Best Testosterone Ester for Low SHBG?

I recently switched to Defy Medical due to wanting to get on testosterone instead of what I used to use which was Clomid. With all of the research that I have done, I have learned due to my low SHBG, I would need a faster acting Ester but at the same time, I am not sure if I want to pin every day. Would using test Propionate ED or EOD be a viable solution for me? Is there a possibility that I can blend more than one Ester together? What would be the harm of any ester that I choose to use whether propionate or cypionate? I also plan on adding HMG and/or HCG to my protocol if that is worth anything. Below will be my labs.

Labs:
Testosterone- 150 ng/dL

SHBG- 10 nmol/L

LH- 5.2

FSH- 2.1

Estradiol- 14.42 PG/ml

Sure, Test P has a 4.5 day half-life, which is about half that of Test C and E, but if you’re pinning daily - the half-life is kind of irrelevant.

I pin Test C daily from Defy as well at 26mg daily (I’ve got below-range SHBG as well)

That’s a conversation for your provider and you to have. People blend them, and you can have them blended for you by pharmacy - but they follow prescriptions.

P hurts more than C, but no real harm difference between the two.

Just watch your e2 when adding HCG. Probably worth your time to start with just Test and get dialed in there before adding a new compound.

For your reading:

It is highly highly individual. U need to try different options to find the One most optimal for you.

Noooo…Test C and E have elimination half life of 4 to 7 days (my personal experience shows about 4.5 days for me). Test P about 24 hours.

Condensed from thread at EM:

The challenge with the Nieschlag data set (1990):

Using the original data points in the paper I calculate the following which fits what is reported in the paper:

1652813042145.png

Elimination half life = 21.6 hr
Absorption half life = 4.1 hr
Tmax = 12 hr

About 13% error on the model fit (RMSE).

1652813226570.png

However the first data point was collected at 14 hr.

Now, what if I add another data point hypothetically collected earlier in the time series:

1652813382393.png

Elimination half life = 22.4 hr
Absorption half life = 1.3 hr
Tmax = 5.6 hr

RMSE on the data fit is about the same.

1652813465841.png

That first data point (if taken earlier in time after injection) can drastically change estimated Tmax without changing estimated elimination half life very much:

1652813505660.png

Would also impact Cmax, AUC and MRT.

I was rather sloppy as I minimized RMSE for each data point instead of absolute deviation for each data point. But it doesn’t change the result too much (13.7 vs 12 hr for Tmax) in the original example and about the same Tmax in the hypothetical example (5.4 vs 5.6 hr Tmax).

In case anyone was wondering why I got 12 hr instead of 14 hr Tmax from the original data set (digitized and pulled into Excel).

Minimizing the absolute deviation weights the data points at higher TT more heavily.

1652818303402.png

1652818532321.png

3 Likes

I had low SHBG when starting TRT (11 nmol/L) and was a non-responder to TRT injecting any further out than EOD dosing, twice weekly dosing and I felt nothing even with a TT @ 700 at trough.

I’m on Jatenzo now dosing @ 237 mg twice daily and I’m showing amazing results.

Do you have diabetes?

@systemlord

Just curious if you’re doing any liver testing? I’m very curious about jatenzo and trying it out. i still cannot find libido anywhere.

ALT @ 19.

Test C

The half-life of testosterone cypionate when injected
intramuscularly is approximately eight days.

Test E

Testosterone Enanthate
Testosterone Enanthate contains the carboxylic acid ester, enanthoic acid. It has a half-life of approximately 7-9 days

Test P

Propionate
Half-life approximately 3.5 days

I guess I’m just not seeing how this lines up with other literature, or how there other data is this inaccurate. I’ll defer to you on this.

1 Like

I should have clarified half lives I mentioned above are for IM.

The Test P reference you cite confuses mean residence time (MRT) for elimination half life. In the simpest 1 compartment model MRT = t0.5/0.693.

So from my example above for Test P:

MRT = 24 hr / 0.693 = 1.5 days.

