Time for TRT or continue supplements?

[daveanthony]

Age 27
205lbs

Diet- lean protein, healthy fats, sweet potatoes, fruit & veggies.

Lift 5-6 times a week

Supplements-
Vit D 2000iu daily (current)
Probiotic daily (current)
Salmon Oil (on and off)
Dhea 25mg/day (newly added)
B12 1,000mcg (newly added)
Gabatone (taurine,valerian, gaba,l-theanine) (newly added for anxiety)


Symptoms-
Anxiety
Restlessness
Irritability
Mood swings
Depression
Brain fog

Recently went to a Naturopathic Dr for the above listed symptoms. After some thorough bloodwork some red flags have been raised.

TT 534
Free Test 51 (46-224)
Testosterone Bioavailable 105.9 (Low) (110-575)

SHGB 49 (10-50)
Dhea Sulfate 251 (85-690)
Dhea Unconjugated 590 (147-1760)
Cortisol 19 (4-22)

From what i have been told my thyroid looks good (check bloods), my cholesterol is decent, and all else checks out.

We discussed my SHGB being the cause of my low free testosterone, binding up all the available testosterone. But she is convinced the problem lies within the DHEA. She has told me trt is an option but she told me adding certain supplementation we could possibly lower shgb therefore raising my free test levels. She wants me to start the DHEA 25mg ed, B12, and the Gabatone. From what i have read many people have mentioned Lowering the SHGB has shown to be very difficult and point to trt as the only solution.

Just looking for some further opinions and some advice. Thank you, and here are my bloods.




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[Couchlockd]

Even on trt, if shbg is high you'll just have high total test and low free test

[daveanthony]

Even on trt, if shbg is high you'll just have high total test and low free test

Any suggestions?


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[Couchlockd]

Any suggestions?


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Optimize vitamin D intake.

Probably minimum 5k iu to 15k iu a day with a fatty breakfast

[daveanthony]

Optimize vitamin D intake.

Probably minimum 5k iu to 15k iu a day with a fatty breakfast

Okay thanks, would you recommend starting supplementing with Boron?


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[Windex]

The general calculation for D is 35 IU per lb of body weight. However, it's perfectly acceptable to start at 5000IU like couch suggested and retest in 90 or 120 days then evaluate from there. Also keep in mind when taking Vitamin D you need to intake both cofactors ; Magnesium (no oxide) and K2 (100mcg). Otherwise you get D leeching calcium from bones without these cofactors.

I split my Vitamin D throughout the day. It's a bit tedious but my philosophy is if I was outside all day I would be getting a stream of Vitamin D like an IV drip. So I try to recreate that. I'm also eating a fat based meal every 2 hours so it's a bit easier for me in that way.

B12 is great but you'd benefit better from a B Complex which covers the whole spectrum. 1000mcg a day is also pretty excessive dose outside a bulking cycle. The type of B complex you want to buy is called methylated (aka activated). In particular, Vitamin B is the key nutrient for your body to regular dopamine and serotonin pathways, so deficient in B6 can lead to things like depression.

I am surprised Magnesium was not checked nor recommended - it's the gold standard to dealing with the majority of your listed symptoms.

In my opinion using L Theanine + Magnesium or even magnesium alone is going to produce way better results than Gabatone. Valerian is a hit or miss placebo, and GABA does not readily pass the blood/brain barrier. A very good product is called Natural Calm (their newest version).


DHEA has a short half life so I would split 26 into 2x 12.5mg. One in morning and one after dinner.

Are your symptoms impacting your sleep quality (aka waking up with brain fog), sleep quantity (hours asleep, # of times awoken), or sleep onset (time to fall asleep) ??

[HoldMyBeer]

Even on trt, if shbg is high you'll just have high total test and low free test

I thought: low shbg = high free test?
Because whatever amount of the (total test not bound to shbg) is the free test. Is that not correct?

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[Couchlockd]

I thought: low shbg = high free test?
Because whatever amount of the (total test not bound to shbg) is the free test. Is that not correct?

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Yes that's correct.

I said high SHBG

[HoldMyBeer]

Yes that's correct.

I said high SHBG

Oh! I miss read that. My bad couch!

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[daveanthony]

The general calculation for D is 35 IU per lb of body weight. However, it's perfectly acceptable to start at 5000IU like couch suggested and retest in 90 or 120 days then evaluate from there. Also keep in mind when taking Vitamin D you need to intake both cofactors ; Magnesium (no oxide) and K2 (100mcg). Otherwise you get D leeching calcium from bones without these cofactors.

I split my Vitamin D throughout the day. It's a bit tedious but my philosophy is if I was outside all day I would be getting a stream of Vitamin D like an IV drip. So I try to recreate that. I'm also eating a fat based meal every 2 hours so it's a bit easier for me in that way.

B12 is great but you'd benefit better from a B Complex which covers the whole spectrum. 1000mcg a day is also pretty excessive dose outside a bulking cycle. The type of B complex you want to buy is called methylated (aka activated). In particular, Vitamin B is the key nutrient for your body to regular dopamine and serotonin pathways, so deficient in B6 can lead to things like depression.

I am surprised Magnesium was not checked nor recommended - it's the gold standard to dealing with the majority of your listed symptoms.

