31 Y/O. Normal TT, Low Free T, Very High SHBG, Low DHEA

Pharma TRT
41

This is really good info.

Everyone recommends the saliva cortisol test (because, they say, the blood cortisol AM test is not sensitive enough) so I wonder if it could be similar with the estradiol test – I know you have to use the ‘super sensitive’ estradiol assay at labcorp, or the “ultra sensitive assay” at quest diagnostics for E2 and most physicians don’t know this and they order the normal E2 test that is only approved for women, I have the specific lab requisition #'s written down somewhere for the correct estradiol test.

EDIT:
LabCorp “Sensitive Estradiol” Code 140244, 500108
Quest Diagnostics “Ultrasensitive Estradiol” Code 30289
ARUP TMX Code 93247
Mayo Clinic “Enhanced Estradiol” Code EEST

The anastrozole(arimidex/A.I) is oral, and the hCG is sub-q so it’s not so bad. But I am injecting 5 days a week you’re right. I’ll eventually scale this back, I’m still kind of in the experimental phase as far as figuring out what does and does not work for me.

I am mostly just trying to figure out these weird migraines. I’ll keep updating my thread, but I plan to treat this more as a steroid cycle than TRT and cycle off testosterone in a few weeks, run post-cycle therapy and try a few alternative treatments I didn’t know about before – if those don’t work I’ll be back to TRT, but I figure it’s worth a try resetting my HPTA as I’m still really young and my T issue is not age-related decline (and my doctors still have no idea what the cause is, nor have they even tried to find out). I’m going to try an HPTA restart, after getting off a long-term medication that could be messing with my levels, and fixing my D2 and DHEA levels.

I did try supplementation and T boosters with only minor success in the past, I’ll keep things updated here with any success. Hopefully i’ll be getting more labwork soon as I really need to know my E2 levels.

I know it’s kind of silly/counter-intuitive to cycle off TRT, but I feel like I didn’t do everything I could and kind of gave up early and started TRT, and I’ only 5 weeks into TRT so now is the time to stop before my pituitary shuts down completely and my hypothalamus stops sending out GnRH. I read LH production starts to die off around week 3 and is gone by week 5, and GnRH production ceases entirely around week 6-7.

42

These sex headaches have nothing to do with high E2, my E2 is always on the low end even at 858 ng/dL.

43

You’re probably right. About all I can do at this point is test my hematocrit/red blood cells, keep an eye on my BP/pulse, and hope they go away when my levels normalize, with the half-life of T-Cyp hCG and arimidex, it seems like it could take a couple weeks or even more for things to stabilize after changing dosages…

I’m at a cross-roads deciding if I’m going to cycle off TRT temporarily to re-run basal levels and try PCT/HPTA reset/clomid, or give it a few more weeks – I do know if I go much longer on TRT my GnRH production will shut down so if I’m going to cycle off and give other options one more try its probably better to do sooner than later…

44

I am just about to hit my 12th week on TRT and I want to come off of TRT and do an HPTA restart. I’ve gone over KSMan’s HPTA restart sticky thread and I can not understand how to best apply it to my situation. I have asked this in that thread without any responses so I’m posting it again here, I really could use some clarification/help from anybody at this point as I have to stop TRT immediately and I want to do it in the safest way possible obviously. Here’s a copy of what I posted in the HPTA restart thread:

A) You(KSMan) say to taper the SERM (Nolvadex) but you don’t say how long or over what course of time I should taper down the Nolvadex? and at what dosage I should just stop taking it?

B) I am already on your suggested TRT protocol with the exception of twice the amount of T-Cyp and twice the amount of Anastrozole(200mg/2mg/weekly). Is it necessary or even helpful to do the initial 4 week hCG only phase if you have taken hCG through your entire T-Cyp cycle?

C) Most other PCT protocols seem to suggest starting the SERM 18-26 days after the last injection of Testosterone, yet you suggest 28-42 days minimum of hCG mono therapy between the last testosterone injection and the start of PCT+Restart? does this have something to do with the half-life of Testosterone Cypionate and how it overlays with starting the SERM? Should I increase this amount of time since I am on twice the amount of Test-Cyp that you recommend?

D) Would the following timeline and dosages be an accurate PCT+HPTA restart based on the above guidelines?

Week 1-12:
100mg Testosterone Cypionate 2x weekly
250IU hCG Sub-Q e.o.d
.5mg Anastrozole 4x weekly

Week 13-16:
250IU hCG e.o.d (continue hCG at the same on-TRT dosage)
0.5mg /week Anastrozole e.o.d (lower Anastrozole dosage from 2mg /week to 0.5mg /week e.o.d immediately after last testosterone shot?)
(Run labs to make sure testes are responding to hCG monotherapy and producing endogenous Testosterone – What TT,FT levels should we be looking for at this point?)

