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Would it be possible to administer SHBG for us guys struggling to benefit from TRT because we have such low SHBG levels? 
Testosterone, Hormones and General Men's Health / Re: Low SHBG
« Last post by StephCurryFtw on March 01, 2021, 03:25:36 pm »
Single-digit SHBG is quite low, certainly not normal for a guy on typical TRT doses. The optimal level is around 30 nMol/L.

Have you had normal levels in the past? If not you may be predisposed to lower levels, perhaps genetically. This can make it tougher to get good results with TRT.

My dad and brother have low SHBG just like I do and my dad has low TT and FT from low LSH/FSH exactly like me. There has to be a genetics-component.
Testosterone, Hormones and General Men's Health / Re: Low SHBG
« Last post by StephCurryFtw on March 01, 2021, 03:24:28 pm »
Single-digit SHBG is quite low, certainly not normal for a guy on typical TRT doses. The optimal level is around 30 nMol/L.

Have you had normal levels in the past? If not you may be predisposed to lower levels, perhaps genetically. This can make it tougher to get good results with TRT.

I have had SHBG levels below 10 even prior to TRT. It has haunted me.
Your total testosterone is surprisingly low for the very large amount of testosterone you're injecting. If your absorption rate is typical then your predicted peak testosterone is bit over 1,000 ng/dL. If I were taking 200 mg T cypionate per week then even my average level would be around 2,400 ng/dL. The 200 mg TC per week represents 20 mg per day of testosterone. The typical natural man makes 6-7 mg T per day, and the reference range is considered 3-9 mg.

In spite of your serum T levels not being outrageously high, your hematocrit is suggesting they are still too high for you. I think you'd do better if your peak testosterone were knocked down to your current trough value. The problem with that is that your new troughs would be around 400-500 ng/dL. As short-lasting daily troughs these are fine and desirable levels. But they can be more problematic when they last a day or more due to less frequent injections.

I don't know how much complexity you're willing to tolerate for marginal gains. I believe the problem with testosterone levels could be solved with daily injections of an appropriate cypionate/propionate blend. This causes serum testosterone to somewhat mimic the variations seen in natural men. I suspect there are some benefits in having a normal peak testosterone of 600-800 ng/dL followed by a trough value later that's ~40% lower. For me having lower testosterone at night has also proved better for sleep.

Progesterone supplementation is another source of marginal gains. At a minimum I have better mood and sleep by raising my level from 0.1 to 0.3 ng/mL. I have used topical and injectable forms of progesterone, and both are effective.

Although your prolactin is in the reference range, some men will have problems when it's over ~10 ng/mL. While on TRT I had my level creep up from 6 to 11, which did correlate with problems. Forcing prolactin down with cabergoline improved some symptoms, but in the end much better results came with protocol modifications that seem to naturally keep prolactin lower.

HCG may be a good fit for you. Because your estradiol is a little on the low side, a boost from hCG could actually be helpful. How much will you take? Typically with TRT guys take 500-1,000 IU per week in divided doses.
Testosterone, Hormones and General Men's Health / Re: Beware of DHT
« Last post by Cataceous on March 01, 2021, 12:12:58 pm »
Have you measured DHT, E2, and PROG to try to quantify what levels cause problems?
Cat, do neurotransmitters play a role in pain perception? ...

Absolutely. Take a look at this article: https://sanescohealth.com/blog/pain-and-neurotransmitter-imbalance/

"Serotonin is intricately involved in modulating pain signaling processes. [18] Serotonin may have an inhibitory effect on pain perception;"
"GABA may enhance pain facilitation and decrease the perception of pain."
"Dopamine pathways influence and enhance pain processing and modulation, working to help relieve pain."
What's the reference range for total estrogen? I doubt it's anything to worry about. Estriol and estrone are much less potent than estradiol, so probably nothing to be worried about with estradiol on the lowish side relative to testosterone.

Is your progesterone measurement on the 0.0-0.5 ng/mL reference range? I think as part of normalizing all hormones it's worthwhile pushing this up to mid-range.

Estrogen, Total - Estrogens, Total 97     Ref Range - pg/mL 40-115

It's on the higher side of the range but not too bad.

You might be on to something with the Progesterone. It's at .1  in the 0.0-0.5ng/mL range.

Pregnenolone was 29. After doing more research it looks like I need to step it up as well. I'm going to see if I get my hands on this to supplement.

I just ran more labs(2/22) on a few other things - here is what I came back with:

DIHYDROTESTOSTERONE, LC/MS/MS   58    Reference Range: 12-65 ng/dL

TSH 1.65 Reference Range: 0.40-4.50 mIU/L

T4, FREE 1.0 Reference Range: 0.8-1.8 ng/dL

PROLACTIN 12.7 Reference Range: 2.0-18.0 ng/mL

CORTISOL, A.M. 18.7 mcg/dL     Reference Range  Specimen: 4.0-22.0

PSA, TOTAL 0.4 Reference Range: < OR = 4.0 ng/mL

Overall it's a battle each day with my mental health.

