TRT help! Losing hope

Pharma / TRT
1

Hello,

Really sorry if I have posted in the wrong category.

I am just looking for advice and guidance on my situation.

A little about me:

Hypogonadism since 2015(idiopathic)

Started TRT about roughly 2022 via private. Was hovering at between 6nmol and 11 being the highest.

Test Cyp 125mg a week split into daily doses

HCG - 500iu week

Ai 0.25mg twice a week

Recent blood review:

Total T - 26 nmol/l

Free T -0.9 nmol/l

SHBG -15

Oestradiol -99 pmol

Prolactin 183 mul

Have been told since I have low SHBG I need to lower my dose to feel better, I lower it and have been down to roughly 15nmol/l total T and still feel the same if not shittier then I get told to increase, then decrease when i start getting to the high end of the range and have been back and forth like this. On top of all the dosage changes I then have to do bloods every 6 weeks. Its draining me… and my pockets..

my question is:

  1. If im on TRT for life, whats the harm on being on the high end of the scale?
  2. Has anyone experienced anything similar? Do low SHBG guys really need to be in a really low dose? If im at around 15/17 nmol why even bother with TRT (is this a wrong mindset to be in?)
  3. If I’m low SHBG, do I have to just carry on being unstable with my levels?
  4. Has anyone just gave up on their clinic and gone to self medicating? Or is this a stupid move?

Really sorry, if this sounds silly.

Thank you all in advance!

2

First off you need to post bloodwork ranges or this means nothing.

1-There is no harm as long as all of your other bloods are inline.
2-I think low SHBG guys need to be on a higher dose as they don’t bind the hormone to the receptors as good. You will have a high free T.
3-What do you mean by this? You are taking testE every day. Your levels should be extremely stable. TestE can be injected 1-2x per week.
4-I’m sure plenty have. It sounds like your going to the wrong clinic. Have you tried DEFY? @blshaw has had a great experience with them and recommends them. You could also try Marek Health.

4

Hi sorry for such a delayed response!

Im based in UK.

Ref ranges:

Total Testosterone:Range 8.6-29 nmol/L

My result - 26 nmol/l

Serum oestradiol range - 41 to 159

My Result: 99 pmol/L

Serum prolactin Range - 86 to 324

My Result - 183 mu/L

SHBG Range - 18 to 54

My Result - 15 nmol/L

Serum albumin range - 35 to 50

My Result - 42 g/L

I hope that helps.

On my point 3, although im on Test ED I find every so often I either have to lower my dose because im on the high end of normal and supposedly its not benefitting low SHBG guys - as I have been told by DR. So I then lower my dose, eventually increase it again cos I end up a little too low or feel shit. Although… now that I think about it.. I don’t think I have ever felt good since starting.

Acne has also been a nightmare!

5

Really appreciate that! Thank you!

I think one of my concerns is giving up on the clinic… I screw up my bloods and then no one to fall back on for guidance.

Also, is there any harm in changing from ED to every 3 days? Or is it best ED for stability since low SHBG metabolises test too quick?

6

You should not need to adjust your dose once you settle on a dose that works. If your taking the same amount of test every day your numbers should not fluctuate unless the lab that compounds your test is shit. What are the ranges on your free test?
Changing your dose frequently means your hormones are all over the place. This goes hand in hand with acne. Also low shbg can cause acne.
What is your bodyfat level?
What does your diet and training look like?
High bodyfat and a poor diet can lower SHBG.
What other bloodwork did they do? If only above do you have other bloods taked by GP that are recent?

1 Like
7

Really appreciate you taking time out and answering!

Body fat is 24% using fat callipers.

Training 3x a week - heavily focused on powerlifting and has been the past 4 / 5 years.

Diet is not the best, it is something I need to work on 100%

Added more bloods below:

Free Test Range is 0.17 - 0.66 nmol/L

Lipids:

Serum total cholesterol level: 6.6 mmol/L

Reference range: Below 5

Serum triglycerides: 0.7 mmol/L

Reference range: 0.0 to 1.6

Serum HDL cholesterol level: 0.9 mmol/L

Reference range: above 1 for Men

Serum LDL cholesterol level: 5.3 mmol/L

Reference range: Below 3

non HDL cholesterol level: 5.7 mmol/L

Reference range: Below 4mmol/L

Serum cholesterol/HDL ratio: 7.3

Reference range: No range

Urea and Electrolytes:

Serum Sodium: 141 mmol/L

Reference range: 133 to 146 mmol/L

Serum Potassium: 4.5 mmol/L

Reference range: 3.5 to 5.3 mmol/L

Serum Urea Level: 5.6 mmol/L

Reference range: 2.5 to 7.8 mmol/L

Serum Creatinine: 135 µmol/L

Reference range: 59 to 104 µmol/L

eGFR (CKD-EPI) / 1.73 m²:

Result: 57 mL/min/1.73 m²

Liver:

Serum ALT Level: 31 iu/L

Reference Range: 1 - 50

Serum Alkaline phosphatase: 56 u/L

Reference range 30 - 130

Serum Bilirubin level: 11 umol/L

Reference Range 0-21

Serum Albumin 41 g/L

Reference Range 35 to 50

Serum Total Protein: 76 g/L

Reference Range 60 - 80

Serum Globulin 35 g/L

Reference Range 15 - 42

HBA1c Level - IFCC: 38 mmol/mol

Reference Range 20 - 41

FBC:

Total white cell count: 7.1 10*9/L

Ref Range - 4.0 - 11.0

Red Blood Cell: 5.02 10*12/L

Ref Range 4.50 - 6.00

Haemoglobin estimation 151.0 g/L

Ref Range 130 - 180.0

Haematocrit: 0.451 L/L

Ref Range 0.400 - 0.520

MCV: 89.80 fL

Ref Range 80.00 - 98.00

Mean corpusc haemoglobin 30.1 pg

Range 27.0 - 33.0

MCHC: 335 g/L

Range 320 -365

Platelet count 315.0 10*9/L

Range 150.0 - 400.0

Red blood cell distribute width: 13%

Range 11 - 15

Neautrophil: 4.18 10*9/L

Range 1.80 - 7.50

Lymphocyte count 1.85 10*9/L

Range 1.00 - 4.00

Eosinophil count: 0.37 10*9/L

Range 0.00 - 0.40

8

You need to work on these. I know with powerlifting goals good diet is not always priority but if you want to improve the issues you are having we need a starting point.
As I suspected your freeT is high so you have a lot of unbound test floating around not bound to receptors which does not benefit you.

9

Is there a way I can optimise my free T? Or get it bound? Sorry if that sounds daft. Guessing the goal here is to optimise my SHBG? I know I have always been low even pre TRT, the highest its ever been was 18.

Is there anything I could introduce to help increase my SHBG?

1 Like
10

You can introduce a better diet leading to better body comp which will help.
Could also try less injections per week.

2 Likes
11

Thanks! Thats interesting you say less frequent.. might try this tbf! I was always under the assumption that frequent injections are needed since I metabolise T too quick.

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12

Remember, when you make changes you need to give it 3 months for the test dose to settle and for your body to reach homeostasis.

1 Like
13

Thank you for all your help man!

1 Like