Very high Free T, really need advice!

[juice2012]

My protocol used to be 100mg of Cyp T per week total (50mg x2 weekly) with no AI and these were my results:

Total Testosterone 534 250 - 1100 ng/dL
Free Testosterone 187.1 35.0 - 155.0 pg/mL
Estradiol 41 pg/mL Males,16 and over : 0-39.8pg/mL
SexHormone Bind Glob 9.83 10 - 57 nmol/L <-- flagged as low

Then we changed my protocol to 120mg a week (60mg x2 weekly) and added .25 mg of arimidex twice a week. I just got my results back and my Free T is VERY high:

Total Testosterone 1009 250 - 1100 ng/dL
Free Testosterone 386.9 35.0 - 155.0 pg/mL H
Estradiol 33 pg/mL Males,16 and over : 0-39.8pg/mL

My doctor now is concerned it's too high and wants me to back off the dose. Free T is so high because SHBG is so low. Also, it's crazy how high my T is after making such a small bump in dose, I really think adding the arimidex is the reason it shot up so much. Unfortunately my symptoms haven't really gone away either. At this point I think whatever is wrong with me isn't solely T related.

However, I don't want to just back off my dose right this second because I am afraid I might feel worse.

How unsafe is it to have Free Testosterone more than double the range?

[SEOINAGE]

I'd back off the dose slightly, and if feel terrible you can bring it back up again.

[steroid.com 1]

You're in good hands; your Doc is dialing you in and doing what's correct.

Good for you!

[labuski]

To answer your question from my limited knowledge, it doesn't hurt at all, go workout and enjoy it!

[juice2012]

My doctor doesn't know anything about TRT and is pretty much a prescription writing machine for me to bring my internet research to. That's why I'm asking here. Total T isn't above range, but Free T is ridiculous. Maybe I should try to get off my AI or something. I kinda don't want to change anything right now though.

[steroid.com 1]

^^^^Honestly, if that's the case with your Doc and you're on an Internet forum looking for ways to manage your health like this is all wrong.

Find another Doctor...seriously.

[juice2012]

Unfortunately, I have an HMO. Every time I change my PCP I have to wait a month, so I completely lack the ability to doctor shop.

[juice2012]

I decided to drop my dose back down to 100mg a week, which is what I started off with. I'll still be taking the AI so I imagine my T will be higher than when I wasn't taking it.

[bass]

most of us face the same problem, only way around it is to lower your dose. when was a sample collected in relation to your last and next shot?

[HRTstudent]

What symptoms do you have?

How long have you been on Testosterone in total?

You actually look like numbers really similar to mine. Low SHBG, but when you try to get a high total T, your fee T skyrockets.

My personal, non-physician, opinion? If you aren't feel much better then lower the dose. I feel that some people are physiologically designed to run on less T and some on more. Perhaps individuals like us are designed to run on less.

Keep an eye on that E2 because with low SHBG your E2 can fluctuate fast.

[HRTstudent]

Oh, and as for more practical advice, stick with the more frequent injections. I actually switched to 3x per week from 2x a week, but I can't say it's much different. The ideal would be every other day (for me) but I'm just not sure the more stable levels would offset having to poke significantly more holes.

How does your nutrition look?

Do you practice any sort of mindfulness/meditation?

What about your thyroid? DHEAs? Ferritin? B12? D?

Overall physical activity?

Do you think you get enough direct, daily sunlight?

[MRNJ1992]

My total T was only 117 but my free was like yours-thru the roof...... got bw on wednesday-will let you know what happens.BTW-just restarted my hrt 5 weeks ago after being off for 4 months...

[bass]

My total T was only 117 but my free was like yours-thru the roof...... got bw on wednesday-will let you know what happens.BTW-just restarted my hrt 5 weeks ago after being off for 4 months...

do you have a thread regarding you stopping and restarting, if not it would be a good thread to follow since there is so much discussion lately about getting off TRT. also interested in your BW results for this topic...

[juice2012]

Bass, both those sets of bloodwork were taken 3.5 days after the last injection. I would get up thrusday morning around 8, go get bloodwork and then drive home and do my next injection then go to work.

