OK Total T , low Free T

[macmathews]

Attached is some of the last bloodwork I had after doing TRT for about 14months..
This is after a PCT of clomid say 12mg EOD for about 3 months..
Why would my Total T be somewhat acceptable yet my Free T is SHIT ?
What is not shown is my SHBG which came back at 23 scale of 13-71 nmol/L
Ideas ?
I am in the process of weighing all my options and trying to educate myself at the same time..

Mac

[IncreaseMyT]

Giver us your stats please if you don't mind, age history etc.

[macmathews]

Age 40.. Now that is..
6'-3" 240lbs.. about 22% bodyfat..
been in the gym serious since about 1992 (trained 4-5 days a week)
Never did AAS.. Noticed around 2006 notable pump loss vs previous years per say..
Only got BW in 2012 because I became VERY depressed..

Mac

[IncreaseMyT]

The reason why your Free T is low is because SHBG usually goes up and down with E. Clomid acts like an anti-estrogen in some tissues AND like an estrogen in other tissues.

So your SHBG probably climbed on the clomid, driving your Free T down.

This is one of the reasons why Clomid therapy usually raises TT but does not always or rarely alleviates the symptoms that come with low testosterone .

This is why injections are considered safer and more effective, because it is the best application at increasing Free T.

Hope this helps.

Injected TRT earns high marks for safety, effectiveness

[bullshark99]

Nice article, I-myT. Your knowledge and attentiveness on this board is becoming a real asset in a very quick fashion, thank you.

[Simon1972]

Clomid is a serm, and acts on the receptor, it doesn't prevent testosterone conversion, just blinds off the receptor from engaging with the estrogen. E will still increase in your body, it just won't do its work in some tissues.

An ai such as armidex might be your ticket. It prevents estrogen from being produced in the first instance.

[IncreaseMyT]

Nice article, I-myT. Your knowledge and attentiveness on this board is becoming a real asset in a very quick fashion, thank you.

Thank you! Its our pleasure to be here. We really believe in the cause and want people to realize testosterone is not a bad word, it actually decreases risk factors for all cause mortality for those who need it.

Like Dr Matt always says, if you had diabetes you would take insulin right? So if you have hypogonadism why wouldn't you take testosterone?

I couldn't agree with him more, and while we are at lets throw up another juicy recent large scale study for all the TRT haters out there:

Barua and colleagues say they don't know the exact reasons for testosterone's apparent benefits for the heart and overall survival. "The mechanisms for these effects remain speculative," they write. Possible explanations, they say, could involve body fat, insulin sensitivity, lipids, blood platelets, inflammation, or other biological pathways. More research is needed, they say, to clarify how testosterone affects the cardiovascular system.

Study of 83,000 veterans finds cardiovascular benefits to testosterone replacement

It is our duty as men to educate other men about the dangers of low testosterone . Not only will optimal levels of testosterone decrease risk factors, it also allows you to enjoy life and reinvigorates you.

Changed my life.

[Mr.BB]

Attached is some of the last bloodwork I had after doing TRT for about 14months..
This is after a PCT of clomid say 12mg EOD for about 3 months..
Why would my Total T be somewhat acceptable yet my Free T is SHIT ?
What is not shown is my SHBG which came back at 23 scale of 13-71 nmol/L
Ideas ?
I am in the process of weighing all my options and trying to educate myself at the same time..

Mac

Total testosterone is the sum of free T, SHBG and albumin bounded. Did you test albumin?

Cant you post the whole bloodwork?

Low free T with normal total T ussually means high SHBG.

Why were you taking 12mg of clomid? Normal dosage is 50mg. Self prescribed? Was it pharma clomid?

We need more info...

[Mr.BB]

Like Dr Matt always says, if you had diabetes you would take insulin right? So if you have hypogonadism why wouldn't you take testosterone ?

Some type 2 diabetes can be reversed, so first you should try to fix the underlying problem. Same with hypogonadism. If you start injecting T just for patching the hypogonadism most of times symptoms will remain, plus most guys dont want to be injecting for the rest of life.
Furthermore, many times upsetting the HPTA will cause irreversible damage, so it is very wise to do a proper diagnostic, dont you think?

