T Nation

Starting TRT with High SHBG, Recommended Dosage/HCG?

Hi all,

Diagnosed with low T. Was prescribed 100 mg/week (am willing to consider all at once or 50 mg 2x a week. Do I need to have HCG if I want to have kids in the next 1-2 years? Is the prescribed amount of T enough to get over the high SHBG? seems like 100-140 is pretty common here.

Symptoms: Low libido, tired, depression.

Strangely, once my dick does get up it’s rock hard.

TSH: 1.13 (.4-4.50 miU/L)

T4 Free: 1.3 (.8-1.8 ng/DL)

T3 Free: 3.2 (2.3-4.2 pg/ML)

T3 Reverse: 10 (8-25 ng/DL)

FSH: 6.7 (1.6-8 miU/L)

LH: 3.9 (1.5-9.3 miU/L)

ESTROGEN, TOTAL, SERUM: 99.1 (60-190 (pg/mL))

DIHYDROTESTOSTERON,LCMSMS: 61 (16-79 (ng/dL))

TESTOSTERONE,TOT,LC/MS/MS: 856 (250-1100 ng/dL)

TESTOSTERONE,FREE: 71 (35-155 pg/mL)

TESTOSTERONE, Bioavailable: 142 (110-575 ng/dL)

ESTRADIOL Sensitive: 24 (<OR = 29 pg/mL)

FERRITIN: 112 (20-345 (ng/mL))

IRON,TOTAL: 148 (50-195 (mcg/dL))

IRON BINDING CAPACITY: 319 (250-425 (mcg/dL (calc))

VITAMIN D: 37 (30-100 (ng/mL))

THYROID PEROXIDASE AB: <1 (<9 (IU/mL))

THYROGLOBULIN ANTIBODIES: <1 (< OR = 1 (IU/mL))

SHBG: 67 (10-50 nmol/L) HIGH

You should be fine with a once a week injection protocol. You’ll likely need more than 100mg to overcome your high SHBG, but it’s fine to start with 100, you can always go up. My guess is you’ll need at least 140-160.

You could hold of on hCG for now, start it 3 months before you are ready to conceive.

Are you doing anything to be elevating it?

I have high shbg and do fine on 100mg a week. Mine WAS that high, but I addressed some of the issues and now im usually 40-50

Keto, IF, Meds, alcohol.

Your testosterone is not that low. Even your free T isn’t that bad.

If you look at your Free T level, your SHBG isn’t very sticky, so you may be able to get away with 100mg weekly. I also believe since SHBG isn’t too greedy I think two injections per weeks is best.

There is a variability in the stickiness of SHBG from person to person, I’ve seen guys SHBG under 40 with lower Free T levels than you. Your pituitary gland would need to push supraphysiological levels in order to increase free T enough to relieve symptoms.

TRT is the correct course of action. You can add FSH to a TRT protocol and works wonders for sperm production. Empower has the cheapest FSH in town.

Thanks everyone. Gf is super concerned about fertility issues and the low t went undiagnosed for so long and it has caused many libido issues and hurt or relationship. Very concerned and hopeful this will get cleared up.

My shbg is/was very similar and I was started on 250 e8d. This worked pretty well for me to start

How often would I need arimidex based on this? He said .5mg once a week at my e levels.

I started off with slightly higher SHBG than you and started on 150mg a week split into two pins. First blood test 6 weeks in and SHBG is down to 54 nmol/L. So far no sides and not using arimidex or anything similar.

So as far as HCG goes, I don’t nessecarily need it now? Looking to have kids within two years and curious what the likelihood of infertility is. It wasn’t prescribed to me during this first round.

I know this could be a nuisance but i felt the best on everyday subQ injections. As you saw in my thread i am now on subq four times a week but thats largely because i am cutting and have hardly any fat to inject in to. Something like 20mg daily could do the trick for you.

Do you feel like you are able to build muscle and see gains on keto and IF?

Why, specfically, do you do keto and IF?

Been running 60mg test c every 3.5 days (120mg weekly total) and ordering labs end of week to get an update on everything. Not using my prescribed arimidex at this moment.

At around week 4 I was back to morning wood and libido everyday, but I was also feeling aggressive and holding around 7/8 pounds of water. Super bloated. My nipples are very sensitive and sore. Week five some of that has gone away but also so did my morning wood and quality of erection. I feel like sleep at night has also maybe been more difficult lately. Some brain fog but I also know that’s historically also been a symptom of my anxiety so I take it with a grain of salt.

Looking to get more information from lab as to whether I need to change t or add in my AI. Hoping the fact that i responded even briefly means I’m on right path. Will keep everyone updated.

All you need to do is decrease the dosage, 50-55mg twice weekly should do the trick, no AI needed.

Even with a shbg of 67? I’ve seen it said guys on here with high shbg typically need larger sizes than average.

I also am switching to defy medical.

It’s not always the case that high SHBG men need large doses, the stickiness of SHBG varies from person to person. I’ve seen guys with an SHBG of 43 and very low Free T and guys with an SHBG of 76 and decent Free T.

See what your labs have to say.

It sounds somewhat common on the forums to have things go well at first and then due to estrogen being too high or low to have results taper off after initially working?

Seems strange that I had my libido and morning wood work so well after the fourthand then I blow up like a balloon (couldn’t buckle my jeans etc), get really bitchy and aggressive and then it falls off lol.