Hello Guys, looking for advice from multiple sources since I have not started TRT yet, and want to do what’s best from the get-go. I have done preliminary work with Entourage Hormones and they are ready to take me on as a patient.
I am 54 y/o, 5’9", 169lbs and have been into health/fitness my whole life, take no medications, and no steroid use.
Listed are my recent lab values, want to see if I need to start TRT or if I should take another path initially to stimulate my system to produce. I am not seeing a Doctor at this time for my hormones, had blood work done on my own.
Test - 307 (264-916)
Free T - 39.2 (50.0-210.0)
SHBG - 95.7 (19.3-76.4)
Estradiol, sensitive - 8.9 (8.0-35.0)
DHEA-S - 267.5 (44.3-331.0)
LH - 2.8 (1.7-8.6)
FSH - 3.8 (1.5-12.4)
Prolactin - 5.2 (4.0-15.2)
PSA - 0.3
TSH: 1.51 (0.27-4.2)
Free T4: 1.17 (0.93-1.70)
Free T3: 2.4 (2.0-4.4)
Any feedback is welcomed, Thanks,
Rich
TRT is your only option, high SHBG is overstating your Total T and is the reason free T is so low. Large infrequent injections is the only protocol that will work for you, typically once weekly. These large doses of T will drive down SHBG freeing up more free T, Nebido isn’t going to be enough as it has slow esters and breaks down too slowly.
I would request test ethanate and you might require supraphysiological doses of test to play upon your high SHBG. The larger the dose, the larger the testosterone peaks and it is this that drive down SHBG and not sustained high levels.
Thyroid isn’t optimal, Free T3 and Free T4 aren’t optimal and TRT requires optimal level to get optimal results. Free T3 and Free T4 need to be midrange or better. Healthy young men range closer to TSH 1.0 with Free T3 and Free T4 midrange.
Suggest you might be iodine deficient, thyroid requires iodine to function, women are ever more susceptible to iodine deficiency. Does anyone in your household consume iodized salts? A restart of your natural production at your age is unheard of, very few young men get successful results using Clomid or HCG monotherapy.
This is the type of response I was hoping for, thanks.
My goal is to start off on the right track rather than experimenting with a cookie cutter approach.
Now to find a doc who will order ethanate.
I’m glad you brought up ethanate and it’s dosing and how it can impact SHBG, an area I don’t understand at this point.
My Mom and Uncle do have Thyroid issues, so certainly in my genes.
I have been Paleo for 5 years and Keto for 3 months, eat eggs nearly everyday with seafood 2-3 times a week. Lately I have been using Dulse, may need to increase frequency. I will look into trace mineral supplementation.
Iodine and selenium can improve thyroid situation, however this will make TSH lab value meaningless in the same way thyroid treatment would drive TSH below range. You more than likely won’t need an AI, so if doctor prescribes hold off until the need arises, too many guys are started out on AI when they don’t require one.
The cookie cutter protocols are used by doctors who are unable to interpret lab data and gain insight into the patients blood biomarkers, this is a easy way to know if the doctor is clueless about such things.
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In other posts of yours I have seen where SHBG is produced by the liver.
Apparently I have a hyper-active liver, my total Cholesterol is high as well.
Watched “Forever Young” last night where Dr. Life indicated TRT can assist with improving Cholesterol. So if testosterone will potentially bring down my SHBG, I may benefit with improved Cholesterol levels.
Your LH is low
Try taking clomid and nolvadex before you try anything else
Nolva and clomid at 50mg and 20mg respectively raised my levels from 260 to 440 in three weeks
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