BTW, why are you calling clomid an anti-estrogen????

[IncreaseMyT]

Some type 2 diabetes can be reversed, so first you should try to fix the underlying problem. Same with hypogonadism. If you start injecting T just for patching the hypogonadism most of times symptoms will remain, plus most guys dont want to be injecting for the rest of life.
Furthermore, many times upsetting the HPTA will cause irreversible damage, so it is very wise to do a proper diagnostic, dont you think?

BTW, why are you calling clomid an anti-estrogen????

Did I say not to do a proper diagnostic? Show me some case studies of these men over 40 diagnosed with hypogonadism and sleep apnea treatment or something else raised TT enough to make a clinically significant difference.

I would love to see them.

Our medical director was an emergency clinician for 15 years and dealt directly with diabetes, strokes and heart attacks so forgive me if I am 100% sure he understands that better than you or I.

I began my career as a teacher, teaching young docs how to do what we do. After about 2 years I moved into private practice and eventually into administration becoming a Medical Director and Chairman for about the last 8 years. In my time as a clinician I routinely dealt with the common emergencies like strokes and heart attacks as well as a host of problems related to diabetes, hypertension and cholesterol. As an administrator I worked with other physicians to promote patient care as well as with administrative leadership to set and achieve departmental goals. I became very accustomed to both identifying patient expectations and exceeding them.

Q and A with Dr Matt Week 1 ~ IMT Staff

With that being said yes I understand diabetes is complex and that was a loose statement he uses sometimes to get clients to understand that hypogonadism is a medical disease. People are afraid they are doing something wrong, and they shouldn't feel that way.

I also appreciate what may or may not happen to guys who start TRT, I have seen at least 1,000 middle aged men start TRT and had the pleasure of reviewing lab work along the way. Symptoms RARELY remain and when they do its usual a sexual symptom that Cialis rectifies.

Clomid acts like an estrogen, and an anti-estrogen. Tamoxifen does not.

As per the fix other thing on T levels, I will wait for those case studies.

[IncreaseMyT]

Furthermore, many times upsetting the HPTA will cause irreversible damage

And please provide some factual basis behind irreversible HPTA function from AAS, cause thats not what we see, and not what we have ever seen.

[Mr.BB]

Did I say not to do a proper diagnostic?

Great! That was my problem with your posts. Maybe I read it wrong. So can you tell us which procedures you guys do for the diagnostic?

And also what are the guidelines and tests performed to rule out contraindications for TRT?

As for case studies, I have none, do you think they exist? All I have is a bunch of guys coming here in the forum with underlying problems like metabolic disease, hypothyroidism, varicoceles, and of course the most common is steroid related HPTA shutdown. Always try to give their balls a chance lol.

[Mr.BB]

And please provide some factual basis behind irreversible HPTA function from AAS, cause thats not what we see, and not what we have ever seen.

Look here, you will find a bunch: ***Cycles going wrong for the young***

[IncreaseMyT]

Sorry don't take my post the wrong way, sometimes I type faster than I think

Are there contradictions to TRT? The only thing I see is sleep apnea. Yes of course you should treat your sleep apnea, the problem is that it doesn't raise TT levels enough to alleviate symptoms.

So at the end of the day you need to optimize your TT levels aside from that.

Other than that what contradictions are you aware of that I am not? Why would there be a contradiction with supplementing a hormone that is suppose to be in your body to begin with?

That would be like saying if your Vitamin D is low you should get evaluated by 6 people that probably don't have a clue about TRT anyway, before you supplement Vitamin D?

I don't see the difference.

As for what we test? That depends a lot of our guys have already been diagnosed by the time they get to us. What happens is their GP prescribes them the gel and their TT levels reach about 400 and thats maxed out.

So then they read somewhere that this guy took testosterone cypionate and he feels great. Then they search testosterone cypionate and wallah here we are.

For the guys that have never been on TRT we recommend our full male panel:

CBC
CMP
Lipid
TT
FT
LH
FSH
HA1c
PSA
Thyroid
E2

We typically treat men that are generally healthy besides their low testosterone level.

