Is Metformin Killing my TRT?

Hey Guys,

I’ve been a member here for a long time but haven’t checked in for a number of years.

I’m a 62YO male who has been on TRT for ten years or so.
Current protocol is to inject .5 ml T-cyp twice weekly, .25 ml HcG twice weekly
and .5mg anastrozole with my bi-weekly injections.

About 4-5 years ago I started taking metformin for longevity (I do not have diabetes
or any sort of A1C problems but it seems that I’ve clearly been insulin resistant
as I’ve grown older). When I first went on it I thought it was great…immediately
shed some weight, became leaner, etc.

But a couple of years ago (mid covid) my labs showed that my SHBG was thru the roof.
I did a bit of research and read on the internet that metformin can contribute to
elevated levels of SHBG. So I went off of it.

Unfortunately, due to a perfect storm of sh%t at the time I also had to go off TRT
entirely (insurance issues) and of course there was covid which kept me from the
gym (and apparently I was too f-ing lazy to work out at home.) Anyway, during a period
of about 9 months I gained weight and developed some noticeable visceral fat
under my sub-q fat.

About a year ago I went back on TRT (T-Cyp + HcG), started cycling again…everything same as
before except for the metformin and anastrozole. (Doc had some concerns about
anastrozole and heart disease.) I do HIIT road cycling every other day and did about
100 miles per week last summer (total about 2100 miles for the season) but it
didn’t seem to move the needle on my weight or stomach fat.

A couple of months ago I learned on the internet that berberine can attack insulin
resistance possibly as well as metformin, so I gave it a try. Three months later, no response
as I could tell…at least as compared to metformin which seemed to slim me/shed weight
almost out of the gate.

So, my doc and I decided to test out metformin again to see how my labs would result.
(and as estradiol was a bit high, I went back on anastrozole).
We took a labs baseline first.
The answer was the expected slimming effect, weight loss, visceral fat reduction, etc.
during my riding season (which began about May 1). But my labs follow up last week
were disappointing. SHBG up and Free T/Bioavail T % down.

Any thoughts, questions, advice dudes? I’m sure some of you might want specific
numbers…which I can provide as a followup (this message is already too long).

Thanks for anyone who chimes in!

How do you feel? High SHBG isn’t something I’d be that worried about. I wouldn’t want low SHBG.

I guess as long as Free T was good, and I felt good, I’d continue on and not worry about the number on the paper for SHBG.

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Labs before / after metformin?
fT measured how?

On exogenous T increasing SHBG does not cause lower absolute fT.

Lower %fT (fT/TT)? yes. Lower fT (ng/dl)? No.

You set your fT by your dose which is regulated by your clearance rate of fT.

With endogenous T production there is no evidence that high SHBG lowers absolute fT either. %fT (ft/TT)? Yes. Absolute fT? No.

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Thank you @mnben87 and @tareload for responding. Since my message earlier I also took a look at my baseline labs that were taken in June 2021 after I had been off of TRT entirely for awhile. So @tareload, I didn’t understand all of your questions, but here are some specifics regarding the labs…and I’ve included the 2021 baseline as well. Labs in 2022 were performed by Quest Diagnostics and the dates were May 5 and July 29. The baseline in 2021 June was done by Arup Labs. I mention this because different labs provide different measurements sometimes, as I’m sure you know.

Hematocrit n/a (June 2021), 51.1(May), 51.7 (July) (range 38 - 50%)
Ferritin (iron) n/a(June 2021), 23.0(May), 57.0(July) (range 23-380 ng/mL)
Total T 684(June 2021), 1188(May), 1693(July) (range 250-827 ng/dl)
Estrad n/a(June 2021), 88(May), 26(July) (range <39)
SHBG 116(June 2021), 52(May), 66(July) range 22-77 nmol/L

Now, although Quest labs doesn’t provide me with the full panel and calcs
like my previous lab did, my doc provided me with them. They are:

Free T 49 pg/ml (June 2021 ARUP), 20.6 or 1.74% (May), 28.2 or 1.67% (July)
Bio T 145 ng/dl (June 2021 ARUP), 570ng/Dl or 48% (May), 765 ng/DL or 45.2% (July)

To answer your question @mnben87 , I feel fine…but TRT has never made me feel great or not and going off of it didn’t make me feel any differently either… I know that must be strange. Nevertheless, I know that too much SHBG can bind up and keep your T from being put to optimal use just as too much estrogen can cause you to aromatize it with the same result.

Looking at my labs now with the benefit of seeing the labs from the previous year I’m seeing that the SHBG is considerably lower (still) than it was at the June 2021 baseline, even though it increased recently between May and July. And, with this odd bump of approx 500 pts in total T (I have no idea why as my protocol has not changed one bit) my percentages dropped but the total amounts of free and bioavailable actually went up.

So, maybe things are not so concerning after all.

Nevertheless, do you guys (or anyone) have any thoughts on controlling SHBG on TRT when you also take Metformin? Or, are there any guys that read this that want to pipe in with major warnings about Metformin? … because I’m reading a lot of negative out there.

Thanks again!

what’s your reasoning to be on HCG at 62 yrs old ?

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Ejaculation force and volume is one thing that are greatly reduced on TRT, HCG can fix that and also restore testicular size.

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i guess that was my point hes 62 and says his wife doesn’t care if they have sex or not … just one more drug to affect E. Get off the Hcg !!

I’ve been told that it enhances TRT and also helps with testicular atrophy.

Bro, I don’t know who’s post you were reading and commenting on but I made no mention of a wife because I don’t have one. Before you come out so strongly against what knowledgeable TRT specialists have told me, you should stop skimming posts and read them fully.

A big part of what we “feel” while on TRT is down to neurotransmitter activity, and for some guys, it’s fucked up already. DA and SA production and transmission are increased while on AAS (and TRT), sometimes that can lead to issues, depending on where you started from. I’d be curious what your PRL levels are while on TRT

What you said is interesting and oddly feels familiar @swoops39 … I don’t know what DA, SA, AAS and PRL levels are but I’d like to learn more.

Tongkat Ali is quite effective at increasing free testosterone. It sounds odd to suggest a testosterone booster on TRT, but its main mechanism of action seems to be either binding or decreasing SHBG.

Dopamine
Serotonin
Anabolic androgenic steroids (test being one of these)
Prolactin

Edit: just realized that may not be what you were asking for, but we use a lot of abbreves here, so maybe it’s helpful for someone

I have read Metformin does blocks the benefits of aerobic exercise on insulin sensitivity and VO2 max.

https://onlinelibrary.wiley.com/doi/full/10.1111/acel.12880

Great stuff @600lb_Gorilla !.. thanks… I’ll check that out.

Got it… thanks

Yes, @systemlord , I just became aware of the same study. Thanks