Nieschlag is the definitive reference here but I admit I have trouble trying to even rationalize a 3.5 day MRT for Test Prop. Adding in the absorption piece will drag MRT out a little more. But I hope you get the idea (in the weeds). Benzyl alcohol in the formulation, site of injection, concentration in oil, etc.

You can download the free pdf in link above. Good read.

1 Like

I would think you’d need a slower acting ester, but still injected more often. In your case, I’d start with EOD of cyp or enanth

I am probably prediabetic and have a lot of family members who have diabetes

Why not propionate or a propionate mix?

If you are, then your SHBG should increase on TRT.

For reference, MRT = AUMC / AUC

The numbers I’ve seen after looking somewhat extensively line up with @tareload (or at least pretty close). It is true that different literature shows different numbers. There are reasons for that. The type of oil matters for example. Castor oil will have a noteworthy longer half life than say mct oil.

All sorts of things can come into play. Individual metabolism, type of injection (maybe), depth of injection (maybe), location (maybe). Probably missing a bunch of things.

1 Like

For everyone’s amusement, I’ve been putting this together over the past couple of weeks or so.

These are random follow-ups, with numbers recorded when I remembered to do so… All have been under care for at least ten months. I have not given them any thought or review. If you torture numbers long enough, they’ll confess to anything.

Regarding SHBG, when determining injection protocols, qd, qod, q3.5d, qwk, whatever, or which ester, I see zero correlation between the two. Sorry, there is no dosing schedule for SHBG below 10, or higher than 40. Or relative to any number. There is no best ester for X level SHBG. Some individuals may feel better with more or less frequent injections. Some may prefer enanthate over cypionate. That is just the way it is. By far, most notice no difference whatsoever. Propionate, yeah, different story, much shorter ester. However, some have reported no difference between it and cypionate with twice weekly dosing. Go figure.

Granted, there have been some who, while doing just fine with twice weekly or weekly dosing for over a year, find out from the internet or a friend that because their SHBG is lower, or it is not “sticky”, they are “burning” through testosterone too quickly and now they feel tired between injections and need qd or qod dosing. Always interesting conversations. As they are when they eventually realize they felt the same or better with less frequent dosing and go back to it.

For me and my practice, I want to know SHBG because if it is high, I know a higher dose of testosterone may be needed to get the free testosterone to a decent level. That means I will not waste time going low and slow, with multiple labs, for several months, “dialing in” while they feel like crap waiting to get the total testosterone high enough to offset their SHBG level of 93. It also does not mean they need a particular ester, or more or less frequent injections, or a cream.