So I don't buy the sleep apnea thing, I think its a BS way for them to make money off of testosterone that is up 500% in recent years.

I do however think it should get treated, but out of the + thousand men that have been or are still an IMT client, we have never had any serious adverse events to report. Most of our clients will tell you we literally changed their life and a lot of our clients are in fact MD's.

Since we do not believe in permanent HPTA suppression, our doctors do not see a problem with a 6-8 month trial run of TRT.

In 2013 a study was done on over a thousand Asian men. They were given testosterone cypionate for 30 months I believe.

All but two of them regained fertility within 6 months of discontinuing treatment. This was without HCG during and without an HPTA restart after. We believe the 2 that didn't regain fertility either had underlying fertility problems before or test data error.

[IncreaseMyT]

Look here, you will find a bunch: ***Cycles going wrong for the young***

Sorry but cannot accept those as real case studies, they may not have done a HPTA restart properly, or used androgens like Trenbolone that are far more suppressive than testosterone .

Obviously we don't prescribe 19-nors so that may be where some confusion is.

[Mr.BB]

Contraindications for TRT

Although TRT is deemed safe, with appropriate monitoring, for the majority of men with hypogonadism, there are a number of contraindications for TRT, some absolute and some relative:

Absolute contraindications:
◾Advanced or metastatic prostate cancer
◾Prostate-specific antigen (PSA) elevated for the patient's age and prostate size
◾Undiagnosed prostatic nodule on digital rectal examination (DRE)*
◾Hematocrit >50% at baseline
◾Untreated breast cancer

Relative contraindications:
◾Severe lower urinary tract symptoms (LUTS) due to benign prostatic hyperplasia
◾Untreated and severe obstructive sleep apnea
◾Uncontrolled (or poorly controlled) congestive heart failure
◾Men desiring fertility

from: New Perspectives on Hypogonadism and Testosterone Replacement in Clinical Practice

---

Sorry but studies on fertility are not really helpfull, many dont even get infertile on to begin with. Many famous bodybuilders and members here, had several kids while on steroids .
If you follow the link I gave you, and maybe stick around a bit more here, you will find several examples of this. Testosterone levels doesnt return to same levels as previous in many, many forum members.

[IncreaseMyT]

Those would all be disclosed in medical history.

I don't know where you got the HCT over 50% but you can throw that one out, the leading TRT expert in the world, Dr Abraham Morgentaler has stated many times 55% is the point where one needs to discontinue TRT. If HCT was high on a lab we would simply send them out to donate or send someone to their house to give them a phleb.

If you think there is a need for a digital rectal exam then you need to talk with our NY, NJ physician he has been a urologist for 17 years and treated men for hypogonadism for 10 and he will tell you it is not necessary:

I have been a practicing urologist for nearly 17 years. I practice both medical and surgical urology. In the last 10 years I have increased my awareness of hypogonadism and its therapies. Hypogonadism is one of those diseases that a physician can truly see a patient change dramatically in a short period of time.

Q AND A WITH DOCTOR R WEEK 1 ~ IMT STAFF

If you would like to submit a formal question to Doctor R relating to this thread I would be happy to get with him and publish it on our blog.

You can take the men desiring fertility out of there too:

Low dose human chorionic gonadotropin appears to maintain semen parameters in hypogonadal men on testosterone replacement therapy. Concurrent testosterone replacement and human chorionic gonadotropin use may preserve fertility in hypogonadal males who desire fertility preservation while on testosterone replacement therapy.

Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. - PubMed - NCBI

BPH - Concomitant treatment with cialis and TRT FDA approved

Congestive heart failure (yes this is one we would be more cautious with and only treat at a physical location of ours close to them)

Prostate cancer (yes this is one we would be more cautious with and only treat at a physical location of ours close to them) Unless of course they are done with treatment, then TRT would actually benefit them.

You do realize optimal TT levels help in early detection for prostate cancer right? This is why doctors say you need manual inspection, because PSA readings become inaccurate with low TT levels. Like I said all of our men get yearly general physicals.

Did I miss any?

[IncreaseMyT]

The HCT thing is really overblown BTW:

What risks do you consider when prescribing testosterone -replacement therapy?