[juice2012]

What symptoms do you have?

How long have you been on Testosterone in total?

You actually look like numbers really similar to mine. Low SHBG, but when you try to get a high total T, your fee T skyrockets.

My personal, non-physician, opinion? If you aren't feel much better then lower the dose. I feel that some people are physiologically designed to run on less T and some on more. Perhaps individuals like us are designed to run on less.

Keep an eye on that E2 because with low SHBG your E2 can fluctuate fast.

My symptoms are similar to chronic fatigue, tired all the time, no energy to go do things like I used to, brain fog, difficulty concentrating. Something just feels "missing".

I've been on Testosterone for just over 3 months.

I'm going to stay on the same AI dose because I don't want E2 to jump back up even though I'm lowering my T dose.

[juice2012]

Oh, and as for more practical advice, stick with the more frequent injections. I actually switched to 3x per week from 2x a week, but I can't say it's much different. The ideal would be every other day (for me) but I'm just not sure the more stable levels would offset having to poke significantly more holes.

How does your nutrition look?

Do you practice any sort of mindfulness/meditation?

What about your thyroid? DHEAs? Ferritin? B12? D?

Overall physical activity?

Do you think you get enough direct, daily sunlight?

I've wondered about injecting less T but more frequently, but doing it 3 times per week, although it would be inconvenient I wonder how it would effect me.

My nutrition sucks right now, I was vegetarian for 18 months and just started eating meat again in the last month or so, I feel no different though since I started eating meat again. My diet is no longer strict like it was when I was lifting because I just don't have the motivation.

I have meditated before and had really profound experiences but like everything else I am not motivated enough to do it regularly, however, it's something I should probably do daily.

Thyroid is good, I've posted bloods on here before. DHEA is almost clinically low, just bought some micronized 25mg, going to start taking them next week after ramping up the pregnenolone I just started taking yesterday (wanted to not take both at the same time to see how each affect me). Ferritin I have no clue. B12 and D are almost at the top of the range now after supplementation.

I lift very irregularly, some weeks I lift 5 days a week sometimes only 1. Been having bad joint pain in my shoulders that really discourages me.

Absolutely do not get enough sunlight despite living in California. I work a desk job and go home when it's dark out.

[TennTarheel]

My symptoms are similar to chronic fatigue, tired all the time, no energy to go do things like I used to, brain fog, difficulty concentrating. Something just feels "missing".

I've been on Testosterone for just over 3 months.

I'm going to stay on the same AI dose because I don't want E2 to jump back up even though I'm lowering my T dose.

I think this is a smart idea. Just change one variable at a time, let your body even out, then re-test. If those results aren't to your liking, then lower the AI a bit. I bet you'll be good just lowering the dose a bit like you're planning.

[bass]

Bass, both those sets of bloodwork were taken 3.5 days after the last injection. I would get up thrusday morning around 8, go get bloodwork and then drive home and do my next injection then go to work.

pretty much what most of us do. its great that you metabolize well, lowering your dose can save you money and still get the benefits. i wish there was a way to raise SHBG, that would definitely balance things up.

[HRTstudent]

I've wondered about injecting less T but more frequently, but doing it 3 times per week, although it would be inconvenient I wonder how it would effect me.

My nutrition sucks right now, I was vegetarian for 18 months and just started eating meat again in the last month or so, I feel no different though since I started eating meat again. My diet is no longer strict like it was when I was lifting because I just don't have the motivation.

I have meditated before and had really profound experiences but like everything else I am not motivated enough to do it regularly, however, it's something I should probably do daily.

Thyroid is good, I've posted bloods on here before. DHEA is almost clinically low, just bought some micronized 25mg, going to start taking them next week after ramping up the pregnenolone I just started taking yesterday (wanted to not take both at the same time to see how each affect me). Ferritin I have no clue. B12 and D are almost at the top of the range now after supplementation.

I lift very irregularly, some weeks I lift 5 days a week sometimes only 1. Been having bad joint pain in my shoulders that really discourages me.

Absolutely do not get enough sunlight despite living in California. I work a desk job and go home when it's dark out.

I see. I think it's only being fair to yourself if you put as much effort into these other areas as you are giving to TRT.

