T Nation

Lowish SHBG, High Free T, Low to Mid Range E2

Hi all, I’ve been battling the right protocol for a couple years now. Some quick info:

38 years old
Pre TRT: 200TT
SHBG: 23

I’ve tried man different protocols.
Test CYP 140mg 1 x Per week: TT ranged from 1500+ a few days after my shot and 400 at trough. I have never needed an AI. Even at the 1500 TT range my E2 was around 30. At 400 it was around 15.

So I switched to sub q 40MG EOD and I’ve been doing this for about a year.
24 hours after shot:
TT: 990 (264 - 916)
FT: 47 (5 - 21)
E2: 33 (8 - 35)

At trough
TT: 684 (264 - 916)
FT: 17 (5 - 21)
E2: 23 (8 - 35)

So you can see even with EOD - I’m getting wide swings. My dose might be too high as my Free T sky rockets but not as much conversion to E2.

Should I just jack up my dose and go ED or would I be better at a lower dose potentially everyday? My only problem is at lower doses (100mg per week) my e2 would drop to around 11 or 12 and I’d have terrible E2 symptoms.

I’m also thinking about maybe doing androgel. I know everyone on here seems to think it’s terrible but willing to try anything.

Thanks for any advice you might have.

Where do you feel good? 24 hours after shot or at trough or somewhere in between?

Your options are pretty clear… daily administration through one form or another. Cream or injections.

Forget about Gel. If you want something topical, get some of the 20% cream from Empower. Gel isn’t strong enough for almost everyone.

If you want to stick with injections then I’d keep the same weekly dose, just administer daily.

I’d try daily injections first and see how that goes since you’re already using that method, just less frequently.

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Your swings will be even more wild on androgel, you’ll never be able to keep levels elevated. You’re metabolising T very quickly and should be injecting daily, your SHBG is going to be lower on TRT, it’s probably <10.

I’ve never seen someone with this large of a gap between peak and trough injecting so frequently and this can only mean your SHBG is very low. I don’t see any thyroid panels done prior to TRT in your thread from 2017.

Hey @systemlord - that make sense.

Here are my Thyroid results:
TSH: .876 (.450 - 4.5)
T4: 1.48 (.82 - 1.77)
T3: 3.6 (2.0 - 4.4)

It’s hit or miss. Some days or better than others and it doesn’t seem to align to when I’m taking my shot.

Your thyroid labs look excellent, your low SHBG is genetic.

Ok @ncsugrad2002 mentioned daily injections. I’ll try switching to that. Are there any other things that you’ve seen work for low shbg. Also, is it surprising that I don’t need an AI and my e2 stays relatively low?

@systemlord - I noticed on another thread from 2018 that you mentioned you have lowish shbg and tend to have lower estrogen with higher free t. Curious what your protocol is?

This protocol included an AI, the daily and EOD protocols. I learned real fast I can’t touch AI’s.

7mg daily
20mg EOD

I’m now 2 weeks in to 20mg ED. I know I need to wait 6 weeks for things to normalize. With that said, the first week was interesting with a big libido increase and feeling good. The last 3 or 4 days I have no energy. Pretty depressed. I’ve never had this big of an issue with a dose change. Should I just keep the course? Work is pretty hard.

There is no shortcut, 6 weeks till levels are stable, then you draw labs. Without labs you have no way to know which direction to go dosing wise.