When patients ask about risks, I remind them that they already have testosterone in their system and that the goal of testosterone treatment is to restore its concentration back to what it was 10 or 15 years previously. And the molecule itself that we give is identical to the one that their bodies make naturally, so in theory, everything should be hunky-dory. But in practice, there are always some curveballs.

For example, testosterone can increase the hematocrit, the percentage of red blood cells in the bloodstream. If the hematocrit goes up too high, we worry about the blood becoming too viscous or thick, possibly predisposing someone to stroke or clotting events. Although, frankly, in a review that I wrote in the New England Journal of Medicine* where we reviewed as much of this as we could, we found no cases of stroke or severe clotting related to testosterone therapy. Nevertheless, the risk exists, so we want to be careful about giving testosterone to men who already have a high hematocrit, such as those with chronic obstructive pulmonary disease, or those who have a red-blood-cell disorder.

Although it’s rare to see swelling caused by fluid retention, physicians need to be careful when prescribing testosterone to men with compromised kidney or liver function, or some degree of congestive heart failure. It can also increase the oiliness of the skin, so that some men get acne or pimples, but that’s quite uncommon, as are sleep apnea and gynecomastia (breast enlargement).

A Harvard expert shares his thoughts on testosterone-replacement therapy - Harvard Prostate Knowledge - Harvard Health Publications

[IncreaseMyT]

Sorry but studies on fertility are not really helpfull, many dont even get infertile on to begin with. .

Actually in the study I cited the TC was 98% (as good as a condom, these were healthy men) effective at making them infertile.

[Youthful55guy]

Attached is some of the last bloodwork I had after doing TRT for about 14months..
This is after a PCT of clomid say 12mg EOD for about 3 months..
Why would my Total T be somewhat acceptable yet my Free T is SHIT ?
What is not shown is my SHBG which came back at 23 scale of 13-71 nmol/L
Ideas ?
I am in the process of weighing all my options and trying to educate myself at the same time..

Mac

Assume you got your answer from the previous posts, that you probably have high SHBG. Which really sucks BTW. In fact, guys with high SHBG often have normal to high/normal Total T. Mine was 618 ng/dL (normal 241-1197) but my Free T was an abysmal 7.1 pg/mL (normal 7.2-24). This is because my SHBG normally is between 70-80 nmol/L (normal 19-76). SHBG protects the T from metabolism in the liver, which is why you can have really good TT but sucky FT. SHBG binds T tightly and is too big to cross the blood-brain barrier, so you can have normal T values and still feel shitty.

The problem is that much of the medical community doesn't believe that SHBG is real. Had to go through 2 docs before I could find one that would treat my condition. The problem is compounded by the fact that none of the OTC stuff that I'm sure a lot of guys are going to post don't do jack to lower your SHBG. You basically have two options:

1) Saturate the SHBG with T so that enough spills over to Free T to keep you in at least a reasonable state. Problem there is that (depending on you SHBG level), you may have to go really high on TT to make that happen. I had to keep my TT in the 1200-1500 ng/mL range to feel close to "normal" and that's not even close to optimal. This can lead to hematocrit problems in the long run because apparently SHBG bound T still has some activity in the peripheral system. Also, finding a doc that will take you that high might be a problem.

2) Use a low dose of an anabolic hormone called Stanozolol (winstrol ) to suppress SHBG so that you can use more reasonable doses of T to keep your Free T within a healthy range. It is EXTREMELY effective at low doses (I use only 10 mg/day) to keep my SHBG in the low/normal range. A typical bodybuilding dose is in the 40-100 mg/day range. It does have some known hepatoxitiy issues with the typical BB doses, but at our low doses, you should be OK. My labs only a very slight (if any) elevation. Again, there is a problem. It is no longer commercially available in the USA. It's not an FDA issue, it's just that the manufacturer no longer distributes here. I get mine on the black market from Europe. Sucks that you have to be an outlaw to get the treatment you need!

