I agree. I actually want him to post and disagree AND debate these internet wannabe doctors. @unreal24278 analysis is great. His perspective is awesome. His experience and intellect are unbelievable or shall I say unreal.
Mmmmm…
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This approach is absolutely essential to productive forum advice, especially regarding a topic as serious as TRT. If a member offers advice and can’t defend themselves against legitimate criticism, then their advice is for shit and should be disregarded.
Anybody can give advice based off a quick Google search or surface-level knowledge of a topic. If you don’t know enough to fully support what you’re saying, then you should be called out.
Coming from a guy who consistently throws a wide net of anti-doctor “sick care” complaints, that’s interesting.
In which other threads has this happened? Has it happened or is this like when KSMan got his panties in a bunch over something that nobody ever actually explained?
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It’s common to see unreal come into a thread and take it over with his endless debates which is the real intent, to bait members into a discussion about being wary of giving advice without scientific backing even though that advice has helped countless men on multiple forums. I provided video with more than enough information to support my position and was met with silence on that particular point.
That’s the pattern you’ll begin to see him entering into the discussion being critical of advice given being vague as to why and then only offering a weak argument for example, daily injections and how it relates to scar tissue, but you know what if that’s what the OP has to do to feel good, then so be it because the alternative is what?
As for anti-doctor “sick care” complaints, I’m disenchanted with the sick care model who profits of disease and is controlled by big pharma, insurance companies and while I understand it may not be the doctors fault, they are complicite.
I’ve heard doctors who left the sick care system state they felt as if they sold a piece of their soul working in a system that makes it impossible to truly help people spending 10 minutes with them telling them there normal all because the insurance company refuses to pay out, yet they are more than happy to collect your monthly premium.
Sure I understand it’s a business to make profit, the profit margins are so absurdly out of balance and coverage so low it’s almost a scam.
Your dead wrong on this. You will have no one support your flaud opinion. You have no idea what unreal is about. Not saying I do but I know enough that he says what he says to educate and to share his knowledge. genuine.
I cant believe this thread turned into you attacking an 18 year old kid.
We can spend lots of energy countering your countless BS in here but we have lives.
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I think that @unreal24278 was merely responding to the cut and paste responses of @systemlord . It doesn’t really matter what anyone says, they get the same response from him, only tweaked to either “high” or “low” SHBG depending on the lab. Same advice either way. And frankly, TRT IS sick care, so going off about sick care is hypocritical at best. It is treating a symptom and not a cause. Care that helps men avoid the need, or restores the function might be evaluated as not sick care. Simply dosing a medicine without regard for the cause is sick care.
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I personally enjoy private pay patients as, after I pay the staff required to code, bill, and collect insurance payments I make an average of 15.00 off a 150.00 a visit. The overhead in running a clinic sure as hell isnt low.
@systemlord @unreal24278 is absolutely not a narcissist. In any capacity. In fact, he has quite a lot of humility considering the level of his knowledgebase and also his intelligence. He cited medical studies, as well as pharmacokinetics and pharmacodynamics of compounds in question. For every video you post about someone recommending shbg and frequent shots you can find videos to counter that claim. What you can’t find are human studies. Just like you can post videos all day about people recommending AI yet no human study has ever been done showing a benefit for them - unless you have breast cancer; in fact human studies shows estrogen being elevated with elevated test is quite protective and healthy.
I like basically everyone on this forum, but the majority of what you guys preach in TRT is anecdotal yet projected as science fact. If something works for someone, that’s awesome. But that doesn’t make it fact. I know lots of guys who feel great running 800mg of test and 400 mg of tren- some for long periods of time, upwards of years. Is that healthy or good? No. Do they feel good? Yes. Hard to argue when someone feels good at the time.
If you want to inject test every day to simulate hormone pulsing then why screw around with esters of test that are so slow to release and cannot mimic natural productions and just use suspension or at most prop? If your goal is to limit the estrogen response that you’re so worried about - fix your liver and elimination pathways. I know you’ve been losing weight and that’s awesome! That helps a ton. But basing injection protocols off of a glycoprotein that changes constantly based on oodles of feedback on an hourly basis seems really silly.
@unreal24278 is one of the best contributors to these forums. There are plenty of great guys in this forum as well. @unreal24278 bases suggestions off of facts and that’s a good standard to use.
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Not at all. You are having a great middle of the road approach. Your suggestions always make sense and I honestly agree with what you just said about the ED approach. Physio jsut doubled down on it as well.
I think we have to realize that new members or folks asking questions do not always realize there are multiple ways to achieve success through TRT.
We should articulate our comments in a manner that leaves room to deviate and other members should correct and fill in option 2, 3 And so on.
How many times have we seen folks change their stance on trt? Jay Campbell of all folks went from an ai loving freak, keep it at 20-30, and then reverted overnight to “my e2 is 100 and I’m doing great!!!”…
Now those suggestions have to be reversed and harm reduction must begin.
So instead of saying I prescribe or do this. Let’s try to say here is what I would do in your shoes or what worked for me and the folks around here.
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I truly think it’s great these issues are getting hashed out, i truly do. understanding how people communicate is key to understanding the message being sent.
i would like to know if i’m basically doing all this with minimal help from my GP (he will prescribe whatever i reasonably ask of him) is the next step i should take to deal with the SHBG and estradiol levels to split my dosing to twice a week?
all my other labs, thyroid, hct, etc. came back normal. though my cholesterol was 199 and hdl 37, ldl 124
again i was on 300mg a week for some time, switched down to 200mg and tested levels about a month after switching to lower dosage.
