T Nation

Newly on TRT, Looking for Advice/Support

Hey everyone. I have read a lot of different threads and responses from this group and you guys seem to know your stuff so I decided to reach out for support and advice. I have had Primary Hypogonadism for the past 6 years. I wont bore you with the details but it started when I turned 27, was put through a battery of tests, nothing abnormal found except my T and Free T. My FSH and LH were very elevated. CT was negative for pituitary tumor. I am now 32 years old 5’7 164 pounds. I spent a lot of time trying to fix this on my own, obviously failed and I have finally given up and decided to dedicate myself to TRT. I struggled with all the classic symptoms, fatigue, low libido, difficulty concentrating ETC. Here are the Lab results prior to TRT.

Total T-50
Free T- under 5(didn’t even register)
FsH-66
Estrogen-10
SGBH-77

All my other labs were normal. lipids were optimal, blood counts optimal. No other issues. Fortunately I eat good and work out often so I am in very good physical shape. I was put on a TRT plan as follows:100MG injection once per week(Testosterone Cipronate). I took the first injection two days ago. I will say that I feel much more awake and able to focus, I don’t feel like I am going to fall asleep and I don’t feel groggy and cloudy all day. Some minor surges in libido but nothing significant, I had morning wood this AM.

I know it takes weeks to feel the full effects. But basically I was thinking about maybe taking the 100MG shots in 50MG increments twice per week. I dread having E2 problems and I really don’t want any more hormonal nightmares, anyway with my SGHB being 77, would two separate injections be necessary? Plus my E2 is already low, so it needs to come up at some point a bit anyway. I have blood work scheduled for mid-may. Thanks for any responses guys.

With tat SHBG you might need more like two shots of 100 mg to get anywhere. It will take a long time for that number to move in any meaningful way. BTW, you now have the award for lowest Total Test ever.

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Yeah, it was pretty pathetic, that’s for sure. Somehow I was able to hit the gym, work ETC despite that horrible number. Got erections too lol. Yeah the SGBH worries me a bit, but I guess we will see what happens. Im encouraged by how I have felt the last couple days, we will see how the second week goes.

The SHBG is more than likely your body reacting to the very low test production. It will likely change eventually (it can swing 500% a day, I mean overall as a median number)

Yeah man, I was thinking that myself. I have done a lot of reading about SGBH in this forum and that’s kind of the vibe I have gotten. I am hoping it drops after a few T injections. Hopefully I continue to feel better, I just don’t know if I should keep injecting once a week for now until I get the labs or inject twice per week @ 50mg, im afraid that its all going to bind to the SGBH and my E2 isn’t going to move.

I guess one thing that is a positive regarding my horrible test production, I shouldn’t crash too much when my body stops “making” my natural test, since it doesn’t really make any as it is anyway. LOL

Once a week. 2x week, whatever, as long as you do the same thing for 6 weeks before your next labs.

yeah that was my plan, see where I am at in six weeks when I go for Labs, thanks for the response

Don’t be surprised if your Total T is only in the low 300’s and free T still almost non-existent on the next labs.
And, out of curiosity, do you know your albumin, RBC or ferritin numbers?

Yeah I got those done, I don’t have them on hand but those were all within the mid normal range. I can post the exact numbers when I get home. Also yeah I am fully expecting my numbers to still be pretty low. Im not gonna hit 700-900 in six weeks.

Albumin binds T as well as SHBG

Isn’t albumin bound T combined with your non bound(free) T? I could’ve swore I read that somewhere

It takes about a year to notice the full benefits of TRT, not weeks you will probably need very high testosterone (above reference ranges) to overcome insanely high SHBG and increase Free T.

Sick care doctors may not be able to accommodate you to allow such high levels, you would then need to seek private care for your TRT.

Welcome. No, two separate injections are not necessary. Most guys (I’d say 85-90% in the world, not the tnation world) take one a week and do well. It won’t hurt to take more however. What will likely be necessary is an increased dose. Nothing wrong with starting at 100mg, but I’m guessing you will do much better with at least 150/week. Good luck

Any chance my SHBG comes down following a steady stream of T? Any chance that its as high as it is because my body produces such low levels of hormones?

Thanks man, appreciate it. I anticipate needing a higher dose. I was thinking the same, around 150MG. We will see how my blood work looks in six weeks. So far I feel physically better, but its still way to early to say anything definitive. I have anxieties about my SHGB being high and I am also worried about Polycythemia and my E2 getting out of control, I am hoping to not need anymore than 150-175MG a week. I will go to 200 a week if need be, but I hope that ends up not being necessary.

Here are some different ideas regarding erythrocytosis (it is not polycythemia) and estrogen with men on TRT:

Everyone is different, but your body likes high SHBG right now for a reason. I would guess that it is just trying to hold onto whatever small amount of test that you are producing.It doesn’t permanently bind to it, that’s just your body carrying it around for later. So, probably, once it gets adjusted to a normal supply of test it will change to a reasonable SHBG.

TRT will decrease SHBG, the more androgens you throw at SHBG, the lower SHBG will decrease, with no decrease beyond a certain point.

Excess androgens lowers SHBG, SHBG is produced in the liver and once elevated, usually there is no way to reverse course without intervention except to throw androgens the liver.

Right now you body is working against itself, pituitary is supposed to increase LH to maintain healthy testosterone, but sometimes the liver starts cranking out excess SHBG ruining that perfect balance and handcuffing Free T in the process.