I’ve slowly read thru this enormous thread. It’s very informative. I’d like to share some of my experiences as some are similar to your situation.
I struggled with muscle aches and pains for almost 7 years along with low energy. I’m 47 now but started having issues at 40. After seeing numerous doctors and paying for tons of labs I switched to a keto and then carnivore diet. I’m 6’2”. Weighed roughly 185-190 but got to 170 thru following diet advice from different docs. I was way too skinny and I didn’t feel any better.
Starting seeing a new doc 9 months ago. Someone finally listened and said my prob was low free t. He gave me t dhea and hcg. Taking 200 of test cyp a week. Tweaked this to EOD IM. My shbg was at 81 pre test. Free t was 2. He also told me to stop keto. He said zero or low carb diets mess with shbg by elevating it. After 6 months my shbg declined to 40. Free t was 13. I went from 175 pounds to 200. Im around 12% bf. I can’t seem to push above 200. I lift every day. Push / pull / legs and start again. I love working out ED. No major aches and pains.
In hindsight low free t was the issue. I think my muscles were wasting which led to the constant pain. I go for new labs June 1. Can’t wait to see where numbers are. The chronic fatigue is gone. Ive put on 25 pounds of muscle in 9 months. Some of my injuries have healed up. I feel alive again.
Takeaways for me:
feel way better injecting EOD. More stable. Started at E4D. I felt like superman d1&2 but crap d3&4.
doc said injecting was better than cream for high shbg. Im simply saying what doc told me. I know this is debatable. I never tried cream so I can’t compare
increased carbs. Im eating between 200-250 g per day. Calories around 2750. If i push carbs above 250 i feel bloated and sluggish
at my age having kids isnt a concern. I take 1 hcg subq a week. 50 just to keep testicles from disappearing
Id love to get to 210 but that’s not a requirement. Im happy having energy again and most of aches pains are gone.
I used to try fasting but in hindsight im too lean to do it. I eat 3 big meals a day have a snack mid morning and late afternoon. Huge protein shake after working out. I think the fast worked against me.
Certainly. We’re all here to help one another. Your particular issue is similar to my issues due to high SHBG and low free t. Your SHBG was higher than mine but my free t was close to zero. I shared my zero or low carb diet mistakes since I initially thought it would help my energy. Instead it made SHBG higher which made my free t lower than it was. It seems the super low free t for me was the issue. You seem to be striving for a super cut or dry physique which has me thinking your restricting carbs and calories. On top of that taking metformin may be making SHBG worse. I may be wrong in drawing parallels but in my mind I’m seeing similarities to mistakes I made and potential issues based on my experiences.
My story so far is way different from the both of you, but my ft is low as well. I also have done keto/low carb on and off for 10+ years. If you pay attention to any of the keto/carnivore channels on YouTube, the ones that get their bloods drawn almost always have horrible tt and ft.
More plates more dates has a good vid on this subject.
My ft runs about 1% of my total testosterone. My tt over the last few has ranged from 330-650 and ft from 3-7.5. I just recently started trt.
In my 10+ years on and off keto I’ve noticed the further I get into weight loss the worse I feel. I always fall off the wagon and gain back all or more weight than I lost.
I’m currently on a ketoish diet and down 35lbs since the first of the year and am getting close to my wall that I normally hit. I know how this story ends…
My question is, what was your switch from keto to your current diet like? I assume you are hitting a protein goal and concentrating on tracking fat to hit your 2700 calories?
My last labs i was around 850 tt and ft 13. I’m hoping to get ft higher.
My switch from keto to carbs was roughly 150g of carbs. I’m trying to minimize sat fat to keep my cholesterol down. I counted calories for about a month. I’m pretty consistent with what i eat. I have a gluten sensitivity so that makes things tougher.
For breakfast i have 2 whole eggs and 2 egg whites. I use fat free milk to scramble eggs. Either a few gf waffles or a muffin. Mid morning snack is oatmeal with milk and a granola bar. Lunch is usually some kind of gf noodles with protein. I’ll typically have fast digesting carbs with a preworkout and then 16 oz milk with protein powder. Late afternoon snack is usually fruit. Dinner is meat with potatoes or rice or pasta. My late night snack may be more carbs if I’m coming up short. If i need more protein ill have greek yogurt and gf granola. I shoot for about 200g protein.