In my opinion using L Theanine + Magnesium or even magnesium alone is going to produce way better results than Gabatone. Valerian is a hit or miss placebo, and GABA does not readily pass the blood/brain barrier. A very good product is called Natural Calm (their newest version).


DHEA has a short half life so I would split 26 into 2x 12.5mg. One in morning and one after dinner.

Are your symptoms impacting your sleep quality (aka waking up with brain fog), sleep quantity (hours asleep, # of times awoken), or sleep onset (time to fall asleep) ??

My sleep patterns could definitely be improved, as far as getting to seep earlier and waking up earlier. I usually wake up feeling down and lousy.

The restlessness/ irritable/ mood swings have been the biggest issue. Always feeling the need to reach for something wether that be a drink or an e cigarette. Im stuck in a vicious cycle with the nicotine. I have been trying to quit for over 2 years on and off. Sometimes going 2 weeks without it (miserably) then slowly but surely returning to it. Ironically enough it makes my anxiety symptoms worse, but the constant need for something creates a panic attack like state where i just say screw it and buy another one.

I bought the natural calm today, the complete b, and the l-theanine.

In your opinion will supplementation alone be enough to change shgb/free test levels enough to see some real changes? Im not doing so well and its ruining all aspects of my life.

Thanks for the reply


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[Youthful55guy]

Age 27

Supplements-
Vit D 2000iu daily (current)
Probiotic daily (current)
Salmon Oil (on and off)
Dhea 25mg/day (newly added)
B12 1,000mcg (newly added)
Gabatone (taurine,valerian, gaba,l-theanine) (newly added for anxiety)

TT 534
Free Test 51 (46-224)
Testosterone Bioavailable 105.9 (Low) (110-575)

SHGB 49 (10-50)
Dhea Sulfate 251 (85-690)
Dhea Unconjugated 590 (147-1760)
Cortisol 19 (4-22)

Some good advice in the previous posts. I echo the advice of increasing Vit. D to at least 5,000 IU per day. Possibly increasing DHEA by adding in a second 25mg in an AM/PM split. Your SHBG is on the high side but not out of range. This is what is driving your Free/Bioavailable T down and possibly what is causing your symptoms. They are certainly consistent with low T symptoms.

Regarding supplements to lower SHBG, I've not been successful with any of them and believe me, I've tried them all. My SHBG is higher than yours and I've found only 2 paths to successful treatment. Given your SHBG is a third again lower than mine, perhaps supplements may help take the edge off. Keep in mind though that as we age, SHBG will creep up as part of the normal aging process, so what works now may not be effective enough 10 years from now.

For me, I've found only 2 treatments that work. The first is to lower the SHBG with very low doses of certain synthetic anabolic hormones, oral Winstrol (Stanozolol) and Anavar (Oxandrolone) are the most effective. My choice of treatment is Winstrol because it's twice as effective as Anavar and is about 4-6X less expensive. However, if you are doing this through legal channels, it is not available in the USA so you won't be able to get a prescription even if you found a doc willing to write one for this off-label use (I doubt you will find one). I have found that 2.5mg of Winstrol twice per day (5mg/day total) is enough to bring my SHBG down from 80-90 nmol/L to a more reasonable and mid-range 30-40 nmol/L. At this very low dose (about 1/10 to 1/20 the dose bodybuilders use) side-effects are minimal and it is suitable for long-term use. Keep in mind that I have much higher SHBG than you, so I suspect you will need a lower dose. This might become difficult in that the most I can cut the 10mg tablets down is into quarters. Perhaps 2.5mg once per day would work for you.

For Anavar, my limited experience is that I need about twice as much (5mg twice per day) to get the same effect as Winstrol. But at this dose, it can have some marginal effects on liver labs. However, in my experience, it is an acceptable effect at that dose. It's the cost that drives me to Winstrol.

Your other treatment option is to saturate the SHBG protein with T so that enough spills over to increase your Free T. Also, increasing Total T has the effect of marginally decreasing SHBG (as does DHEA another weak androgen). My experience is that you would want to start with about 100mg/week T-cyp in at least 2 divided doses (I prefer E3D dosing of 40-50mg) and then retest in 6 weeks and adjust (if necessary) from there until Free T is at least mid-range/ I prefer the upper 75th percentile for a 30 year old man, which is about 20-26 pg/mL in the LabCorp test (they use age-adjusted ranges).

[Windex]

My sleep patterns could definitely be improved, as far as getting to seep earlier and waking up earlier. I usually wake up feeling down and lousy.

The restlessness/ irritable/ mood swings have been the biggest issue. Always feeling the need to reach for something wether that be a drink or an e cigarette. Im stuck in a vicious cycle with the nicotine. I have been trying to quit for over 2 years on and off. Sometimes going 2 weeks without it (miserably) then slowly but surely returning to it. Ironically enough it makes my anxiety symptoms worse, but the constant need for something creates a panic attack like state where i just say screw it and buy another one.

I bought the natural calm today, the complete b, and the l-theanine.

In your opinion will supplementation alone be enough to change shgb/free test levels enough to see some real changes? Im not doing so well and its ruining all aspects of my life.

Thanks for the reply


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Everyone is different - impossible to give you a black and white yes/no answer. Just a matter of running the program and pulling bloodwork as you progress.