That’s interesting that you brought up SHGB. I honestly wasn’t too informed on the importance of it. I know that TRT lowers SHGB, which causes higher free T levels, which is a good thing.
I have long suspected that I had some sort of insulin resistance. Given my log here, could you provide any theories as to why it would be so low?
SHBG has both enhancing and inhibiting hormonal influences. Its decreases with high levels of insulin, growth hormone, insulin-like growth factor 1 (IGF-1), androgens, prolactin and transcortin. High estrogen, and thyroxine cause it to increase.
Recent evidence suggests hepatic lipogenesis reduces SHBG, not insulin. Genetic corollaries to this mechanism have been identified.[3][4]
WITH this SHBG unlikely you will feel great. What is your protocol? SHBG 20 is all easy.
WITH this SHBG unlikely you will feel great. What is your protocol? SHBG 20 is all easy. Remember the less SHBG, T more free, more Estradiol free too.
If you look on the picture to the left I list the protocol I was on at the time of the blood tests. I’ve run the gambit since beginning. The *see note protocols are listed at the bottom.
All who care to share their opinion,
I am seriously considering switching back to androgel 1.62. Since switching to test cyp, I have experienced chronic and painful acne vulagaris. Mostly on the back, but enough on the face that it’s embarrassing. I have attempted to use acne body wash on the back area to no avail. Also, this may alleviate the low DHT since switching to injections.
Does anyone have any input regarding acne on test cyp? Is there another option that would be better suited such as enanthate, etc?
Transdermal T might not eliminate the acne but would increase DHT [and libido] and probably would increase T–>E2.
" if androgel increases DHT to aromatase, and anastrozole prevents aromatase (even the aromatase of T->DHT)"
Nonsense. Aromatase has nothing to do with T–>DHT.
KSman,
can you give me your interpretation of my latest lab I posted January 8th? There are fluctuations I have no idea what to make of. I listed my concerns in the same post.
For body acne I started using Nizoral shampoo as a body wash and it has done way more than Doxicycline and prescription benzoil peroxide did for me. My acne is drying up and I don’t notice new acne forming. It’s almost to the point where I wouldn’t be embarrassed to take my shirt off. I got my doc to prescribe it and the co pay was about $2. My doc was skeptical but I think the next time I see her she will be in for a surprise.
I appreciate the feedback, Mike. I switched back to the gel the other day. It’s already clearing up a lot. Problem is, I’m getting some of the same symptoms as pre-TRT. Can’t win for losing man.
I’ll try that in the future if/when I switch back to T cyp. It got so bad I had one large cyst on each shoulder and it prevented me from going to sleep one night (I sleep on my sides). That was my tipping point. But now I’m back to pre-TRT symptoms, so my other tipping point will be coming shortly.
I have procured some hydrocortizone tablets to raise my low cortisol. I plan on getting a 4 point cortisol test prior to taking them. I am running out of options and am not sure where to go from here.
Edit: I’ve read a lot of negative posts (and positive) about Dr. Overbeck and Shawn (hardasnails). Does anyone have any opinions positive or negative concerning them?
Hey I wish you luck with the gel. You’re in a tough spot now for sure. If you can try to get a compounded cream. I had 20% cream that raised my levels to about triple what testim and then Axiron could and if you are going transdermal I think the high concentration compounded creams are the best choice. They made my DHT skyrocket to twice the top of the range so you will definitely get some improvement there.
I know we both have lower DHT levels and some low libido with it, hence your switching back to transdermals from injections. My libido has been better the last couple weeks on my injections after raising my dose slightly by 10mg per week (from 120mg to 130mg a week). I also switched to aromasin from arimidex in the middle of last week so I’ll keep you posted on how my libido does on aromasin. So far so good for me on that. Like I said above the Nizoral has been great for my acne. This is tricky finding the right balance with TRT, I’ve been at it for 8 months now and I think I’m finally getting to a good place with it. I’m certainly 100 times better than when I started TRT. Keep at it I know you will get to a good place with your TRT.