A possible 3rd option that I have not investigated yet is another (weak) anabolic hormone called Danazol, which is also supposed to lower SHBG. There's not as much published in the medical literature supporting it, but some guys say it is effective. It also doesn't have the the liver toxicity issues of stanozolol and is still commercially available in the USA, so you might be able to get a doc to write a script. It's also supposed to have some mild E2 conversion blocking activity too. I haven't tried it yet, so I cannot speak for it's effectiveness.I"D LOVE TO HEAR OF OTHER GUYS EXPERIENCE HERE WITH DANAZOL.

Note: You cannot use Stanozolol or Danazol as a solo treatment. They will bring your SHBG down, but they also suppress the HPTA and natural T production.

[IncreaseMyT]

I"D LOVE TO HEAR OF OTHER GUYS EXPERIENCE HERE WITH DANAZOL.

It works but your not gonna need in with injectable testosterone . The last problem your going to have is a low free roaming testosterone.

Not sure about it solo, wouldn't recommend it.

[Mr.BB]

Sorry, but the guidelines I posted was copied from actual medical guidelines published in March 2016. Maybe you didnt follow the link and missed it. Abraham Morgentaler, which you say is the world leader in TRT, is one of the writers of what I posted.

If you want to argue about it, go ahead, but they are all Professors of Medicine, either in Men's Health or Urology.

To me seems rather reckless that you (representing a clinic) dont recognize published medical guidelines written by, as you say, world leaders in TRT.

Personnaly, I can tell you that my doctor followed these guidelines when diagnosing my case, blooworks and ultrasounds were ordered before prescribing Nebido. I would be worried if he didnt, and probably look for another doc to follow me if it wasnt the case.

Those would all be disclosed in medical history.

I don't know where you got the HCT over 50% but you can throw that one out, the leading TRT expert in the world, Dr Abraham Morgentaler has stated many times 55% is the point where one needs to discontinue TRT. If HCT was high on a lab we would simply send them out to donate or send someone to their house to give them a phleb.

If you think there is a need for a digital rectal exam then you need to talk with our NY, NJ physician he has been a urologist for 17 years and treated men for hypogonadism for 10 and he will tell you it is not necessary:



Q AND A WITH DOCTOR R WEEK 1 ~ IMT STAFF

If you would like to submit a formal question to Doctor R relating to this thread I would be happy to get with him and publish it on our blog.

You can take the men desiring fertility out of there too:



Concomitant intramuscular human chorionic gonadotropin preserves spermatogenesis in men undergoing testosterone replacement therapy. - PubMed - NCBI

BPH - Concomitant treatment with cialis and TRT FDA approved

Congestive heart failure (yes this is one we would be more cautious with and only treat at a physical location of ours close to them)

Prostate cancer (yes this is one we would be more cautious with and only treat at a physical location of ours close to them) Unless of course they are done with treatment, then TRT would actually benefit them.

You do realize optimal TT levels help in early detection for prostate cancer right? This is why doctors say you need manual inspection, because PSA readings become inaccurate with low TT levels. Like I said all of our men get yearly general physicals.

Did I miss any?

[IncreaseMyT]

Reckless? I have substantiated every case scenario I don't know what else you want me to say.

Sounds to me like you have spent too much time reading and not enough time being involved with patients being treated for hormonal deficiencies or with the physicians that treat them.

Your not understanding the difference between baseline HCT and levels that require treatment discontinuation. HCT is EASILY managed, you not understanding that makes me wonder how much experience you actually have?

So even though I have justified every statement I made, it seems you are convinced you somehow know something we don't after 6 years and some of the best TRT doctors in the country.

We stand behind every statement I made, and are pleased to know that we offer one the most comprehensive endocrine treatment programs in the world.

[IncreaseMyT]

Sorry to blow up your thread OP but that whole prostate stuff gets me going, all started with a study in 1938 by charles huggins. Its total BS. If testosterone affected your prostate negatively every 21 year old on the planet would have prostate cancer.

Not rocket science.

Its estro conversion.

[Youthful55guy]

It works but your not gonna need in with injectable testosterone . The last problem your going to have is a low free roaming testosterone.

Not sure about it solo, wouldn't recommend it.

Agree! In fact I just got back from the gym and it was bothering me the whole time I was there that I didn't include that important bit of information in my prior post. I was hoping to get back here in time to edit it before it was noticed by anyone. I'll still go back and edit the post in case a newbie reads it and doesn't go any further.