You may, like me, be headed down a path where TRT ultimately is not the answer to your problems. It certainly may help, but you almost certainly have a multifaceted problem of which testosterone is merely one piece.

[HRTstudent]

And I would really recommend next blood work you get your iron serum and ferritin checked. As a vegetarian it's very likely you werent getting enough. This can have a profound impact on many systems in the body.

Our bodies absorb iron best from meat - better than plants.

[juice2012]

pretty much what most of us do. its great that you metabolize well, lowering your dose can save you money and still get the benefits. i wish there was a way to raise SHBG, that would definitely balance things up.

I wish there was too man, in all my research before I started TRT I never saw low-SHBG to be an issue people really had to deal with.

[juice2012]

I see. I think it's only being fair to yourself if you put as much effort into these other areas as you are giving to TRT.

You may, like me, be headed down a path where TRT ultimately is not the answer to your problems. It certainly may help, but you almost certainly have a multifaceted problem of which testosterone is merely one piece.

TRT has definitely helped my libido and thus my relationship with my girlfriend. I still am more tired than I should be and still don't have much interest in things like I used to (anhedonia/depression most likely). I'm trying to take this whole process so and only adding one drug at a time.

After reading about CFS it kinda freaked me out. It's rare people make a full recovery, and I'm still angry I never got a real diagnosis of what is wrong with me. We just treated low T because it was low hanging fruit.

My sleep doctor just got my prescription for Nuvigil approved because using a CPAP isn't really helping. We'll see how that makes me feel.

How did your journey lead you to TRT?

[juice2012]

I just had a thought about low SHBG. Over the summer while getting BW it came back that my Vitamin D was low. I did a 50,000/week IU "blast" and have been taking 10,000 per day since then. My D level was at 60 last time i had to checked, it's probably up to at least 80 by now. Doesn't Vit-D lower SHBG? I wonder if I stopped taking it would my SHBG come back up?

[HRTstudent]

TRT has definitely helped my libido and thus my relationship with my girlfriend. I still am more tired than I should be and still don't have much interest in things like I used to (anhedonia/depression most likely). I'm trying to take this whole process so and only adding one drug at a time.

After reading about CFS it kinda freaked me out. It's rare people make a full recovery, and I'm still angry I never got a real diagnosis of what is wrong with me. We just treated low T because it was low hanging fruit.

My sleep doctor just got my prescription for Nuvigil approved because using a CPAP isn't really helping. We'll see how that makes me feel.

How did your journey lead you to TRT?

When it comes to depression, I subscribe to the idea that it is multi-faceted. I have no doubt that going on TRT can improve one's depression, but it will not necessarily remove it altogether. For those people who simply go on TRT and life is awesome and 100% I tend to think they are the exception, the "easy" cases and maybe they didn't have depression beyond just a short stint of low mood.

So, while I am not one to say throw the kitchen sink at your depression, I would urge you to consider a rounded approach to treating yourself. If you just take the T shots and hope it will make your life totally different, you'll probably be disappointed. But what happens if you start getting out more, eat a truly nutrient-rich diet, eliminate most processed foods, and practice stress reduction? What happens then...? Just the sound of it seems far more promising!

As for what led me to TRT, I needed to make changes... and my spouse kind of urged me to do it because I lacked any real meaningful vigor for life (maybe I was studying too much philosophy and ancient history, lol). Otherwise, I have no doubt I would have ignored it and tried to tough it out. I had pretty much the standard symptoms of low testosterone across the board, with the exception of sexual inadequacies. So I got some bloodwork done and everything looked okay, but I had the T levels of someone over 65. I decided that I went to the doc because I needed to make a change and after sleeping and thinking on it, decided to try TRT.

My time in TRT taught me a lot. It's far from an easy, quick fix for many people -- myself included. Not only that, but I've learned that true HRT is far more than just TRT. Perhaps the most important aspect of getting "well" is fixing nutrition. I believe ma of us delude ourselves into think our nutrition is "better than most" because we don't drink, or don't smoke, or we don't each much fast food. But really, that just means what you are NOT doing -- "What ARE you doing?" is a much more important question.

