Just to clarify, if you believed the free T result you’d convert 26 pg/mL to 2.6 nd/dL then divide by 2435:
2.6/2435 = 0.00107 or 0.107%. Clearly something is amiss :-).
With your albumin, I’d estimate…
42 ng/dL / 2435 nd/dL = 1.7% (ballpark with Vermeulen).
Interesting! So my Albumin actually indicates the fT is even lower than one would expect. How odd.
It seems the “only administering a high dose of T” approach isn’t working for me. Would you agree?
I understand that pull! I have heard of high-SHBG guys trying out low-dose stanozolol (as well as oxandrolone). How bad did your lipids get?
…than one would expect with typical albumin of 4.3 g/dL. Albumin considered weakly bound to some T hence that T gets pulled out of the free T pile.
Long term impact of lipid particle counts along with other AAS effects indicate to me long term you roll the dice. Results linked above were ugly to me but I am sure experienced users don’t worry about it if you are only using for 6 weeks once or twice a year. But then you have to only use it once or twice a year for 6 weeks at a time which becomes difficult once you like the results.
Oof, yeah, and I’d be looking at long-term danazol, for sure. Given that I am monitoring things pretty religiously, though, it might not be a bad idea. I don’t see how things will get better unless I try something like that (or oxandrolone/stanozolol). It seems more T isn’t the answer, unless perhaps I really push it. It’s already high at 238 mg/week.
Whether I used 7.5 mg per day or 50 mg/day of oxandrolone didn’t matter, both crushed my SHBG and lipids. Good luck with finding your balance.
https://academic.oup.com/jcem/article/89/2/525/2840749
Androgen deficiency in women is increasingly recognized as a new clinical syndrome and has raised our awareness of the importance of accurate and well-validated measurements of serum free testosterone (T) concentrations in women. Therefore, we compared serum free T levels measured by equilibrium dialysis to those measured by a direct RIA (analog method) and to those calculated from the law of mass action (requires the measurement of total T and SHBG). We also calculated the free androgen index, 100 × T/SHBG, as a simple index known to correlate with free T. Subjects were 147 women with variable androgen and estrogen statuses. All were studied three times in 1 month and included women 1) with regular menses (estrogen positive, T positive), 2) more than 50 yr old and not receiving estrogen (estrogen negative, T positive), 3) receiving estrogen (estrogen positive, T negative), and 4) with severe androgen deficiency secondary to hypopituitarism (estrogen negative, T negative). Calculated values for free T using the laws of mass action correlated well with those obtained from equilibrium dialysis (r = 0.99; P < 0.0001). However, the agreement depended strongly on the specific assays used for total T and SHBG. In contrast, the direct RIA method had unacceptably high systematic bias and random variability and did not correlate as well with equilibrium dialysis values (r = 0.81; P < 0.0001). In addition, the lower limit of detection was higher for the direct RIA than for equilibrium dialysis or calculated free T. Free androgen index correlates well with free T by equilibrium dialysis (r = 0.93; P < 0.0001), but is a unitless number without reference to the physical reality of free T. We conclude that the mass action equation and equilibrium dialysis are the preferred methods for use in diagnosing androgen deficiency in women.
Damn, brother. I’m really sorry to hear that. It seems if you could use some oxandrolone without too negative of repercussions, that would be ideal.
So, my provider is good with reintroducing danazol or trying out oxandrolone. Which one would you recommend? I’m really unsure. Danazol comes in 25/50/75, and oxandrolone in 5/15/25/50.
If methodical you could test dose response with oxandrolone starting low. I started high then also tested low to see dose response with both protocols (50 mg/day vs mean 7.5 mg/day). I’d test lipids, cRP after 4 weeks and make sure you have baseline to compare.
If I understand correctly (reading up now on Bizarro Superman now, lol), oxandrolone should produce more GAINZ than danazol?
To me your tolerance for lipids being out of whack is similar to what happens when you experience stock market loss, you only know your tolerance once you experience a big hit. I couldn’t justify the hit but perhaps your genetics are more robust and you’ll have a better response. Good luck with the methodical testing!