What i meant to say was that you can use Stanozolol or Danazol to reduce SHBG so that you can use more reasonable doses of T to get your Free T within a healthy range. Both Stanozolol and Danazol will suppress the HPTA and natural T production.

Thanks for pointing it out!

[hammerheart]

Sorry to blow up your thread OP but that whole prostate stuff gets me going, all started with a study in 1938 by charles huggins. Its total BS. If testosterone affected your prostate negatively every 21 year old on the planet would have prostate cancer.

Not rocket science.

Its estro conversion.

I got a PSA reading of 7.5 ng/dl last february... went to the urologist, he checked my prostate and was just normal. PSA eventually returned to baseline in a month. I'm sure as hell it was due to unmanaged oestradiol...

[hammerheart]

Agree! In fact I just got back from the gym and it was bothering me the whole time I was there that I didn't include that important bit of information in my prior post. I was hoping to get back here in time to edit it before it was noticed by anyone. I'll still go back and edit the post in case a newbie reads it and doesn't go any further.

What i meant to say was that you can use Stanozolol or Danazol to reduce SHBG so that you can use more reasonable doses of T to get your Free T within a healthy range. Both Stanozolol and Danazol will suppress the HPTA and natural T production.

Thanks for pointing it out!

How about way less harsh compounds like mesterolone?

[macmathews]

Total testosterone is the sum of free T, SHBG and albumin bounded. Did you test albumin?

Cant you post the whole bloodwork?

Low free T with normal total T ussually means high SHBG.

Why were you taking 12mg of clomid? Normal dosage is 50mg. Self prescribed? Was it pharma clomid?

We need more info...

Ok
in case my original post was not clear..
My original post BW was about 8 weeks after stopping the clomiphene. And while I did not get my SHBG at that time.
Before I did TRT it was like also noted 23 (lower in the range)
Attached here is my bloodwork at the end of 4 months of nothing but 25mg EOD Pharm Clomiphene.
I started with 2 weeks at 50mg ED but from previous experience and like you can see my LH is HIGH..

[Mr.BB]

Your pituitary responds nicely to clomiphene.

Does your lab has Bio-available testosterone test?
This will include the weak albumin bound, and would provide a better "picture".

More important, how do you feel?

If you are having low T symptoms and thinking of restarting TRT I would advise nebido, it allows for low pinning frequency (10-14 weeks), and the slow ester never really puts you on supra-physiological values, which is great for lower aromatization and overall well being (no peaks and valleys).

Why did you stop TRT anyways?

[IncreaseMyT]

I would advise nebido, it allows for low pinning frequency (10-14 weeks), and the slow ester never really puts you on supra-physiological values, which is great for lower aromatization and overall well being (no peaks and valleys).

You do realize Nebido is just testosterone undecanoate right? Every 10 to 11 week week injections? It cant be more than a 14 day ester, at the ABSOLUTE most 18-20 days.

I am not trying to be combative, my posts are for educational purposes, but that sir is reckless advice.

You cannot substantiate your statement of (no peaks and valleys) if your doing the recommended dosage of 600mg every 10 weeks your TT levels are hitting 5,000 ng/dl.

Nebido is a marketing scam, its not new and every 10-14 week injections is downright DANGEROUS.

I don't know who told you all the misinformation but sounds like you took the bait - hook, line and sinker.

Hope this helps

[macmathews]

Your pituitary responds nicely to clomiphene.

Does your lab has Bio-available testosterone test?
This will include the weak albumin bound, and would provide a better "picture".

More important, how do you feel?

If you are having low T symptoms and thinking of restarting TRT I would advise nebido, it allows for low pinning frequency (10-14 weeks), and the slow ester never really puts you on supra-physiological values, which is great for lower aromatization and overall well being (no peaks and valleys).

Why did you stop TRT anyways?

I just feel OK. My libido is no where near where it was while on TRT.
I plan on new blood work since I have been a couple years off everything..

