Low SHBG, Jatenzo, dumpster fire needs advice

Pharma
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Another low SHBG guy, thinking I am unique and just looking to vent and perhaps get some insight! I’ve been on TRT over 12 years, posted here a lot in the beginning when I had issues, tried to come off a few times, and feel like I have been chasing it ever since.

To try and make it short, and I can fill in the gaps if needed, I have never really ‘felt’ the benefits and I constantly battle rapid H&H increases and body oriented anxiety, although I never really thought the body anxiety or body sensations were related until recently. I mean I put on muscle easy, but it never helped my sex drive or ED, or mentally felt great or increased energy.

Even on doses as low as 60mg/week T Cyp, my Free T has always been at the top or over the top of the range, but my Total T will be pretty low. I also have low SHBG (11 at last test).

I was in the hospital in the summer and a doctor said to talk to my TRT doc about Jatenzo oral T because it might not raise my H&H the same way. Being tired of donating blood coupled with trying to keep my iron levels from tanking we decided to give it a go.

Jatenzo 197mg start 6/19/25 - First 2.5 weeks were great. I felt motivated, I had energy, etc. I was getting nocturnal erections. By the 3rd week everything started dropping and I was making notes of weird waves of anxiety. Just adrenaline type surges washing over me. Was dealing with a lot of increasing body pain, tightness, twitches, etc so I didn’t correlate with Jatenzo.

Labs Showed TT 311 (264-916ng/dl), FT 27.4 (7.2-24ng/dl).

Doc said let’s try and get that TT up some to see if we can get you feeling the benefits.

Jatenzo 237 mg start 9/2/25 - At first no real changes, but by 9/12/25 I was greasy, irritable, palms sweating, so much amplified perception of pain and fear, and my nervous system felt like someone was pouring gasoline into it.

Labs on 9/18 - TT 449, FT 35.2 (7.2-24) (only good thing is that my H&H actually stayed within range for the first time ever)

I’m still not putting the pieces together until I start doing some Grok searches and it says under FT spikes “This excess can overstimulate your nervous system, ramping up amygdala activity and causing anxiety waves, irritability, and that muscle tension sensation you describe.”

9/22/25 - I skip a nighttime dose and the next morning dose, then in the afternoon I take one of the old lower dose pills I had left. That day I felt like the switch was turned off and so many symptoms just vanished. My doc phoned in the lower dose again to see. Although the constant palm sweating and irritability decreased, the random fear, random anxiety, and most notably the heightened perception to pain remained. For example, I have muscles in my chest and neck that feel tight and they hurt, but my brain is interpreting it as if they are ripping off the bone, death is imminent, etc. I felt like back when I was coming off Benzos in 2013 so i am breaking out every coping skill, breathing technique, calming herb, and everything I can think of but it’s like putting out a house fire with a squirt gun..

9/27/25, yesterday - I skipped both doses of Jatenzo. I had a great day. Calm, my body felt under control, no amplified pain, no surges, and even waking up this morning I didn’t wake with dread and pain and fighting weird body sensations. It’s not just a feeling of ‘hey my deep diaphragm box breathing is taking the edge of” it’s more like “hey someone took out the adrenaline IV out of my arm and I don’t need the coping skills”.

So - The answer seems obvious - break out the needle, go back to injections, donate blood and quit stressing!! But, I’d love to get the most out of it for once. I have tried daily/weekly/2x/IM/SubQ dosing, and for most of the past 10 years I have settled on 3x/week SubQ. However, now I am wondering how much of my low level background battling of this body oriented anxiety is attributed to testosterone rather than me being ‘just an anxious guy’ . My inclination for dosing, even when I was on 60 mg/week, was “If I am going to be on TRT, why am I going to take less than that and not get benefits” But maybe the answer is because even at those low doses, I’m a damned superhero who can free all the T and put it to work!

But seriously, how do I get the most out of this? Do I worry if my total T is like 300-400 but my Free T is at the top of the range? What the hell is it with the Jatenzo that felt like I was straight up injecting gasoline and nightmare juice? Any other pointers?

(I’m waiting on a few new labs, and I know everyone hates just summaries, but my Thyroid is always decently in range, my estradiol will fluctuate but was actually low last time I checked in spring, my iron levels are good now)

Thanks in advance for even letting me vent.

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Low SHBG sufferer here too, im 100% sure its your SHBG. But since you already tried almost everything i cant think of anything else that might help you raise it. Other than drastically increasing e2, which for me personally has an extremely calming effect. Also what oil was in your testosterone? I purposely use a product that has castor oil, because its the thickest out of all pharma testosterone products. The thicker the oil, the less of it gets into the blood per whatever unit of time. I figured that i always used to have low SHBG but it was still in the lower third of the normal range, but “regular” TRT protocols will completely send it to low single digits. So basically what u wanna do is everything you can to lower the amount of test that hits your system at once or mor like lower the rate at which test gets into the bloodstream. That really seems to be the key when it comes to managing too low SHBG. Short injection intervalls with either Enanthate or Cyp, do it subQ, use castor oil and use a really really low dose and then give it time, at least 3 months. Ive had some conversations with Ai and had it do some calculations on the acumulation of the testosterone and basically you can get into the middle or even upper third of the reference range using these methods by only injecting like 80mg or even less per week if you give it enough time to accumulate.

