Any recommendations for high SHBG and E2 regimen?

[sarge40]

I started TRT a few months back and am currently taking 200mg/EW along with 1mg adex and 500iu hcg both twice a week. My BW prior to starting indicated that my SHBG was just above the max clinical range and my E2 was at the very high end of the clinical range. I assume that the high t dose is intended to power through the SHBG, and the high adex is to control my apparent high E2 conversion coupled with the high t dose which is likely pushing the pathway further. I don't know about the hcg, but it doesn't seem like its working anyway since the boys have shrunk after some serious achy episodes. Curious since the high dose should be doing something.

So, a few months in, I am showing some symptoms of high e. My diet has been pretty clean and I lift and do cardio on a religious basis. My pec and gut fat has not gone away, my face is bloated, and I have some itchy nipple episodes. Muscle tone and size has increased, but I have gained a few percent worth of bodyfat since starting. Im waiting for BW results to confirm.

I wanted to try splitting my dose to control E2 conversion avoiding the serum t spikes, but I understand that that might not be the best approach with the high SHBG. The same thing with lowering my dose. I've also been very curious about SQ pinning but I dont think it gets the serum t levels high enough to defeat the SHBG issue. It seems like with the high SHBG and E2, there is really no good approach.

I would really like to cut my doses down, as they are all on the very high end. It doesn't seem like my problem is a common one on the boards. I see a lot of guys with high E2 and low SHBG, but can't find anyone with a good approach to defeating high levels of both. Anyone have any suggestions? I'd like to bring some well thought out suggestions to the doc next time I see him and get his thoughts.

[2Sox]

First you need to post your blood test results so the people here can be most useful. Without numbers, we're shooting blind.

Nevertheless, even without knowing these numbers, some conservative suggestions still can be made:
Immediately cut you weekly T dose to 100mg and stop your Adex - for now - which is WAY too much. Wait for your blood work before you make another move with an AI.
Your supposition about SQ injections is erroneous. I'd advise you revisit this.
Space your T injections out to reduce aromatization and to better control E2 conversion. Consider daily or twice weekly.

You may want to consider a lower dose of hCG and do it daily - or three times a week. 100-125iu/day or 250iu 3xweek. All SQ.

Can't advise on SHBG. Let's hear from others on this.

[Beethoven]

I am curious also about your protocol. First off that you were started on a high dose rather than a lower dose and titrate up. Secondly that you were instructed to take 1 mg of Adex without having BW. You could probably get by with less HCG as well. I agree with 2Sox, splitting your dose up will help but more importantly post you complete BW with ranges.

[Kozmo]

Apparently your diet is not clean enough

[kelkel]

Were you diagnosed as primary or secondary?
TRT is not a miracle drug. It will not turn you into a lean-mean machine. That's nutrition and training.
Test turns to Estrogen via the 5A-R enzyme which is in tissue throughout your body, but particularly in stomach fat. Big hint there. Less stomach fat = less aromatization.
Quickest way to suppress shbg is with testosterone . You're doing that. See where you're at with your next BW.
1mg adex X 2 is ridiculous. Consider that's more than double what guys normally run for a 500mg per week cycle. Love to see pre-TRT BW to see why this was prescribed.
Eventually at that dose you'll more than likely crash your E. This will have similar symptoms as high E.

Again, your shbg will come down via suppression by testosterone. How much is anyone's guess but shbg is a needed glyco protein. To low is not good either. Mid-range is where you want to be. E2 is obviously controllable.

Post up pre-TRT BW if possible and then your new stuff when it arrives. Love to have a look.

And welcome to the forum Sarge.

[sarge40]

Thanks guys. I know that I didn't provide BW numbers. I am still waiting on the most recent BW, and never got around to posting my original numbers. I know that I can only solicit so much information with limited information, and I appreciate your patience.

2sox - I would agree with your suggestions if it were not for the high SHBG, but I don't know if I can get the SHBG down that way. I have looked into it and it seems like the steady delivery from a lower dose split SQ, would definitely help with any E2 issues.

Kozmo - My diet has remained the same since pre-TRT when I was shedding pounds and BF quite effectively. That's the head scratcher. I am guessing something is happening with my E2, which the high adex should be killing, but it smells like high E2 to me.

Kelkel - I was diagnosed as secondary. My LH and FSH were down at the bottom of the clinical range (again, will have to post numbers when I can). I know that testosterone isn't a miracle drug. I am watching my diet, and hitting the gym with no expectations that my progress would be any better than someone else with my genetics and routine but with normal t levels (I don't mean that I am not giving it my all at the gym). Bodybuilding isn't in my cards anyway, especially after sustaining a type IV slap tear from a mishap when overdoing incline dumbbells, that was never properly fixed. I just want to feel better again and get back into a healthy shape.

Thanks to all, and I will get numbers up when I get them compiled.

[Kozmo]

Aromatase enzyme converts test to estrogen. The 5 ar converts test to dht.

[kelkel]

Aromatase enzyme converts test to estrogen. The 5 ar converts test to dht.

Yes. It's also involved in androgen and estrogen metabolism. But yes, most known for DHT cause everyone's worried about hair loss with testosterone . And you're right, I could have worded it more clearly. Thanks Kozmo.