On keto or carnivore my calories were too low. Missing carbs hurt my energy but also free t. When i switched back to carbs and way more calories plus testosterone it was immediate energy. Like i noted above i gained 25 pounds of muscle in 9 months. My pants fit fine. My slim shirts no longer fit. But i could workout without being sore as heck for 2-3 days. Plus i could start lifting heavier weights which was awesome to see. I felt like i had been getting weaker over the years. Looking back i was cuz with no free t my muscles weren’t building.
We have a similar dose, and I’ve also found EOD IM works best for me after experimenting with lots of different approaches. Likewise, the cream hasn’t been as good as injections for me.
This is nuts, man! So glad you found someone who understood and was able to fix you up. Smart doctor, too, knowing about the connection between SHBG and low-carb. Few docs would know that.
This is an amazing transformation, both in terms of labs and body composition. What was your lifting like before you got on T? You sound like someone who’s long been committed to the gym, but it seems unbelievable that you could gain 25 lb LBM in 9 months if you’d been lifting for years, even with Free T improving considerably.
Agreed – fasting doesn’t make sense for guys like us. Plus it can lead to weird eating disorder type behaviors, which I seem prone to (and probably anyone would be if they dieted religiously for 2-3 years as I did).
How much BF do you think you’ve gained amid the surge in MM?
Yeah, it probably was – I stopped metformin probably a little over a year ago and don’t miss it. My SHBG seems to have settled in the mid-70s. The lowest I’ve ever seen was 46, but I was taking Danazol, which didn’t seem like a good long-term solution. It’s awesome yours has dropped so much through just T and dietary changes.
Looking back at old bloods, my T:FT ratio was always best (and SHBG lowest) when Danazol was in the mix. I decided to drop it for simplicity (only wanted to be on T), longevity (long-term effects of Danazol seem unclear), and cost purposes, but considering reintroducing it — what do you think, @readalot?
Last Danazol labs (2019, at Quest):
@ 25 mg EOD with 260 T: TT 2889, FT 555 (1.9%), SHBG 72
@ 25 mg ED with 200 T: TT 1919, FT 422 (2.2%), SHBG 46
Current labs (Labcorp) with 238 T: TT 2435, FT 26.0 (1.1%), SHBG 73
I had been using a trainer for a few years. Probably since 40 I would workout in my basement 3-4 times a week. Nothing crazy. But the trainer was like age 44-46 and in a real gym. He said to me - how is the training going? I said to be perfectly honest I think I’m getting weaker. He told me not to say that out loud in the gym again. Looking back I was working out hard, which rips the muscles, but with such low free t I don’t think i was able to rebuild it. The exact opposite was i was eating up the muscle which was why i was always so sore. Being so lean I would only jog a mile or so a few times a week. I had to stop cuz my legs would get so sore it hurt to walk for the next few days. With straightening things out i jog 1-1.5 miles before i lift on leg days. I hit legs twice a week and I’m back to normal in a day. But going for an 8 minute mile I’m not killing myself and hopefully putting some blood in my legs. I need a squat rack tho. I’m able to lift heavier weights so a little safety would be nice.
Regarding body fat, i was at 10% pre test. 12% post. I think in the mirror my muscle tone was bad pre test cuz i was never building up. I think gaining the 25 pounds in 9 months was my body rebuilding from years of destruction, hard lifting and crushing the calories and carbs. Put this in perspective- i hit 200 pounds a month ago. Im at 201 now. My guess is 200 is my natural weight. My gains will be slow but more natural now. All i know is I have decent energy and I’m no where near as sore as i was.
Thanks for sharing. This is fascinating to me. I am so sore all the time. Leg days or even walking excessively takes me a few days of recovery. I have to be very careful about how I space out workouts.
I just got my new labs, though, and my FT remains quite high at 26.0. Nonetheless, TT is astronomical at 2435 (ratio of 1.1%).
