Thank you for the feedback, man. The one I take comes with copper and selenium, so I’d think that risk would be mitigated.
I had an interesting chat with Saya about the “overcome high SHBG with more T” approach. He also doesn’t think that works for everyone, namely guys like me who have high SHBG but also worse bloodwork when the T dose gets too high.
Well I’m no Dr. Saya, but you more than overcame your high SHBG because your free T is much too high. Consequently, your bloodwork is negatively affected by your too high free T and the aromatase inhibition. So, my amateur prescription would have been: reduce the testosterone, drop the AI, and stop worrying about SHBG (that means no oxandrolone).
Interesting. You think this impacted LDL? I asked Saya and he said no, the AI should have no effect. I was on the “no AI” train for years but he thinks controlling estrogen is in my best interest.
There are some studies that show anastrozole decreases HDL and/or increases LDL cholesterol. If we think estradiol has a generally favorable impact on lipid profile while androgens have a negative impact, what should we expect to happen when we skew the ratio heavily towards androgens by adding an AI and oxandrolone?
Of course, this discussion assumes elevated LDL cholesterol is a legitimate concern which I’m not sure it is.
I mean yeah, if you need to run 58 ng/dl free T, then controlling estrogen might be in your best interest. At more typical TRT levels of free T like 20-30 ng/dl, maybe not.
Fair enough. Saya wasn’t panicked about my labs with consideration of the full profile (including decent Small LDL-P and LDL size numbers). Something I’ll be keeping a close eye on, though.
I’m thinking a lower AI dose might be the most elegant solution. I was already on a low dose at 0.125 3x/week, but I went from 0 to that. Maybe I’ll take the AI 1-2x/week.
As I look through my labs at what’s been “optimal,” in terms of hormone profile and overall health, it seems my spring 2022 protocol (260 mg T-cyp, Danazol 25 mg EOD) was best. I wasn’t taking an AI; estradiol was 102, SHBG 70.
Update:
To recap, labs were really bad in January. After some medication and diet changes, things look a bit better now, but still some red flags.
I think dropping the AI helped, but adding oxandrolone (even at a pretty low dose) is also producing poor health indicators.
Cholesterol looks bad (though LDL has dropped from 194 to 102). I’m paying close attention to ApoB.
FT is crazy - highest I’ve ever had. Overall, I’m feeling good, but not like I’d imagine I would with an FT like this.
Physique is looking good and my mood’s been good too, but my libido has just been meh. From what I understand, oxandrolone is more anabolic than androgenic, so maybe that helps explain it. (DHT has dropped from 255 to 118, and TT from 3030 to 1542.)
I have a follow up with Dr. Saya soon. I imagine we’ll either change medications or cut the oxandrolone dose - maybe to 11.5 EOD.
I haven’t been able to get SHBG to a reasonable level with T on its own. I’m wondering if my perpetually high SHBG could indicate an underlying liver issue. Liver enzymes aren’t terrible but aren’t good either.
@FunkOdyssey @alex_uk @QuadQueen @blshaw @kazuya_mishima1 @disciplined_trt
It looks like you’re on the right track. Definite improvement here.
Nothing helpful to add but good to see you posting, how’s life in general?
How much you weighing these days? Still managing to get regular lifting in?
Thank you brother! Life is great. Wife is expecting our second baby (a girl this time) in July. God is good!
I’m somewhere in the 180s, and yep. I do BJJ 2x/week and lift 4-5x. Training is going well. Appreciate you commenting my man!
That is such awesome news, congratulations! And Amen to that!
From memory you’d got up to 190 previously? Happy with current state? Presumably training BJJ is easier when you’re not constantly battling the scale?
Yessir, I was a little bigger this spring. I decided to take off 5-10 lbs of BF, just to look a little leaner for summer.
Training both in the gym and at BJJ is going very well. I really like BJJ to keep me from obsessing about appearance and to present a continual challenge - you’re always progressing, you know? And then in the gym I’ve been a little stronger each workout. I’m sure the anavar has helped 
Protocol updates after my consult with Dr. Saya:
I’ll check everything again in 6 months. Cholesterol numbers should look better with the oxandrolone decreasing. FT will come down, too, but it’s probably too high right now anyway.