I’ve just started reading up on aromasin recently. Still not too spun up yet. Is it possible that aromasin is the reason your DHT rose? The reason I ask is because I experimented with three different dosages of test cyp. I started with 70mg/week because the testopel pellets were raising T slightly. Then I went to 100mg/week. Not really any improvement. I went to 150mg/week and still noticed no real improvement. In that time I just became more and more prone to acne. I’ve never had to wash my back other than my daily shower, but when I began injections, if I didn’t wash my back every night before I went to sleep it got markedly worse.
Were you not doing well on the cream? What were your reasons for switching to the injections? I don’t have any experience with compounded creams, but I have read that they can vary from pharmacy to pharmacy. Which compounding pharmacy was yours compounded?
I’m not sure if my DHT has risen however I know my libido has risen. I’d imagine my DHT went up nominally from the increased testosterone and I’m not sure if aromasin made any difference DHT wise. Others have reported better libido on aromasin so I figured it was worth a try. So far the increased test and the aromasin together are working good. I’ll report labs next time I get them.
I did better on test cream rather than testim or axiron. It raised my levels to the 500’s while testim and axiron couldn’t get me beyond 200. My acne actually started on the test cream, in part I think because my DHT went way high and my e2 got elevated. My test levels weren’t high enough and my DHT was too high, and when I combined those two things with the transference risks I decided to do injections. I got my test cream at a local compounding pharmacy in Northern California called dollar drug. I think it was $40 or so for a multi month supply before insurance reimbursed me.
I haven’t updated my log in a minute, so I’ll share the changes and developments with you guys.
I was experiencing a pretty heavy bout of acne while on test cyp injections. I started the injections at the same time as I started anastrozole. Like I stated previously, I had had enough when I had acne vulgaris on both shoulders and it actually prevented me from going to sleep one night it hurt so bad. I switched back to androgel, where I experienced zero acne. I continued anastrozole at 1mg/week. I continued to experience acne, although at a much lower level. Lowered anastrozole to .5mg/week. Acne lessened even more. I began to notice a correlation between the timing of dosing anastrozole and some acne. The day after I would take it, existing acne would flare up a bit. I decided to cut it out all together to see what happened. It’s been almost a week since my last dose. The acne has almost completely subsided. I haven’t read a lot about anastrozole causing acne. I might be one of the special few, as I always seem to be.
Despite all that, I still don’t feel quite “there” yet. I suspected my cortisol levels since they plummeted after beginning cabergoline. Cabergoline has been shown to lower cortisol levels. I had a 4-point saliva test done, which didn’t come back too bad from what I understand. Results are as follows:
Morning: 6.4 ng/ml (3.7-9.5)
Noon: 0.8 ng/ml (1.2-3.0)
Evening: 1.1 ng/ml (0.6-1.9)
Night: 0.4 ng/ml (0.4-1.0)
I’m seeing a BodyLogicMD specialist in April to see if he can decipher what’s going on. Most everything is good now (libido, sleep, erections, etc), but the energy levels are still not there. I continue to wake up exhausted.
Edit: I forgot to mention that I started taking adaptogenic herbs after reading a log on stopthethyroidmadness website. They seem to be alleviating the cortisol fluctuations throughout the day. Time will tell.
Cabergoline can work with some patients [35%] to normalize cortisol in some patients with Cushing’s Disease. But the average dose was 3.5mg/week. Normal caber doses are 0.5mg/week. I do not know how much of this tumor activity suppression translates to normal people. I take 0.5 caber/week and my 8AM cortisol is near top range. So I would be an exception.
Note that whatever the effects of caber, the control loop will tend to override the changes unless caber affects the control loop regulation itself. Is there really any evidence that caber causes problems in normal doses?
When you lower E2, there may be more FT–>DHT instead of FT–>E2 and FT–>SHBG+T
[quote]KSman wrote:
Cabergoline can work with some patients [35%] to normalize cortisol in some patients with Cushing’s Disease. But the average dose was 3.5mg/week. Normal caber doses are 0.5mg/week. I do not know how much of this tumor activity suppression translates to normal people. I take 0.5 caber/week and my 8AM cortisol is near top range. So I would be an exception.
