For all the high SHBG guys out there (high in-range or out-of-range), curious what your SHBG is, what protocol you’re on, and how you feel.
My SHBG is ~62 (and has been as high as mid-70’s) and I just bumped dosage from 100mg/wk e7d to 70mg e3.5d (140mg/wk). Increased dosage because I still had sexual side effects of low free-T after 6 months TRT at 100mg/wk.
I’m asking the question because it seems like high SHBG is fairly rare and I’m wondering if there’s any consensus amongst us folk regarding dosage range to get dialed in.
If there aren’t any/many high SHBG guys out there on 100mg/wk that feel good, that likely tells us something. If virtually all the high SHBG guys are at 150mg/wk to 200mg/wk, that’s illustrative.
I looked back at highpull’s post that was a random sample of 50 of his patients. None had SHBG over 50 in that sample, and 90%+ had SHBG 40 or lower, which illustrates part of the problem. Only a small fraction of guys seeking low-T treatment have high SHBG relative to normal or low SHBG so doctors don’t have much experience with guys like us. I know my PCP doesn’t have any and it doesn’t seem like my endo has much personal experience with it either.
Also regarding highpull’s data it looks (and sounds, if I’ve understood him accurately) like he starts out most guys at 150mg/wk - 200mg/wk in his practice so it may be hard to say based on his experience whether guys with high SHBG respond positively to dosages lower than 150mg/wk. Circumstantially I suspect there aren’t too many that do.
Personally, my endo and GP are both fairly conservative with dosage and I’m at least mildly concerned I’m going to have a hard time getting them to keep titrating much past where I’m at (140mg/wk) even though there’s some evidence it may take more than that to get over the top of my high SHBG.
Anywho, just curious to see what protocols are either working, or not, for the other high SHBG guys out there.
So you have started more frequent injections ? I thought once a week is better for high shgb. I too suffer with it and just had loads of advice saying drop to once a week . Was on 100mg not trying 150
Yes, because so many patients get on the internet and do their “research” before consults. That is what they want. I don’t think elevated SHBG requires a particular injection frequency, so I don’t think once a week is better for guys with higher SHBG. I think some guys are more sensitive to fluctuations.
Once a week may seem better because they get a larger single dose, but the trough will be lower, so overall they aren’t better unless they are not sensitive to fluctuations. Higher SHBG means I’ll start them with a larger dose, but I let them pick the injection schedule.
Just my experiences, the only treatment factor I’ve seen correlated with SHBG was milligrams.
So to keep red cells at a healthy level it’s better for more frequent shots than one big one per week. So it’s like a constant trickle of test coming in to the body. . I’m feeling my heart beat more on an evening when rested … had this even on 100 mg a week. Just had all red bloods checked.
This seems to be the TRT corollary to the saying about cars that people “buy horsepower but drive torque.”
Do you find that for symptom abatement, it’s common to get by on a lower dose per week if your frequency is higher because that raises your trough relative to the same weekly dose administered less frequently?
I was thinking up till now that, aside from patients that are very sensitive to fluctuations, overall symptom abatement had more to do with average rather than trough levels.
My hematocrit is barely out of range (52.2; was 50.9 pre-TRT) so the increased frequency was mainly to reduce peaks, which will hopefully mitigate against further-increased hematocrit.
I also don’t care that much about reducing SHBG now that I’m on TRT. On top of mine seeming stubborn (it didn’t respond one iota to supplementation or lifestyle changes tried for nearly a year before TRT) I can just titrate up until I’ve got enough bioavailable androgens.
Thanks . I may try this . I don’t particularly want to inject 150mg once a week. So yeah I may also do three days . Thanks for the reply . Appreciate it
Mon/Thurs Cypionate injections 130mg per dose. Total T 995, Free T 29, SHBG 22. Feel like a rock star. Added 5mg daily Tadalafil 1 week ago. Train 4 days week. Age 62. This week taking dose to 180mg per.
66 few weeks back low E2 and very low Free T . Was on 100 mg twice a week n just started once a week and tomorrow will be my first 150 mg shot. . Didn’t know if I should spread it out with more injections or just try the one shot for 6-8:weeks to see how I go …bit was just the feeling of my heart beat especially at evening times that worries me
Nah, more common with the low-carb, keto, carnivore craze going right now. Really for guys on TRT the number doesn’t matter; if it’s high you can take more test to compensate for it so FT gets to a good range. More problematic for nattys
So more frequent may stablize bloods and not spike the red cell counts as much. Mind it’s my injection tomorrow and the heart rate has been faster and noticeable more for a while now … as the my red blood cell counts are ok the only one raised was the mean cell heamaglobin is 33 from a range of 27-32… U think it’s nothing to worry about
I may have been genetically predisposed to higher SHBG anyway but five or six years of low carb/paleo, with the last 1.5 years incorporating consistent intermittent fasting, sealed the deal for me.
After that, no amount of lifestyle changes seemed to budge my SHBG.