Then again, it’s hard to wrap my head around a provider who will give a script for 50 mg/day of stanozolol for 12 weeks but then also tells you make sure your Hct doesn’t go above 51. It’s a wild world out there. 
Good summary of direct RIA free T method and why it’s especially useless if you are running outside the physiologic range the test is designed for. Once you go outside dynamic range you reach saturation effect and test won’t differentiate between say 40 ng/dL vs 80 ng/dL (similar to what @bkb333 experienced here). This is in addition to the assay typically being off by a factor of 6 inside the dynamic range.
Fascinating stuff. I’ll get the right test next time!
I was prescribed 50 mg oxandrolone but he mentioned I could take three per week if I’d like instead of ED. What do you think? Could the inconsistency be an issue?
Definitely cost effective to get the 50 mg per serving vs the lower doses per serving. That’s why I like the troches as you could carefully split them but who knows how homogeneous the API distribution is inside each troche. Actually at the 7.5 mg/day mean dosing I was using 15 mg capsule EOD. Although elimination half life of oxandrolone is short (may 8-12 hours), you could try 3 times per week with 50 mg at a time to test mean dosing equivalent of 150/7 or about 21 mg/day. Of course your peak/trough will be markedly different than if you were only taking one 20 mg capsule per day.
Per mg, you gotta pay alot more to do the 5 mg/day experiment if you go the compounded route.
That’s a lot of math. You really get into this stuff! Just out of curiosity, my doc doesn’t try to chase SHBG. His recommendation is to flood the system with exogenous test. This way SHBG is inundated and can’t bind it all up. He mentioned issues (didn’t get into specifics cuz we didn’t go that route) with chasing SHBG. So, why are you guys taking extra stuff to specifically lower SHBG? It seems like you’re still experiencing problems (soreness) with high total and free t. The puzzle here is where is it coming from?
What’s your vitamin D levels? Have you had it checked? When i started my journey i was at a 5. I currently take 5000 iu a day with K2. I can’t remember where I specifically am but im at the top or slightly over the high reference range. Low vitamin D affects so many processes in the body and it can cause soreness and lethargy if very low. Btw- i paid $125 for a private blood draw to test vitamin d and zinc oxide. Insurance pays for none of this.
One of the many many docs i saw told me that my E2 was too high. She never picked up on next to zero free t. I mention this cuz my new doc also doesn’t like to target estrogen due to potential issues. Apparently low estrogen can be a huge problem for soreness and irritability. I think it leads to pain in the joints. Im thinking out loud here since i don’t recall anyone mentioning estrogen as a potential source of pain. Btw - when i was taking an AI I didn’t feel any better. My E2 was 35 at one point before AI. My new doc said stop immediately. And at my weight at that point i was a solid A-cup so no gyno or love handles.
Absolutely.
Ahh, the costs of taking stuff other than T - how I haven’t missed this I’m thinking I might do 50 mg EOD. If I do that, do you think it would make more sense to take it on injection days or non-injection days?
Sounds like the Nichols logic. Is he your doc? He’s a smart guy and has chimed in on this thread.
I do understand this perspective, for sure, and think it would work for just about everyone. However, it seemingly isn’t working in my case. My SHBG started in the 180s (!) and won’t go any lower than 70 on T alone. I think most/all TRT docs would agree that 238 mg/week is a rather high dose, so I’m not sure how much more ‘flooding’ could be done. It seems I need that flooding and something else.
I think the real puzzle is why free T is not higher given the sky-high TT. I don’t think I should need total T to be in excess of 2000 to reach a decent free T. Furthermore, the ratio between the two is poor given my dosage.
Fair question. Though I haven’t had it tested recently, I take 9,000 per day, so I really doubt this is an issue.
Another important point. I also believe estrogen is valuable and hopped off my AI a couple years ago. Since, I haven’t worried about estrogen. My E2 was 53 on last test but has run as high as 91.