Then of course avoid every possible SHBG lowering supplement or medication. Lower your fast carb intake and switch it to complex carbs, lower the overall amount, do everything you can to maximize insulin sensitivity. (Insulin indirectly lowers SHBG).

What was your E2? And also what was your E2 and SHBG before ever starting TRT? Maybe you have a low E2 Problem aswell, which is what i have too. Luckily the subQ injections give me plenty E2 (intramuscular gives me low single digit e2)

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Thanks for the reply.

So many of the things I have tried have just been to try and feel good, but not done looking through the lens of having low SHBG. And so many things I have felt I attributed to just being anxious, or having other issues, so I might have to start over and dose and schedule with this in mind and give it time to work.

My current Tcyp is cottonseed oil. I have tried t Prop, T enan, and in the beginning I tried some different oils because I would get massive welts and redness so we tried different oils.
I am waiting on new lab results, but after 2 few weeks on Jatenzo I go the following (bear in mind I was still feeling good at this point)

NEW LABS 09/26/25

  • Free T 39.1 (7.2-24) HIGH
  • DHEAS 467 (71.6-375.4) HIGH
  • E2, <5 pg/dl (7.6-42.6) LOW
  • SHBG 12.2 nmol/l(19.3-76.4) LOW
  • Prolactin 13.2 (3.6-25.2)
  • PSA 1.1 (0-4)

E2 - The above doesn’t show much e2, so this is wild. Most posts say low SHBG also means high E2, but maybe like you this is not the case for me??? Maybe I need to think about getting a little E2 to buffer the free T…..

Insulin - My blood sugar baseline runs a little higher than it should be(110 am), but I eat low carb, and have for many years. Until a few months ago I did drink too much, butafter 2 bouts of Afib, I have given that up again.

I just looked back at my original labs and I wish I had never gone on TRT. But at the time, we were focusing on TT numbers and I didn’t know that all my problems were likley from interdose withdrawals of xanax so i was pushing my doctor to try anything to help me feel better. These were my labs before starting TRT

08/14/2012 original before TRT

  • DHEAS 657 (80-560)
  • Prolactin 10.4 (2.1-17.7)
  • Progesterone 1.17 (.28-1.22)
  • Estradiol <18 (<53)
  • LH 3.8 (1.5-9.3)
  • FSH 2.6 (1.4-18.1)
  • SHBG 17 (9-54)
  • DHT 24 (no range given)
  • TT 335 ng/dl (160-726)
  • FT calculated 92.2 (21-135)
  • Testo Bioavailable calculated 216 (48-317)
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yeah both before and after TRT your E2 doesnt look good at all. Way too low in my opinion. Low E2 personally turns me into an extremely aggressive monster and also gives me unbelievable joint pain. I then took some estrogen valerate and it all went away. I did get some hot rashes and stuff like that but i felt much better especially joint wise but also psychologically. Whats interesting is that for some reason, when i do estrogen for like 2 weeks, instead of shutting my aromatase activity down even further, it actually boosts it so the positive effects last for like another 2-3 months after i stop taking it. Increasing your E2 also increases your SHBG

1 Like
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I was very irritable these past 2 months but not aggressive. But my body has hurt like crazy. Not joints, more like tight and painful muscles and very weak.

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I thought stopping the jatenzo was the answer. Saturday Sunday and Monday were pretty good.
Going back to daily injections, Sunday I did only 6mg and still felt great.

Monday I did 14 mg thinking I would do 5 days on and two off for 70mg a week. I had some breakthrough pain and panic yesterday. But short lived.

Today I got nervous and backed down to like 8mg. Most of the afternoon I’ve been in pain, stiff, waves of panic , feeling off, and not to mention stabbing left arm pain and sternum pain that radiates up the right breast. I’ve been told before it isn’t heart related but it is sure unnerving when it happens.
I know hormones take time. It’s just frustrating because when I stopped the rapid onset testosterone in Jatenzo I felt so incredibly calm and back to normal. Then even adding in a very low dose of t cyp and I feel like it’s all back to chaos.
So is it the test? Or is it the really low e2? Or is it that when any amount of test hits the bloodstream with my low shbg and low e2 that it brings out the worst? Maybe it will take time to increase e2? I’m half tempted to dab on some of my wife’s estrogen cream if it wouldn’t fick everything up.

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Estrogen controls creation of shbg in the liver…..is your e2 relativity low as well?

You can also try moving to less frequent injections.

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My e2 ultra sensitive was less than the detection limit of 5.
I thought with low shbg I should do daily shots to help keep the free T from spiking so I was giving that a shot.