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woah, thanks for the support guys 
@physioLojik, @Chris_Colucci @enackers @charlie12 @ChickenLittle
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Beware thyroid reference ranges aren’t normal as these normal ranges are invalid, no two doctors can agree on normal. TSH <2.5 or closer to 1.0 is optimal, Free T3 should be midrange or higher, Reverse T3 <15 ng/dL.
Reference ranges for TSH and thyroid hormones
The evidence for a narrower thyrotropin reference range
It has become clear that previously accepted reference ranges are no longer valid as a result of both the development of more highly sensitive TSH assays and the appreciation that reference populations previously considered normal were contaminated with individuals with various degrees of thyroid dysfunction that served to increase mean TSH levels for the group. Recent laboratory guidelines from the National Academy of Clinical Biochemistry indicate that more than 95% of normal individuals have TSH levels below 2.5 mU/liter.
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The question is how do you feel at this dose? If you feel great don’t worry about the estrogen numbers.
If estrogen is causing an issue then make changes. We’re talking quality of life issues not nipple sensitivity. Right now all I see is a number and nothing said about symptoms.
Keep in mind rule of thumb is to make changes when you have symptoms and blood work backs it up.
Personally I would go from once a week to twice or three. Going daily is a ton of work. The point is you have multiple solutions. If one doesn’t work you try the next and so forth.
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TSH 1.11
T3 3.5
T4 1.2
not sure if it makes a difference with the variable reference range. thanks
i feel pretty good. just a lil concerned if i’m getting the full benefits of taking test with the low shbg and if any issues may creep up down the line with the high estrogen. my libido has been a mess for some time, my energy levels are decent for a 47 yr old gator wrestler
You’re visits are only 150? Visits to my endocrinologist are nearly 500$ (not after subsidy obviously), more like 250 out of pocket per visit.
Do you RUN the clinic, or do you work as one of the doctors. That’s mightily impressive if you run you’re own clinic. I think you’re name has to have more formal prefixes/ English honorifics added if you run an entire clinic.
Dr Mr Dr Professor Sire Mr Dr Sir Esquire Rabbi Sir.
Lol lol. Our typical follow up appointments at my last group was 150 billed to insurance as a base.
I run my clinic now @unreal24278
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That is wild. when you say labido what do you mean? If estrogen isnt causing that many issues dont worry about SHBG, get that out of your mind until it is an issue. Until then your just going through the normal steps we all take when on trt. I am talking about dialing in your protocol.
Not sure if its estrogen causing the labido issue. I and many have high estrogen above your number and we are fine. Describe the issue more and im sure someone can help.
Dont worry about lab ranges, shbg, estrogen unless you are having sides. until then just enjoy the trt.
Now that we have all the Kumbaya’s done.
I would like your thoughts @unreal24278 on SHGB and E2.
Google:
Sex hormone-binding globulin or sex steroid-binding globulin is a glycoprotein that binds to androgens and estrogens. /Google
If SHGB binds Free T and Free E2 so we basicly can’t use or feel them would you not think a person with an average high SHGB could tolerate more E2 since the SHGB would bind it up? We would not feel it and we would not get negative side effects. It would be motabilized(sp?) and pissed out.
In the same thought if a person had an average low SHGB they could not tolerate as much Free E2 because there is not enough SHGB to control it. That person would experience high E2 side effects sooner.
And if all that makes any sense my position that a person with low SHGB should run a lower E2 to keep the bad side effects away because he does not have enough SHGB to bind it up than a person with high SHGB should work.
What say you?
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These are excellent levels, your TSH is optimal. Our numbers are very close, my TSH tends to run <1.0 and have seen a select few guys with very low TSH naturally.
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Nah, it’s about ratio, also SHBG bound test isn’t useless, it’s a constant feedback loop, hence why SHBG fluctuates so much throughout the day, a blood test is a mere snapshot at what you’re hormonal status was at that second the bloods were taken, various situations will require you’re body to utilise more free T, in which SHBG will decrease/increase or whatever. Some people do however have chronically high/ low SHBG
When you have higher free E, it’s correlated with higher Free T, thus the ratio of T–>E and DHT being appropriate typically means an individual won’t experience sides.
About pissing out hormones… The majority of “testosterone” we piss out is the metabolites, SHBG has nothing to do with testosterone being metabolised into various metabolites. Only about 2% of test is released in urine in it’s purest form. I believe testosterone is metabolised via conjugation, however I could be wrong.
Finally, dosing. Let’s say two people metabolise and excrete T at the same rate but one has an SHBG of 100 and the other has an SHBG of 10.
100 dude takes 100mg —> TT goes up to 2000, what will his free T be?
10 dude takes 100mg ----> TT goes up to 400 or whatever, what will his free T be?
They’ll both be (likely) roughly the same, it’s a rough concept and it doesn’t quite work like this, but you see what I mean about the SHBG dosing thing being BS.
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This is what I have always thought. It doesn’t take much T to get my total T super high because of my high SHBG.
Question: could there be any negative consequences of having Total T way above range if free T is within range (high normal)?