I have low sex drive, foggy memory, lack of morning/nocturnal erections, etc.

My doctor did prescribe HcG and I compound pharmacy is supposed to be calling me early next week to mail to me.

See anything suspicious on the latest labs?

Hi Daddel,

I am 38 y/o, 1,9m tall, slim, sporty, and have been dealing with low libido and especially ED for about almost 15 years. It started in 2005, when I was in my early 20s: I took Finasteride for several months, stopped and developed "PFS". Symptoms: Low libido, ED and sleep and concentration were also getting worse. However, my main focus is on low libido and ED. Sex since then was only possible with PDE5 inhibitors.

I am 36 and had some of the same symptoms most of my life. Before I got on TRT I spent 3years (24-27)using over the counter erection boosters that you can get here in the United States. They come with massive headaches and body aches, but it was the only thing that could get me erect and keep me there.

PDE5 inhibitors only work sometimes. It seems like everything in my life has to fall into place for them to work. Good sleep, exercise, low stress, etc. And you know life is life and that is hard to do.

I'm on the same boat right now and going back to the drawing board. I will share any information I have or success.

Testosterone, Hormones and General Men's Health / Beware of DHT
« Last post by PakMan on February 28, 2021, 12:29:09 pm »
I Started low dose TRT in 2016 for mainly libido/erection issues but also had mood and concentration problems. Wasn't much successful and cortisol went too low so quit after 8 or 9 months. Then tried HCG which worked for about 2 months but then E got too high and it stopped working at all. From then onwards, I was just chasing symptoms by trying different stuff. Low dose TE, TP, AI's, Proviron and different herbs. I knew that DHT was crucial for libido but wasn't able to raise it in a balanced way with consistent results. Every time it would work for some days and go too high with low estrogen symptoms (teary eyes, low mood, libido crash etc.) To get out of that (androgenic) state I had to take progesterone and I could then take T without above symptoms, but, in this (estrogenic) state, I still had very little desire plus erection problems. Then again, I would try an AI or zinc or Proviron with T or HCG for the next round.
   My heart was fine with all of this until the fall of 2019. I had injected low dose TE and also taken Proviron. Then I also ingested some astragalus root powder. I later found on the net that this lowers progesterone and estrogen. Any way at around midnight I woke up with my heart really struggling. It felt like it was pumping oil or something. I rushed up to my room and took a 100 mg progesterone pill and in minutes heart spasms went away and I was able to sleep. Next morning I went to the hospital for ECG and it was fine although I felt tired the whole day. Even though I became very careful I nevertheless had more cardiovascular events a few months later (heart palps, shortness of breath, nausea etc.) and to my horror, the progesterone did not help but made it worse (by supposedly blocking E I think). I went to the hospital the ECG was again fine and they gave me a date for stress test. I was feeling fine on that day and the stress test was also ok. Later I also had an Echocardiogram (ultrasound of heart) and that was fine too except the doctor said my heart walls were slightly thicker but he didn't seem concerned at all. I never told any doctor of steroids or anything I had taken.
   I have stopped all steroids/AI etc. It has become clear that anything that raises DHT causes an immediate cardiovascular event. Also anything that lowers E is bad, even heart healthy stuff like Pomegranate juice. If I drink it for 3 or 4 days I get pain in my chest. AI's are totally out of question. Even Boron has started to cause heart pain. Not sure why that is. May be because it lowers SHBG and frees up T/DHT?
 Any thing that blocks DHT (without blocking E also) relieves my heart of the pain like Finasteride, Astaxanthin, Rosemary oil, Lavender oil etc. Estrogenic and Anti androgenic stuff is what my heart is screaming for and it is not because my DHT is high. I just cannot seem to tolerate even normal range. I am really stuck with apparently no way without sacrificing one (sex) for the other (heart) . 
   This is just a warning to anyone who is on AI's or is trying to raise his DHT. If you can, please get off it before your heart stops tolerating androgens. Google DHT and heart and you will find links. Testosterones beneficial effects on heart are caused by its conversion to Estrogen while its deleterious effects are caused by its conversion to DHT. Of course this will not be true for everyone but there is a good chance you will screw your heart like me. Look it up.
Funny you mention allergic repsonse because I believe high histamine was causing the asthma and my nose being stopped up all the time so I guess it's possible it's causing the whole body pain. I can tell you this, the first three months I was on T and it was actually working I had no pain whatsoever. It was glorious. I've had low back issues since I was 18 and I felt so great during those 3 months that I built an in ground swimming pool myself and never got tired nor had my back hurt.

I might have spoke too soon about the asthma because it's back pretty bad today after being gone for the last week or so. I'm trying to think if I forgot a T dose in the last few days but I don't think I did.

Cat, do neurotransmitters play a role in pain perception? I've read that dopamine can act like a pain reliever of sorts. They think it might play a role in fibromyalgia.
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