Week 17-20:
20mg Tamoxifen e.o.d
0.5mg Anastrozole /week e.o.d

Week 21-22:
10mg Tamoxifen e.o.d
0.5mg Anastrozole /week e.o.d

Week 23-24:
10mg Tamoxifen 2x weekly
0.5mg Anastrozole /week e.o.d

Week 25-28: (You say in another thread to continue Anastrozole for 4 weeks to avoid estrogen rebound?)
0.5mg /week Anastrozole e.o.d

Week 29-30:
0.25mg /week Anastrozole e.o.d

Week 32:
Labs: LH/FSH, TT, FT, E2.

E) Is there some way to shorten this PCT+HPTA Restart without affecting safety or efficacy?

F) When you say e.o.d dosing is three times a week close enough? actual e.o.d dosing changes every other week and makes things a little more complicated to track?

Thank You so much for your time,
Gary M.

45

Since I cant seem to understand KSMan’s HPTA Restart+PCT thread, how does the PCT/Restart protocol in the following thread compare?: Article: PCT post Testosterone Therapy | Excel Male TRT Forum

It sounds pretty similar to KSMan’s protocol, but is laid out in a way that I can easily understand. Should I go this route? It sounds like this protocol comes from Defy Medical.

46

I’ve done about as much research as I can do… it seems like I’m not going to get any help here so I’m left to my own devices… if anyone is curious about properly applying KSMan’s HPTA restart protocol and using it to come off TRT, this is the best I can come up with based on standard PCT advice and KSman’s own advice in multiple threads:

(PS. I dissolve 1mg Anastrozole tablet into 1 ml of vodka using a dropper bottle that counts out to 20 drops per ml / this is standard, and then I use 10 drops per week, or 5 drops twice a week, etc).

Weeks 1-4:
250IU hCG Mon, Wed. Fri
5 drops Anastrozole Liquid (0.25mg) Mon, Fri
(Run Labs before the end of week 4, should expect to see 350 ng/dL or greater Testosterone if Testes are responding to hCG stimulation)

Weeks 5-6:
20mg Tamoxifen Mon, Wed, Fri
5 drops Anastrozole Liquid (0.25mg) Mon, Fri

Weeks 7-8:
10mg Tamoxifen Mon, Wed, Fri
5 drops Anastrozole Liquid (0.25mg) Mon, Fri
(Run labs at week 8 to see if LH/FSH has rebooted, check TT,FT)

Weeks 9-10:
5 drops Anastrozole Liquid (0.25mg) Mon, Fri

Weeks: 11-12:
2 drops Anastrozole Liquid (0.12mg) Mon, Fri

I believe KSMan actually might have intended for his protocol to run 20mg tamoxifen for a full 4 weeks and then taper out over an additional 4 weeks, but this seems incredibly long compared to your average bodybuilders Nolvadex PCT of 20/20/10/10… I also believe he may have intended for the Anastrazole taper to last a full 4 weeks but this again seems absurdly long for the average length of PCT and obviously can be extended or restarted if estrogen rebound becomes a problem. I can’t seem to get any clarification here or elsewhere and this is the best I can come up with, I don’t have any more time to do research, I have to tell my doctor what prescriptions I need literally tomorrow or I won’t be getting any medications at all for PCT, so this is what I’m going with…

Thanks,
Gary M.

47

I don’t think you understand the gravity of your situation with your SHBG, it’s insanely high and TRT is the only way to bring it down to healthy levels. You only gave TRT 3 months, TRT requires patience. Some guys don’t tolerate HCG well so you need to perhaps try without it.

48

The SHBG being so high was related to a medication I have since tapered off of (Buprenorphine).

Initially I thought that this medication would not be impacting my TT,FT,SHBG based on some medical studies…

now that I am off of this medication I want to try an HPTA restart.

I know that once you hit 4-6 months on TRT it’s for life, I’d like to try other approaches NOW, before I completely kill my testes/HPTA rather than regret not doing that later.

49

You’re acting without any labs, I haven’t seen any labs since starting TRT. Why don’t you wait for labs and then make your move?

At the 3 months mark I felt alright but not great, glad I waited a few more months.

Try posting in “KSman is here” thread to get his attention.

50

I went in for labs last thursday, Just waiting for the results.

If I want to come off and do PCT/HPTA restart, I need to tell my doctor exactly what medications I need before Tuesday. (He is a close friend of mine and is going on an extended vacation). I will definitely post my labs and base decisions on this. I would just like to know what HPTA restart protocol is suggested and get the meds while I can if that is what I end up having to do.