I stopped TRT because after being on for about 14 months and learning about male hormones, I figured out that my testosterone was in the shitter due to HIGH stress and the fact that I was barely sleeping.
Like 2 Hrs a night not sleeping.. And for me it was a vicious cycle.. My son was diagnosed with Autism.. I was very stressed and in turn stopped sleeping and barely ate.. ( I took it hard to say the least )
My orginal blood work during this time was horrible for good reason.. I started on 200mg weekly Test Cyp.. but my LH was less than 2.. Doc should have fed me clomiphene then.. Anyhow T injections had me sleeping within 3 days.. So for me VERY low test affected my sleep and in turn that kept my test down..
I would have just stayed on TRT but I was afraid since my Doc was getting very OLD that when she retired nobody would treat me.. My GP was afraid of the idea (roid rage ) I told her I had never had less anger in my life.
Now Within an hour or so drive there is a clinic where TRT is his practice

Kyle

[macmathews]

Sorry to blow up your thread OP but that whole prostate stuff gets me going, all started with a study in 1938 by charles huggins. Its total BS. If testosterone affected your prostate negatively every 21 year old on the planet would have prostate cancer.

Not rocket science.

Its estro conversion.

No worries..
All in all I think this type of discussion is great for all to see and learn from.. - In the end its up to the individual to take the plunge or not - this is the cross road I am at.
If I go, it will be all in.. Since I am somewhat of a SUGAR addict I realize this could play a role in my hormones and am working hard to get my diet in check before I get NEW bloodwork to give myself an Honest
evaluation of where I stand..
I will say when I was on 100mg Weekly at 37 YRS old I was stronger than I had ever been in my "Prime"
Leads me to beleive that my natural T levels had never been GREAT.. That being said, I beleive I do have the genetics to build quality muscle since I was accused of "cranking" many times back then which says to me there is more to building muscle than just T numbers.

Mac

[Youthful55guy]

How about way less harsh compounds like mesterolone?

I'm not familiar with it, but will look into it. Thanks for the suggestion. I went with Stanozolol because there was some pretty good published research supporting it's use and supporting chatter in the BB forums. The cumulative wisdom is that Stanozolol gets it's bad press from the ridiculous doses BBs take for the anabolic effect. I'm interested in the compound only for SHBG lowering effect and I can attest that it is extremely effective at low doses.

My plan is to first optimize the dose of Stanozolol. I started at 15mg/day, dropped to 12mg, and now am at 10mg. Labs showed that both 15 and 12 mg suppressed SHBG too much. I believe that 10 mg will be about right. I plan on running the labs again in a couple of weeks. I also monitor liver function and it is pretty much uneffected. Then I plan to optimize my Free T at the optimized dose of Stanozolol by continually lowering my T dose to get it down into a healthy range. It shot up once I stated Stanozolol and I lowered it once to get it close to the upper end of the range.

After I figure out all of that, I'll consider experimenting with Danazol or perhaps as you suggested mesterolone. I need to do more research first. I don't like making changes to my protocol unless I fully understand what i am doing and have labs to support it.

[Youthful55guy]

Ok
in case my original post was not clear..
My original post BW was about 8 weeks after stopping the clomiphene. And while I did not get my SHBG at that time.
Before I did TRT it was like also noted 23 (lower in the range)
Attached here is my bloodwork at the end of 4 months of nothing but 25mg EOD Pharm Clomiphene.
I started with 2 weeks at 50mg ED but from previous experience and like you can see my LH is HIGH..

So, you are saying that the SHBG went up after starting clomiphine and you were taking 50mg daily. Correct?

A couple of things to consider.

1) That's a very high dose of clomiphine, but I guess it depends on your goals of treatment. Most of the forum chatter and my personal experience is that 12 mg daily is about the right dose for preventing testicular atrophy. Not sure what effect this has as a solo treatment if that is what you are attempting. At 12 mg daily, I did not feel any estrogenic effects as i had prior to that at higher doses. I stopped clomid after about 8 weeks (it was a temporary experiment) and went back to HCG .

2) It is possible (though I'm only speculating) that since clomiphine (clomid) is an estrogen derivative, it may increase SHBG. I've not seen any research to corroborate that, but it wouldn't surprise me. I know guys that swear that once they got their E2 under control that SHBG dropped into a normal range. This has not been my experience, but others do claim this.

