Here is my bloodwork. I think I have hypogonadism. Is it primary or secondary? Should I start TRT soon? I am 24. My SHBG is high. Free T is low. Total T is 600 so normal. LH is 3.7 so low-normal. Any quick advise would be great. Also if I do get on TRT, should I take an AI?
While LH is decent and won’t win any guinness records, your other problem is your liver is producing to much SHBG, some of you T is bound up and unavailable shrinking Free T. Medications and alcohol can cause SHBG the increase.
If you are unable to decrease SHBG naturally your only recourse is moderate doses of testosterone, 50-60mg twice weekly. AI should only be taken if labs and symptoms are present, AI’s are power and can drop estrogen to zero and it could take weeks, months to recover.
You can always lower the Test dosage to bring down estrogen if there’s room to do so.
DHEA is somewhat low, you may consider supplementing it on a lower dosage to start and slowly work your way up in dosage. DHEA can increase estrogen in some guys.
How’s your general lifestyle? Do you take any prescription medications? Diet? Stress? More labs would be nice, adrenal function, iron studies, CBC.
Weeeeeellllll, he could take a surpaphysiologic dose of testosterone, of course this isn’t a great idea long term, but in the short term it should drop his SHBG as androgens tend to lower SHBG. Another course is to use danazol or DHT derivitaves, such as a low dose (say 0.1-0.2mg/kg) of stanozolol, danazol has to be used at higher doses and it appears to have quite an impact on erythropoiesis therefore stanozolol, despite its immense harshness with regards to lipids, hepatotoxicity, potential joint pain etc, is probably the better choice. Mesterolone could also be used if he’s in a European country. If OP isn’t on trt data suggests he MIGHT (big emphasis on the might) be able to get away with using a low dose of mesterolone (say 25mgs/day) without significantly suppressing the HTPA, however mesterolone also appears to be very harsh on the lipids.
This is me just going on about shit for no reason but did you know that DHEA isomers are being sold OTC at the moment, they’re not DHEA though, 1-DHEA is a precursor to 1-AD (a PH that is no longer available), which is a precursor to 1-test (DHB), Now there’s very little research on these isomers, with the exception of a study showing 1-dhea can add lean mass, reduce fat mass and screw up cholesterol in four weeks, however theoretically 1-DHEA shouldn’t be able to convert to Estrogen like regular DHEA, however since it isn’t actually DHEA it’s very unlikely it acts like DHEA or has the same beneficial effects, as a matter of fact it appears to act in a similar fashion to anabolic steroids (Wikipedia even classifies it as an anabolic-androgenic steroid). 19nor-DHEA also exists and one other but I forgot what it is.
You didn’t mention any symptoms. What are they? You are unlikely to get an Endo to help you as you still fall in normal ranges. Are you willing to pay out of pocket? Back to symptoms… at your age I would avoid TRT if your symptoms are not affecting you severely.