I wonder if the low ratio could be dictating soreness. Free T could be high, but its low relative value is having the same effect on me you experienced. Is that possible?
Thanks for sharing but this last entry doesn’t compute for me. This is Labcorp LC/MS for TT and fT with ED or Ultrafiltration? Given your TT and SHBG your FT should be around 50 ng/dL (about 2% fT/TT as your previous results) using Vermeulen method which tracks accurate free T reasonably well (within 20%). Typo? Please confirm TT, SHBG and fT values on last test and test specifics.
Also it really helps to include units with your numbers. A guy new to this will look at all three entries you have there and be completely lost…why is FT so much larger in first two entries than last one? pg/mL vs nd/dL.
You are absolutely right that lowering your SHBG via medication will increase the relative percentage of free T (ratio of free T to total T) but will not increase your absolute free T value (e.g., XX ng/dL) for a given testosterone dosage. This is different than what you read and hear online all the time that lowering your SHBG will free up more T or increase your free T. When you decrease your SHBG your TT for a given dosing protocol will drop but free T won’t change given the amount of exogenous T you are taking didn’t change and mass in = mass out at steady state. Hence your free T stays the same and total T goes down (fT/TT goes up).
With something like danazol or other 17-AA steroid, you are putting your lipids at risk plus other concerns so it doesn’t seem to me to be a prudent long-term plan. Best current available advice from medical professionals would indicate against this approach. I know @youthful55guy has shared his extensive experiments with this type of approach on the internet and @unreal24278 has some good comments on danazol if you search on here for “danazol”.
So for you it continues to be walking a fine line on fT/TT for symptom resolution vs elevating Hct over time. While noble, blood donation more than a couple times a year creates issues for many.
Sorry for my confusion; I should’ve been clearer. Indeed, my numbers come via Labcorp LC/MS for TT and FT.
SHBG (tested in part 1/2, first week of April): 73.1 nmol/L (Ref 16.5-55.9)
Total T (tested in part 2/2, one week later): 2435.2 ng/dL (Ref 264-916)
Free T (tested in part 2): 26.0 pg/mL (Ref 9.3-26.5)
I wish I had all tested at the exact same time, but the script got botched. I assume my SHBG has not changed considerably, though – it’s stayed steady in the low-to-mid-70s lately.
I thought for the conversion from pg/mL to nd/dL, I was to move the decimal for Free T one place (becoming 260), then divide it by the Total T (2435.2), yielding a ratio of 1.1%. I’m sure I’m missing something. Using the Free & Bioavailable Testosterone calculator online, I also see almost 2% (1.98%), but the Free number it calculates (47.5) obviously is quite a bit higher than what I received (26.0).
I’d greatly appreciate you clearing up what I’m missing here. Your wisdom is needed!
I get what you’re saying completely. From your understanding (be it via research or anecdotes), would increasing the relative percentage make me feel better (e.g., libido, soreness)?
I’ve actually bantered with @youthful55guy on other forums! He’s a huge help. I’m going to look into their comments here. Thank you for the recommendations! As you noted, it is a difficult balance.
Wow, ok. So looking at the ref range on your latest fT assay this is the dreaded direct RIA free T test I spoke about here:
26 pg/mL = 2.6 ng/dL. Adjusting by the typical factor of 6 yields about 17.3 ng/dL. So nowhere near the expected fT (for this TT and SHBG) of ~50 ng/dL using an accurate free T assay (ED or ultrafiltration combined with LC/MS/MS for TT). Your result here with the direct free T test is even further off than typical. If you want a decent estimate of free T use the Vermeulen online calculator or use ED/ultrafiltration test with Labcorp (equivalent with Quest).
Yeah, I felt alot better when the relative percentage was higher but I was on 50 mg/day of oxandrolone so not a fair comparison to the typical 100 mg/week of TC I was taking at baseline. My recovery and soreness were much better but my lipids scared the crap out of me :-).
If/when I try the stanozolol, I’ll update you. Doesn’t seem prudent to me but I am toying with it. The Dark Side beckons but I must be strong.