Lowering SHBG to Increase Free T -- Treatment Options?

[Dr.V.P.C.]

I treat some cases like this with : (compound here in Brazil, once a day, everyday).
Ostarine 5mg lower shbg and anabolic with low hpta impact
Clomid 7mg - boosts test
Exemestane 3mg - boost test without crash e2
Tadalafil 5mg - nitric oxide
Great results.

[bkb333]

After my most recent round of bloodwork, I was curious where some longevity biomarkers were sitting, so I asked for follow-up tests. I had them done Monday and just got the results. The key numbers — HCT is midrange and has not changed significantly (45.7-46.3); same for HGB (15.5-15.6); and same for RBC (5.19-5.20).

However, I have seen notable changes in ALT (34 in February, shortly after I first started TRT, and now 61) and AST (33 in February, 62 now). Additionally, ALP has dropped from 48-36. I don’t know anything about these biomarkers but have learned workout timing affects liver enzymes. I had these tests conducted at 8 a.m. Monday, did an hour of intense cardio on Sunday evening (6 p.m.), and lifted hard (back) on Saturday afternoon. I spoke with my provider, who wasn't very concerned and chalked the numbers up to workout timing. I ordered some NAC to supplement.

As a reminder, my T numbers exploded on my last bloodwork. Total T shot up to 2889, with Free T at 543.1. The ratio of Free:Total T was significantly better than what I’d seen before — an encouraging sign — but I lowered my dose (from 200-180/week) because of warnings about the sky-high T levels and how those may harm my long-term health. I also increased Danazol from 25 mg EOD to 25 mg ED (SHBG was still somewhat high at 72).

Given these new results, do you think I should stick with that plan moving forward? I am very happy to see the HCT/HGB/RBC numbers!

[bkb333]

I treat some cases like this with : (compound here in Brazil, once a day, everyday).
Ostarine 5mg lower shbg and anabolic with low hpta impact
Clomid 7mg - boosts test
Exemestane 3mg - boost test without crash e2
Tadalafil 5mg - nitric oxide
Great results.

Thanks for sharing. That's interesting. I haven't used any of these medications. How does this type of protocol typically impact free/total T ratios?

[Youthful55guy]

After my most recent round of bloodwork, I was curious where some longevity biomarkers were sitting, so I asked for follow-up tests. I had them done Monday and just got the results. The key numbers — HCT is midrange and has not changed significantly (45.7-46.3); same for HGB (15.5-15.6); and same for RBC (5.19-5.20).

However, I have seen notable changes in ALT (34 in February, shortly after I first started TRT, and now 61) and AST (33 in February, 62 now). Additionally, ALP has dropped from 48-36. I don’t know anything about these biomarkers but have learned workout timing affects liver enzymes. I had these tests conducted at 8 a.m. Monday, did an hour of intense cardio on Sunday evening (6 p.m.), and lifted hard (back) on Saturday afternoon. I spoke with my provider, who wasn't very concerned and chalked the numbers up to workout timing. I ordered some NAC to supplement.

As a reminder, my T numbers exploded on my last bloodwork. Total T shot up to 2889, with Free T at 543.1. The ratio of Free:Total T was significantly better than what I’d seen before — an encouraging sign — but I lowered my dose (from 200-180/week) because of warnings about the sky-high T levels and how those may harm my long-term health. I also increased Danazol from 25 mg EOD to 25 mg ED (SHBG was still somewhat high at 72).

Given these new results, do you think I should stick with that plan moving forward? I am very happy to see the HCT/HGB/RBC numbers!

Just repeating previous advice, given that you are using Danazol, you will more than likely need to decrease T a lot more. I suggest 120/week and then retest in 6 weeks.

Yes, intense exercise can affect liver enzymes, but so can a lot of OTC such as most oral analgesics (ibuprofen, naproxen, etc.) and prescription drugs (e.g., SRIs). However, it may be the rather stout dose of Danazol. I'd do some research on that drug to understand more about potential side-effects. I have no experience with it.

Those are getting to be rather high ALT and AST levels. However, many docs don't worry about moderately high liver enzymes if they know that a particular drug is pushing them out of range. Out of range liver enzymes can be indicative of liver disease, or it can simply indicate that you liver is working harder to detoxify the drugs. Adding NAC is a good idea (I do twice daily regardless of whether or not I'm taking Winstrol). I'd also consider adding in some Silymarin.

[Ashop]

I do all my experiment with blood work and I've seen both ANAVAR and WINSTROL work well in this situation.

[Youthful55guy]

I do all my experiment with blood work and I've seen both ANAVAR and WINSTROL work well in this situation.

Same experience with me. I've tried them both and they both are extremely effective at suppressing SHBG. There's good RCT publications for Anavar as well. My experience is that (mg for mg) Winstrol is more effective, meaning you need about half the amount to get the same effect. For me, Winstrol optimized my SHBG at 2.5mg 2X per day, whereas I need 5mg 2X per day for Anavar for the same effect. You should dose 2X per day with either drug because they have very short half lives. Another point in Winstrol's favor is that it is about 6X less expensive, so less apt to be counterfeit (not worth their time).

Regarding liver toxicity, not much published (that I've found) on Winstrol. The RCT study on Anavar that I discussed earlier showed that at 20mg/day it was tolerated with acceptable liver toxicity. There was a dose-response in toxicity with the various dose groups (placebo, 20, 40, and 80 mg). The most interesting finding (for me anyway) is that hemoglobin was unaffected at all dose groups. This is contrary to some of the Bro Science I've read that part of Anavar's benefit to athletic performance is stimulation of RBC production for increased endurance. This study would argue that is not the case (at least in HIV patients).

Here's the link and full citation: https://www.ncbi.nlm.nih.gov/pubmed/16540931
Grunfeld, C., Kotler, D.P., Dobs, A., Glesby, M., and Bhasin, S. (2006). Oxandrolone in the treatment of HIV-associated weight loss in men: a randomized, double-blind, placebo-controlled study. J Acquir Immune Defic Syndr 41, 304-314.

[Dr.V.P.C.]

Thanks for sharing. That's interesting. I haven't used any of these medications. How does this type of protocol typically impact free/total T ratios?

Every time i tried , both total T and free T jumped .
Shgb got low but not too low like happens most times with var and winny.
And hdl did not crash to lower than 40.

[bkb333]

Those are getting to be rather high ALT and AST levels. However, many docs don't worry about moderately high liver enzymes if they know that a particular drug is pushing them out of range. Out of range liver enzymes can be indicative of liver disease, or it can simply indicate that you liver is working harder to detoxify the drugs. Adding NAC is a good idea (I do twice daily regardless of whether or not I'm taking Winstrol). I'd also consider adding in some Silymarin.

This did seem to be the case with my doctor -- he chalked it up to my workouts and to the danazol, and said we may scale back the danazol if the liver numbers get closer to 100. I did order some NAC (1000 mg tablets). How much would you recommend taking?

[Youthful55guy]

This did seem to be the case with my doctor -- he chalked it up to my workouts and to the danazol, and said we may scale back the danazol if the liver numbers get closer to 100. I did order some NAC (1000 mg tablets). How much would you recommend taking?

I take 1200 mg twice daily (AM and PM). The product I use (NOW brand) also has some Selenium and Molybdenum in it. Not sure why it's included or if that is useful in liver detoxification.