Increasing Bio-Available T

So i’ve been on Sustanon since late 2019, having been diagnosed with Klinefelters in 2015 and previously been on the gel and Nebido. I self inject sustanon every 3 weeks; follow an anti-inflammatory diet which has reduced my bmi, visceral fat levels, subcutaneous fat levels, etc;

I supplement with tongkat ali, nitric oxide, l-lysine and Fadogia Agrestis.

I have just requested an SHBG blood test and free T blood test and the results are back.

Serum Albumin - 44 g/L
Serum FSH - 13.9 IU/L
Serum LH - 8.9 IU/L
Serum Testosterone - 29.08 nmol/L
SHBG - 57 nmol/L

which calculates out as:

Free T - 0.466 nmol/L = 1.8%
Bioavailable T - 11.2 nmol/L = 38.3%

So obviously this is (within range apparently (but very low) bioavailable T.

So my question is - how do I raise my bioavailable T levels?

Increase your dose of Testosterone

My dose of TRT is a standard dose of Sustanon 250 every 3 weeks.

Its not possible to increase my dose of TRT without pushing other blood levels dangerously high.

What other methods can anyone suggest?

If it’s an SHBG thing, some tips here:

So the NHS Free T level has come back as being in range - their calculation is defined as 465.4 pmol/L which does equate to 0.466 nmol/L.

How does that figure equate to being in range when my Bioavailable T levels are so low?

@swoops39 Laid out probably the most optimal (probably the best) approach for you — but how can you be sure it’s going to mess up your bloods if you haven’t even tried it? Right now — a long-acting ester and with that injection schedule and a long-acting ester, you’re basically strapped into a three-week hormonal rollercoaster. Your levels are likely spiking and crashing, which can seriously throw off how you feel between doses.
Also, don’t skip your thyroid panel — Klinefelter’s often comes with some off thyroid values, and that could be a hidden reason why your free T isn’t where it should be.

NHS is a joke btw.

2 Likes

How do you know? Have you tried?

I’d rather have low T than endure that rollercoaster. Why don’t you spread that out to once or twice weekly? 100mg/wk would probably put your total and free testosterone within range without dangerously raising other metrics

Seems like he’s more fixated on chasing that free T or bioavailable number on paper than actually focusing on symptom relief.

@LivingWith Are you getting your bloods drawn at the trough, just before your next injection? That could explain why your SHBG is at 54. A 250mg dose of any testosterone ester should typically lower SHBG significantly, unless there are other underlying issues, like thyroid problems, affecting it.

Yes the NHS is a joke especially when TRT types are like a lottery with nebido and sustanon the only offerings in east sussex, yet other areas of the uk provide cypionate and will put you on HGH.

I have done a 125mg dose every 10 days in the past but I felt no different from taking 250mg every 21 days.

@tacojitzu - no i am not fixated on chasing a free T or bioavailable number on paper. I am 49, 195cm, 90kg with a small amount of stomach fat and can lose weight easily with a high protein anti-inflammatory diet but I’m assuming that if my SHBG levels were lower and bio-available T levels were higher - then maybe I might actually feel more able in the sex department and more able to build muscle.

These most recent ones were done 1 week before my next injection - hence the 29 total t level; the previous ones were done 1 day before my next injection and my total t level was at 15.

@rusty_hammer - my question here would be how high is too high in the total T reading as some of my readings have been in the 52 nmol/L range.

That would depend on your health overall, cardio heart health, BP, symptoms, etc etc

Can you possibly change the injection interval of the sustanon?

I once took it e3w and while it maintained good levels for 2 weeks (and supraphysiological levels for 2-3 days) it wasn’t adequate for maintaining normal serum testosterone levels

At the very least 150-200mg e2w would be better

Because this is in range

It’s like mid normal

To be expected on 250mg e3w, esp shortly after injecting

My peak was 55nmol and my nadir was 5nmol/l

I take 100mg/wk now. It’s the dose I feel best at