glands, and doc said everything looks perfect, no need to worry about any tumor or something like that..also a dexamethasone suppression test and thyroid as well, I would appreciate your thoughts on the following please :

Thyroid :

FT4 - 20.87 pmol/L (10.6 - 22.7)

FT3 - 5.1 pmol/L (3.4 - 6.8)

TgAb - < 10 UI/mL â?¤ 115

TPO - 15.27 UI/mL < 34

Dexamethasone supression test - Cortisol (serum) :

Yesterday morning at 8:00 a.m - 830.3 nmol/L ( 7 - 10 a.m : 171 - 536 )

On the same day at 23:00 p.m been taking two tablets (0.5g each) of dexamethasone.

Today morning at 8:30 a.m - Cortisol serum - 26.2 nmol/L ( 7 - 10 a.m : 171 - 536 )

So , I guess I do not have to worry about Cushing disease or something like that right?

I am still on the gel for TRT , and soon, I will see a new doctor which I hope will be more opened to different forms of TRT.