I don’t want to be on TRT 5 years from now and regret never finding out if it was the Buprenorphine suppressing my HPTA – it’s a strong partial opiate agonist, which certainly can have that effect.

I’ve also come along way in my training (bodybuilding) and diet, and realized just how much my lack of growth over the prior 2 years was related to both of these things, and probably less so testosterone levels…

51

I didn’t see you were on Buprenorphine, that changes things. I was on Klonopin for 30 years, it was too late for me. I always had high liver enzymes while on the medication, now it’s all normal now that I’m off all medications. However my T production didn’t recover, it was the withdraw that killed my T production. Perhaps the medication was causing liver issues and HPTA issues.

I’m a dead man without TRT.

52

Exactly my concerns. It seems like it would be worth it to at-least try an HPTA restart+PCT before I get to the point where coming off of TRT is almost impossible – I feel like at 12-14 weeks on T-Cyp the HPTA hasn’t been suppressed too long to come off and run PCT, so now is the time to try it if I’m ever going to. (I would obviously come back on TRT after 6-8 months if things don’t improve).

I’m just not sure about the lengh of time to run Nolvadex based on KSMan’s protocol, it’s really a bit tricky to read his guidelines there, someone really needs to get some clarification on that for the newB guys like me.

The fact that I was only 26 years old when the Low-T started and that’s around when I started Buprenorphine makes me think that it is no coincidence. That’s aweful young to experience T Decline (I’m 32 now).

PPS. I was also on alot of bodybuilding supps when the labs with elevated SHBG were drawn, and I’ve read some of these pre-post workout supps can mess with SHBG and other lab results.

If you follow the HPTA restart protocol to the letter it’s like a 5 month process… it seems a bit crazy to run PCT for 5 months when I could come off T-Cyp and be normal in 3 months without PCT (assuming I started with a healthy pituitary/testes that were just depressed from medication)…

I think I’m going to ask my doc to write up 10mg tamoxifen a day for 30 days, 50mg clomiphene citrate a day for 30 days, 1mg anastrazole a day for 30 days, 250IU hCG e.o.d for 1 month , and that should hopefully cover all my bases if my PCT plans change in the next week or two.

53

Which pre/post workout supplements raise SHBG?

54

SHBG is difficult to manipulate, plant based diets typically raise SHBG.

55

So for some reason it took forever, but I finally got my on-TRT lab results back.

Iron Saturation: 10 (LOW) Reference: 15-55%
Luteinizing Hormone: 0.4 (LOW) Reference: 1.7-8.6 mIU/mL
FSH: 1.5 (NORMAL) Reference: 1.5-12.4 mIU/mL
IGF-1: 247 (HIGH) Reference: 88-246 ng/mL
Free T3: 5.2 (HIGH) Reference: 2.0-4.4 pg/mL
SHBG: 51.5 (NORMAL!) 16.5-55.9 nmol/L
Testosterone Serum: 1411 (HIGH) Reference: 264-916 ng/dL
Free Testosterone(Direct): 27.0 (HIGH) Reference: 8.7-25.1 pg/mL
LDL Cholesterol Calc: 117 (HIGH) Reference: 0-99 mg/dL
Dihydrotestosterone: 199 (HIGH) Reference: not mentioned?
25-hydroxy, Vitamin D: 27 (LOW) Reference: not mentioned – below it says D-2 <1.0 but D-3 is normal

My case is starting to look very weird? Before I started TRT my SHBG was absurdly high, and my doctors all thought I had hypothyroid/hashemoto’s because my TSH levels were all over the place and my T3 was slightly low-normal. Now my T3 is absurdly high pointing at the OPPOSITE hyperthyroidism? Why did my T3 and SHBG levels change so drastically with testosterone supplementation?

Also why is my IGF-1 so elevated? I read that this hints at a pituitary tumor?(haven’t been checked), is this normal while on TRT for some guys?

Lastly, I supplement a lot of iron and vitamin D, my current tests say my iron blood levels are good and all my iron levels are good EXCEPT for iron saturation which is low?

I’m now about 1.2 weeks into PCT and still in the hCG-Arimidex stage.

If anyone has any advice on what these relatively strange lab results could mean I would really appreciate the insights. I forgot to mention my estradiol was perfect at 18.

Thanks,
Gary M.

56

It appears there is a correlation between elevated hCG in the blood causing lowered TSH and elevated thyroxine levels? Do you think this could be the cause of the elevated T3?

57

What’s the significance he was on Buprenorphine in relationship to testosterone and or SBHG?

58

Reading this now systemlord. I too have my withdrawal messing with my free t