[HRTstudent]

I just had a thought about low SHBG. Over the summer while getting BW it came back that my Vitamin D was low. I did a 50,000/week IU "blast" and have been taking 10,000 per day since then. My D level was at 60 last time i had to checked, it's probably up to at least 80 by now. Doesn't Vit-D lower SHBG? I wonder if I stopped taking it would my SHBG come back up?

I'm not sure how profound the impact of vitamin D might be. But, I would say try to maintain that level around 60-70. It's probably the "safest" range we know of right now to ensure there is no deficiency, yet not too high to cause adverse events.

One thing is certain for me, I would rather have a vitamin D in a good range than possibly raise my SHBG a couple points, and drop down to a low-range D status.

I have come across some decent info that points towards low SHBG being a sign/symptom of a mild inflammatory state in the body. Correcting nutrition could possibly fix that state and have a positive impact on SHBG IF that was the cause for one's low SHBG in the first place.

Again, it goes back to the well-rounded approach to wellness... start getting all these issues fixed and that will have a positive cascade effect on your entire health and wellness.

[juice2012]

When it comes to depression, I subscribe to the idea that it is multi-faceted. I have no doubt that going on TRT can improve one's depression, but it will not necessarily remove it altogether. For those people who simply go on TRT and life is awesome and 100% I tend to think they are the exception, the "easy" cases and maybe they didn't have depression beyond just a short stint of low mood.

So, while I am not one to say throw the kitchen sink at your depression, I would urge you to consider a rounded approach to treating yourself. If you just take the T shots and hope it will make your life totally different, you'll probably be disappointed. But what happens if you start getting out more, eat a truly nutrient-rich diet, eliminate most processed foods, and practice stress reduction? What happens then...? Just the sound of it seems far more promising!

As for what led me to TRT, I needed to make changes... and my spouse kind of urged me to do it because I lacked any real meaningful vigor for life (maybe I was studying too much philosophy and ancient history, lol). Otherwise, I have no doubt I would have ignored it and tried to tough it out. I had pretty much the standard symptoms of low testosterone across the board, with the exception of sexual inadequacies. So I got some bloodwork done and everything looked okay, but I had the T levels of someone over 65. I decided that I went to the doc because I needed to make a change and after sleeping and thinking on it, decided to try TRT.

My time in TRT taught me a lot. It's far from an easy, quick fix for many people -- myself included. Not only that, but I've learned that true HRT is far more than just TRT. Perhaps the most important aspect of getting "well" is fixing nutrition. I believe ma of us delude ourselves into think our nutrition is "better than most" because we don't drink, or don't smoke, or we don't each much fast food. But really, that just means what you are NOT doing -- "What ARE you doing?" is a much more important question.

I agree with almost everything you say. After realizing that TRT isn't going to fix all of my issues, but I'm to a point where I'm no longer missing work or worrying about losing my job, I'm starting to look into fixing other deficiencies.

I got my vitamin D back up to a good range. My high prolactin is being nuked by caberoline twice a week. I'm taking 4 grams of fish oil per day. And I just started taking pregnenolone this week, today is my 3rd day on it and I took 30mg in the morning. I'm going to go up to 50mg and see how I feel. To be honest though today I feel a little different. Not quite sure how to explain it but I feel a little "better". I feel like I actually want to go do something at night instead of sit around my house and watch TV. Next week I'm going to start DHEA. I am trying to be patient with making all these changes. Other issues I need to address is joint pain in my shoulders after lifting, and figuring out how to deal with depression.

I'm no longer worried about a quick fix. Just looking for long term well being.

[HRTstudent]

That's good to hear that you get "it" and realize testosterone therapy is simply not the ultimate bandaid that takes care of shortcomings in other areas. It's a trap I see too often. Not only that, but I went through a period where I was so "hormone-centric" that I forgot that these hormones are just the messengers for the supplies in the body. I let my nutrition slip a little. It's easy to miss the forest for the trees, as they say.

Finding ways to incorporate more nutritious food into my lifestyle has been, perhaps, the most grueling thing. It's easy to poke a needle a few times a week. It's asking a lot more of someone to implement new nutritional practices. (Unless you love to cook... then, I wish you lived next door.)