DOSE TOTAL T FREE T ESTRADIOL SHBG AI
60mg q3.5d 670 137 25 4 .4mg/wk
60mg q3.5d 1241 320 59 19
60mg q3.5d 809 182 46 11
60mg q3.5d 1145 244 64 22
60mg q3.5d 1021 217 77 19
60mg q3.5d 1327 289 68 52
60mg q3.5d 772 201 55 27
60mg q3.5d 833 165 38 18
60mg q3.5d 669 178 36 28
60mg q3.5d 743 178 29 31
70mg q3.5d 956 247 74 26
70mg q3.5d 767 199 54 34
70mg q3.5d 917 186 42 29
70mg q3.5d 843 197 38 42
70mg q3.5d 1263 291 50 17
70mg q3.5d 1578 364 48 29
70mg q3.5d 642 115 65 27
70mg q3.5d 1070 276 90 20
70mg q3.5d 967 233 57 8
70mg q3.5d 813 165 43 29
75mg q3.5d 876 211 68 26
75mg q3.5d 1134 245 51 34
75mg q3.5d 1008 227 37 18
80mg q3.5d 912 206 47 17
80mg q3.5d 966 223 67 27
80mg q3.5d 1073 229 72 18
80mg q3.5d 779 183 52 21
80mg q3.5d 473 99 44 30
80mg q3.5d 901 245 60 15
80mg q3.5d 1131 171 94 24
80mg q3.5d 1618 326 35 37 .25mg/wk
80mg q3.5d 713 123 63 43
80mg q3.5d 943 242 52 26
80mg q3.5d 1047 264 49 29
80mg q3.5d 912 157 64 22
80mg q3.5d 1008 223 54 31
80mg q3.5d 1153 287 71 12
80mg q3.5d 1055 219 55 27
80mg q3.5d 679 166 41 21
80mg q3.5d 838 191 54 24
80mg q3.5d 1098 262 81 20
80mg q3.5d 1238 297 62 27
80mg q3.5d 1118 233 56 31
80mg q3.5d 965 255 71 26
85mg q3.5d 1134 198 47 33
85mg q3.5d 549 144 52 18
85mg q3.5d 1089 179 40 67
160mg qwk 893 228 67 12
160mg qwk 922 214 58 21
160mg qwk 943 266 62 14
160mg qwk 1011 276 58 26
160mg qwk 1322 302 62 31
160mg qwk 998 222 87 44
160mg qwk 909 171 61 13
160mg qwk 1054 243 48 29
160mg qwk 887 221 51 10
160mg qwk 1055 249 43 13
160mg qwk 807 179 49 27
160mg qwk 683 144 61 41
160mg qwk 1629 415 100 23
160mg qwk 1248 281 47 32
160mg qwk 863 199 55 26
160mg qwk 1421 342 65 33
160mg qwk 989 265 54 16
160mg qwk 1031 242 55 21
160mg qwk 734 222 49 26
160mg qwk 899 213 60 22
160mg qwk 1043 278 63 9
90mg q3.5d 812 188 43 22
90mg q3.5d 1121 303 67 49
90mg q3.5d 1032 224 46 20
90mg q3.5d 1089 253 71 26
90mg q3.5d 923 103 22 62
90mg q3.5d 1269 293 37 16
90mg q3.5d 1034 239 56 31
180mg qwk 1076 311 62 7
180mg qwk 1408 324 54 38
180mg qwk 1124 268 63 24
180mg qwk 833 241 77 34
180mg qwk 966 222 56 32
180mg qwk 1238 241 57 29
180mg qwk 935 233 72 26
180mg qwk 1008 247 56 24
180mg qwk 975 269 58 12
180mg qwk 873 213 59 23
180mg qwk 797 219 41 15
180mg qwk 954 288 51 16
180mg qwk 1252 329 83 10
180mg qwk 1102 197 61 19
100mg q3.5d 1801 481 97 14
100mg q3.5d 1081 202 68 23
100mg q3.5d 1276 327 78 9
200mg qwk 923 276 53 22
200mg qwk 1327 342 39 4
200mg qwk 1090 212 51 43
200mg qwk 1080 159 56 64
200mg qwk 1248 312 53 30
200mg qwk 798 163 20 50
200mg qwk 951 226 41 8
200mg qwk 1432 289 64 16
200mg qwk 1177 255 45 29
200mg qwk 965 242 60 3
200mg qwk 1121 311 58 11
200mg qwk 1347 343 67 14
200mg qwk 920 227 58 22
200mg qwk 1145 287 62 8
200mg qwk 954 221 53 21
110mg q3.5d 1128 348 46 17
110mg q3.5d 1311 323 74 38
120mg q3.5d 940 313 74 23
120mg q3.5d 1389 342 27 21 .2mg/wk
120mg q3.5d 1256 321 68 30
6 Likes

Always happy for your input and level of detail =)

Thanks for sharing!

To confirm…

Trough measurements?
FT calculated or equilibrium dialysis pg/ml?
E2 measurement? pg/ml

Test dosage will set fT and SHBG + fT then sets TT. fT vs dose is set by individual metabolism of free testosterone which is many times correlated with SHBG. Correlation potentially not causation. The fundamental relationship of TT, SHBG, and fT still gets confused quite a bit.

And this is why I always read your posts.

trough
equilibrium dialysis pg/mL
pg/mL

I think I understand the fundamental relationship between fT, TT and SHBG. What I do not see is a correlation between SHBG and dose frequency or SHBG and a particular ester.