Anyone here with low SHBG who are doing well on TRT?

[Renholder]

Hello all,

Lately it has come to my attention that there is a group of men with low SHBG who may be more challenged in their TRT compared to those with normal SHBG levels. I always knew mine was low, but never put much thought into it until I read some more on the subject.

However, it seems that there are several men with low SHBG who do very well on TRT as well. Is there anyone here?

Let's define low SHBG as at least below 20, but I'm probably mostly interested in those that are even lower.

Mine is 13 on my last BW. 16 prior to that, but never been higher in recent years. TRT is still not working great for me and I wonder if this can be a factor. Even with T levels at 600 ng/dl, I'm above top of the range on what they call free testosterone index here in Norway.

Thanks in advance,

Renholder

[kelkel]

I believe both Vette and Bass have lower shbg levels Ren. Crisler doesn't feel much can be done regarding it. Says the body will find it's own balance.

This is from Scally:

Neuroendocrine Regulation of Growth Hormone and Androgen Axes by SERMs

--------------------------------------------------------------------------------

Birzniece V, Sata A, Sutanto S, Ho KKY. Neuroendocrine Regulation of Growth Hormone and Androgen Axes by Selective Estrogen Receptor Modulators in Healthy Men. J Clin Endocrinol Metab:jc.2010-1477. Neuroendocrine Regulation of Growth Hormone and Androgen Axes by Selective Estrogen Receptor Modulators in Healthy Men -- Birzniece et al., 10.1210/jc.2010-1477 -- Journal of Clinical Endocrinology & Metabolism

Context: In men, the stimulation of GH and inhibition of LH secretion by testosterone requires aromatization to estradiol. Tamoxifen , a selective estrogen receptor modulator (SERM), possesses central estrogen antagonistic effect but peripheral hepatic agonist effect, lowering IGF-I. Thus, tamoxifen is likely to perturb the neuroendocrine regulation of GH and gonadal axes. Raloxifene, a SERM, is used for therapy of osteoporosis in both sexes. Its neuroendocrine effects in men are poorly understood.

Objective: The aim was to compare the impact of raloxifene and tamoxifen on GH-IGF-I and gonadal axes in healthy men.

Design: We conducted a randomized, open-label crossover study.

Patients and Intervention: Ten healthy men were randomized to 2-wk sequential treatment with tamoxifen (10 and 20 mg/d) and raloxifene (60 and 120 mg/d), with a 2-wk intervening washout period.

Main Outcome Measures: We measured the GH response to arginine and circulating levels of IGF-I, LH, FSH, testosterone, and SHBG.

Results: Tamoxifen, but not raloxifene, significantly reduced IGF-I levels by 25 {+/-} 6% (P < 0.01) and increased SHBG levels by 20 {+/-} 7% (P < 0.05) at the higher therapeutic dose. There was a nonstatistically significant trend toward a reduction in the GH response to arginine with both SERMs. Both drugs significantly increased LH, FSH, and testosterone concentrations. The mean increase in testosterone (40 vs. 25%; P < 0.05) and LH (70 vs. 30%; P < 0.01) was significantly greater with tamoxifen than with raloxifene treatment.

Conclusions: Tamoxifen, but not raloxifene, reduces IGF-I levels. Both SERMs stimulate the gonadal axis, with tamoxifen imparting a greater effect. We conclude that in therapeutic doses, raloxifene perturbs the GH and gonadal axes to a lesser degree than tamoxifen.



http://www.ncbi.nlm.nih.gov/pubmed/22293276

[Trific]

Ren, do you take a bunch of D? I found this: "I saw my doc yesterday. We concluded that the 10k units of vit D I was taking everyday was driving my SHBG down and increasing my Free T"

Maybe that is why your SHBG is low??? I think it's early days yet on your nebido venture....

[Ace111]

Is this similar to the 'free testosterone index' you're talking about? http://en.wikipedia.org/wiki/Free_androgen_index

I'm not on TRT but mine is 12 so I'm close to top of the range on the FAI. How are low SHBG men more challenged in regards to TRT?

[Trific]

The free T he referred to is in this definition: "Testosterone circulates in the blood 98% bound to protein. In men, approximately 40% of the binding is to the high affinity sex hormone binding globulin (SHBG), and approximately 60% bound weakly to albumin. The measurement of serum testosterone or “total” measures free plus protein bound testosterone. “Free” or dialyzable testosterone measurements are estimates of the fraction of testosterone in blood that is not bound to protein."
This free is usually around 2% of the total. The index you mentioned is similiar though.

[Vettester]

Yeah, I hit 9 to 12 all the time. No complications for me, just 3.3% or so of free test to work with.

[steroid.com 1]

Yeah, I hit 9 to 12 all the time. No complications for me, just 3.3% or so of free test to work with.

^^^^Oh,how nice to see you pop in once and a while these days Vette

Busy boy these days I guess...

[Renholder]

Crisler doesn't feel much can be done regarding it. Says the body will find it's own balance.

From what I understand, what both he and Dr Mariano recommends, is smaller and more frequent injections since the T is metabolized so fast with low SHBG. Maybe also lower doses, but I don't know that for sure.