[macmathews]

So, you are saying that the SHBG went up after starting clomiphine and you were taking 50mg daily. Correct?

A couple of things to consider.

1) That's a very high dose of clomiphine, but I guess it depends on your goals of treatment. Most of the forum chatter and my personal experience is that 12 mg daily is about the right dose for preventing testicular atrophy. Not sure what effect this has as a solo treatment if that is what you are attempting. At 12 mg daily, I did not feel any estrogenic effects as i had prior to that at higher doses. I stopped clomid after about 8 weeks (it was a temporary experiment) and went back to HCG .

2) It is possible (though I'm only speculating) that since clomiphine (clomid) is an estrogen derivative, it may increase SHBG. I've not seen any research to corroborate that, but it wouldn't surprise me. I know guys that swear that once they got their E2 under control that SHBG dropped into a normal range. This has not been my experience, but others do claim this.

Yes , my SHBG doubled..
I took 50mg ED for 2 weeks and then about 3.5 months of 25 EOD.. the bloodwork posted shows elevated E and LH.
But my free T is still lower in the range while total T is upper in the range and my SHBG is only about 40.

I was hornier than a 6 peckered billygoat though

Mac

[Mr.BB]

You do realize Nebido is just testosterone undecanoate right? Every 10 to 11 week week injections? It cant be more than a 14 day ester, at the ABSOLUTE most 18-20 days.

I am not trying to be combative, my posts are for educational purposes, but that sir is reckless advice.

You cannot substantiate your statement of (no peaks and valleys) if your doing the recommended dosage of 600mg every 10 weeks your TT levels are hitting 5,000 ng/dl.

Nebido is a marketing scam, its not new and every 10-14 week injections is downright DANGEROUS.

I don't know who told you all the misinformation but sounds like you took the bait - hook, line and sinker.

Hope this helps

Can you please show me the case studies to confirm your claim testosterone undecanoate usage in TRT being reckless and dangerous?

I would love to see it

[IncreaseMyT]

Nebido is not reckless, the administration schedule you recommended is.

[Mr.BB]

^^^Information from: New Perspectives on Hypogonadism and Testosterone Replacement in Clinical Practice

Authors: Geoffrey Hackett, MD, FRCPI, MRCGP; Alvaro Morales, MD, FRCSC, FACS; Abraham Morgentaler, MD, FACS; Michael Zitzmann, MD, PhD

March, 2016


Please dont argue with information written by, as you say, world leaders in TRT, it will make you look bad.

[macmathews]

^^^Information from: New Perspectives on Hypogonadism and Testosterone Replacement in Clinical Practice

Authors: Geoffrey Hackett, MD, FRCPI, MRCGP; Alvaro Morales, MD, FRCSC, FACS; Abraham Morgentaler, MD, FACS; Michael Zitzmann, MD, PhD

March, 2016


Please dont argue with information written by, as you say, world leaders in TRT, it will make you look bad.

It also looks like he may recommend enanthate every 2-3 weeks.. Not sure who would use that as a typical Regime..
Certainly NOT me..

Mac

[IncreaseMyT]

^^^Information from: New Perspectives on Hypogonadism and Testosterone Replacement in Clinical Practice

Authors: Geoffrey Hackett, MD, FRCPI, MRCGP; Alvaro Morales, MD, FRCSC, FACS; Abraham Morgentaler, MD, FACS; Michael Zitzmann, MD, PhD

March, 2016


Please dont argue with information written by, as you say, world leaders in TRT, it will make you look bad.

None of them know their ass from a hole in the ground if they are a proponent of every 10 week injections.

You obviously do not understand how TT levels rise and fall, and obviously neither do they.

1,000 mg in one shot? ARE YOU NUTS? haha I am seriously beside myself that you and whoever they are do not understand that TT levels will hit 7,000 ng/dl with a shot like that once steady state has been achieved. If you think thats not dangerous and reckless you have a lot to learn.

Like I said earlier you read way too much and don't realize there is a very small % of doctors in the world that understand the pharmacokinetics and pharmacologic attributes of the medicine they are discussing.