Okay I think I understand now. Basically 40 e2 wouldn’t have as much as an effect on someone with higher SHBG, because it binds up more of that estridol and it wouldn’t affect them. But since my SHBG is so low, more of that e2 gets into my system, because more is bioavalaoble? So 40 e2, even though it’s not super high, it has sort of an amplified effect since more of it isn’t being binded? Am I following now?
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Yes, that’s exactly what that means. We are cursed.
Did defy recommend the daily injections to you?
This is exactly what I see in men with high E2 and low SHBG, free E2 percentage is very high.
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Yes.
I’ll reiterate the difficulties, from experience, of doing TRT with low SHBG. Its possible to get results, but it requires a bit more persistence and dedication. Sounds like you are on the right path and looking at going with a hormone specialist. The mood swings you speak of can be estrogen related. You also have mentioned your weight…which is high considering you say you arent very muscular. High body fat can make estrogen more difficult to manage. Losing weight and an overall healthy lifestyle should be a high priority, especially when choosing to start TRT. Something else you can mention to the Dr’s is your high Calcium levels…calcium inhibits iron absorption. So maybe get an iron panel done to see if there is an issue there. Just keep checking off the boxes and you’ll figure it out.
A couple of things:
Don’t get too hung up with flying by the numbers. Instead, go with any symptoms.
Stay with whatever change you make for at least six weeks, and some would argue for longer. Get thyroid labs which include free T3, free T4 and reverse T3.
For your amusement, below are labs from a guy taking 200mg once a week. Total testosterone is 798ng/dL. He does great. Free testosterone is at 3%.