Note that whatever the effects of caber, the control loop will tend to override the changes unless caber affects the control loop regulation itself. Is there really any evidence that caber causes problems in normal doses?
When you lower E2, there may be more FT–>DHT instead of FT–>E2 and FT–>SHBG+T
[/quote]
Not sure I follow you here KSman. Is this control loop in reference to cortisol?
Cortisol levels went from 15.3 pre-caber, to 7.1 after beginning caber. I always relate to the four-day period after beginning cabergoline where I felt fantastic, woke up refreshed, and had a wonderful outlook on life. That was roughly a week after beginning cabergoline. I hadn’t even started TRT yet. That four-day period of feeling great quickly dissipated and I felt even worse than before. This could have been a placebo effect, where I thought all my problems had been solved, OR, perhaps I passed through my cortisol sweet spot? All I know is that four-day period really clued me in to what I was supposed to feel like, compared to what I actually felt like. I’ve been striving for that feeling since I lost it.
I will say this about that saliva cortisol test. Some days the afternoon fatigue is worse than the others. That particular day, it wasn’t too bad. So, it’s possible that other days could come back even lower in evening and night numbers.
I’m updating this for all who can’t find the answer to why they still don’t feel well. Maybe I’m the anomaly, as I always seem to be. I’ve done countless hours of research; Used the scientific method on myself with everything I could find that seemed to make absolute sense to me. I stumbled upon a post in my meanderings from VTballer talking about a cortisol deficiency. I studied my blood tests, and am reminded of the “4 day period” in which I felt “well”. I decided to refrain from taking my cabergoline for around 10 days since cabergoline has been shown to lower cortisol levels, but nothing seemed to change. Perhaps I didn’t refrain for long enough. It is a much needed drug in my situation so I’m essentially trading bad for worse.
Since I have experimented on myself because I have little medical oversight due to my extenuating circumstances, I decided to try to supplement hydrocortizone tablets. They have already made quite a bit of difference. Maybe it’s too soon to tell and I have lingering placebo effect, but I doubt it. My energy levels have risen throughout the day. The social exhaustion I experienced has appeared to fade. There are countless indicators that tell me I am more connected than before.
We are not all the same. There is no one size fits all.
For your common knowledge, the adrenal glands have a negative feedback loop for producing cortisol, much like how the body has a negative feedback loop for testosterone. When you supply your body with exogenous (external) testosterone, the body thinks you have enough and you’re good, so it stops sending LH to the testes and you become “shut down”.
So, when you supply yourself with hydrocortisone despite having some to begin with, your body shuts down cortisol production and you drop to lower than you were before.
I started with 15mg/day and felt great for a couple of days, then I crashed hard. After my appt with a bodylogicMD specialist, he explained the process and upped it to 30mg/day. So far so good. Will keep informed.
Be aware of your cortisol levels.
yes, suddenly stopping cortico-steroids can be dangerous/deadly, one might need a med-alert bracelet.
Dose should make you feel well and not stimulated. Early effects will be odd as you will have your dose on top of your own levels and there are mental transients as well. If you take too much, you can create demands that exhaust other systems, the next weak link.
Caber has a longer half life of effect, much longer than serum half life.
If there are reports of adrenal insufficiency in patients using cabergoline, that does not mean that caber caused that. We have guys here who use the internet and who have adrenal issues and I also do not think that using the internet cause the adrenal issues. Often it can be a doctor looking deeper at a patients condition and finding a latent problem. We know that stress, infections, accidents, surgeries, diets, starvation etc can cause adrenal problems.
Good thread!! Thx for Sharing your experiences with us 
I’m about to hop on a plane so I don’t have time to really do an update, but here are my latest bloods. Long story short, 81mg of androgel gets me to 755 for TT, but 75mg of compounded creams gets me to 255. AND, my progesterone is low despite there being 15mg of progesterone IN THE CREAM? Before we all go jumping on the injections bandwagon (which I’m considering doing again), I’ve established that I do absorb transdermal, so does the issue with the compound in which it is suspended?
Please discuss. I’ll be back in a few hours.