Ren, do you take a bunch of D? I found this: "I saw my doc yesterday. We concluded that the 10k units of vit D I was taking everyday was driving my SHBG down and increasing my Free T"

Maybe that is why your SHBG is low??? I think it's early days yet on your nebido venture....

Hey,

I just started supplementing D again, but I never took super high doses and I'm still not top range on blood work, so I'm not sure if that could be it. But thanks man!

Is this similar to the 'free testosterone index' you're talking about? http://en.wikipedia.org/wiki/Free_androgen_index

I'm not on TRT but mine is 12 so I'm close to top of the range on the FAI. How are low SHBG men more challenged in regards to TRT?

I believe it's similar, but not the same.

One week after my previous Nebido shot, I had the following BW:

Total testosterone 41,1 nmol/l (8,0-35,0) - 1185 ng/dl
SHBG 16,0 nmol/l (8-60)
Free testosterone index 25,0 (3,0-14,7)

As you see, I'm over 10 points above top of the range.

At these levels, I did not really feel well, but the strange thing is that I never had any feeling that my T was high either. Nothing dramatic in the gym, no increased aggression, beard growth, etc.

Basically, SHBG binds to testosterone. If it's too high, you have less free testosterone, but if it's too low, the problem is that it's metabolized at a much faster rate and it's been theorized that this makes levels much less stable, more E2 swings, etc.

Yeah, I hit 9 to 12 all the time. No complications for me, just 3.3% or so of free test to work with.

And you feel great? Good libido?

What's your protocol?

Thanks.

[badrad123]

Hello all,

Lately it has come to my attention that there is a group of men with low SHBG who may be more challenged in their TRT compared to those with normal SHBG levels. I always knew mine was low, but never put much thought into it until I read some more on the subject.


However, it seems that there are several men with low SHBG who do very well on TRT as well. Is there anyone here?

Let's define low SHBG as at least below 20, but I'm probably mostly interested in those that are even lower.

Mine is 13 on my last BW. 16 prior to that, but never been higher in recent years. TRT is still not working great for me and I wonder if this can be a factor. Even with T levels at 600 ng/dl, I'm above top of the range on what they call free testosterone index here in Norway.


Thanks in advance,


Renholder

Any luck finding poeple doing well with low SHBG? Mine is 11 (Range 13-71)and has never been above 13. I inject 38mg E3D. Thanks.

[HRTstudent]

I have low (low-normal) SHBG. At first I had no positive results from TRT despite high testosterone . Lowering the dose didn't exactly make a big difference. But I have finally started to notice improvement after I started to focus more on the "other things."

I have said it before, but I don't doubt that it slips through the cracks... but testosterone is a signaling molecule. You can press the gas pedal all you want and even upgrade the pedal to some sweet looking chromed out monogrammed pedal, but if there's nothing in the tank then you aren't going to get anywhere.

[kelkel]

Ren, yes to the smaller doses. A larger, singular dose would only serve to suppress shbg further. It's a recommended way of dealing with high shbg actually.

[badrad123]

I have low (low-normal) SHBG. At first I had no positive results from TRT despite high testosterone . Lowering the dose didn't exactly make a big difference. But I have finally started to notice improvement after I started to focus more on the "other things."

I have said it before, but I don't doubt that it slips through the cracks... but testosterone is a signaling molecule. You can press the gas pedal all you want and even upgrade the pedal to some sweet looking chromed out monogrammed pedal, but if there's nothing in the tank then you aren't going to get anywhere.

So what other things did you focus on? I'm thinking my blood sugar and adrenals are part of the problem so I'm going to focus on getting those in check. I was also thinking about going to EOD injections since I'm eating up the T. Or as gd recommended doing just one shot a week which might drive up SHBG a bit. Not sure which yet.

[ZenFitness]

This thread is interesting... I don't think I've ever had SHBG tested (unless it goes by a different name). My total T floats around 775 - 800 but my free T is typically over the top of the range. Is high free T indicative of low SHBG? I do take about 4000 - 6000 IUs of Vitamin D a day.

Not trying to hijack here, just curious.

[FRDave]

My last labs had my SHBG at 20.52 with total test at 749 and free test at 3.3% and I feel great!

My SHBG have always been right at 20, before and after supplementing with 12,000IU of D3 daily.

[kelkel]

Yes Zen, shbg binds test. The more it binds the less free T available to do it's job. So a high free T level "can" be indicative of a low (er) shbg level. Mid range is just fine. Vit D helps to lower shbg. Again, good BW is key.

@ FRDave. Glad to see you're keeping track of your BW. That's how you do it!

[ZenFitness]

Thanks kelkel... does this mean low SHBG is desireable as free T is available to "do its job"? Sorry... I'm learning here, and I appreciate your input!!

[kelkel]

No, mid-range is actually more desireable. We have shbg for a reason. Look at it as a regulator similar to the pituitary. It helps keep you balanced. It elevates with age. Mine was in the 40's at one time but I was able to lower it to the mid-thirties and so far have maintained that level.

[dreadnok89]

I read the higher it is the worse it is for you? That's what binds to your free test and devours it. My free test was awful last bloodwork