Originally Posted by Ex Dubio
OK, first thing that comes to mind in addressing SHBG then would be an anti-hyperlipidemic drug. I'd imagine considering a statin -- despite your age -- might be worthwhile, if triglycerides are significantly elevated. I presume the triglycerides tests have been performed fasting?
To what extent did it raise testosterone? You had no subjective benefits on it? What dose and frequency?
A Clomid stimulation test 50mg twice daily for 7 days brought my < 300 ng/dL T to 700+ng/dL. I was then prescribed 15mg every two days, which was boosted to 30mg every two days. Blood labs were not taken after this. My doctor only asked to see TT, which made me mad enough to drop him (he didn't request E2, DHT or anything else.)
I broke down into tears once or twice on Clomid. That essentially describes the effect on my mood.
I meant using it combined with testosterone therapy. It won't do anything good by itself.
Dr. John Crisler made a mistake by prescribing me testosteone cyptionate injections, plus Arimidex, plus pregnenelone. The testosteorne injections shot my FT and E through the roof. The Arimidex successfully brought my estrogen (and other estrogens!) into the "perfect" range, enough that he claimed that he had never seen such an ideal estrogen profile.
It didn't matter. Erections were extremely hard to summon and when they'd come, they'd dissapear just as fast. I was able to have awkward and dissatisfying sex a few times on this combination I didn't enjoy it at all, and it would take one hour or more of foreplay for me to get an erection that I thought would last to the point of getting it near the vagina before it vanished.
And none of these had any effect on libido? Let me ask a few more questions then:
1. When did your problems start? Have you ever had a healthy libido?
The problems started as young as I can remember. I began to have masturbatory problems at 13. My libido kept vanishing, and I'd masturbate anyway out of frustration, hoping to reignite it. If I did so, I'd basically masturbate a half-flaccid penis to an orgasm and ejaculation without any neurotransmitter release.
In highschool, I had to keep a calendar to mark the days I masturbated. I needed to "skip 2 days" inbetween each, or I was guaranteed to destroy my libido. By college, this interval had expaneded to at least a week, and sometimes my libido would vanish for multiple weeks at a time.
My body odor continually shifts. Apocrine sweat completely vanishes and I smell like a kid instead of an adult. It is truly bizarre. If ever my hormones balance and I can 'get horny', I suddenly require deodorant.
2. What was your original diagnosis? How low are your serum testosterone levels?
At age 19, secondary hypogonadism. I went in to have my thyroid tested since I wasn't getting morning erections or spontaneous erections, nor had I ever had a nocturnal emission in my life. My doctor secretly threw in TT/FT and it was discovered that I had 185 ng/dL TT at age 19 -- clinical hypogonadism.
3. Can you post the latest numbers for testosterone, E2, SHBG, etc.?
Testosterone, serum 326 ng/dL (241-827)
Free testosterone 7.0 pg/mL (9.3 - 26.5)
SHBG, serum 19 nmol/L (13-71)
This was at a time when I was avoiding both meat and sugar, which, according to studies, elevates SHBG. My normal level of SHBG is 9-13, on the same scale.
Previous labs (while on a normal diet) look the same, except SHBG is much lower and FT is slightly higher, but still too low.
4. Can you give us a list of drugs you're taking now?
At this point only hCG, 350 IU every 4th day. I dropped the T3 and deprenyl cold turkey. No side effects.
What the ****? Is this the same doctor who's been prescribing everything else? How has he been prescribing the rest?
He ordered it from a compounding pharmacy. It is testosterone in propylene glycol. Dr. Eugene Shippen prescribed it. He has a few books out, so I figured he knew his stuff. He insists that I should also apply this preparation to the head of my penis. (Yes, seriously.)
Is there any data whatsoever on this condition of low SHBG? Does the condition have a name? I'm not doubting you, but you're either referencing data I don't have or engaging in speculation as to what might happen when you don't have much information.
There is. It is simply called SHBG deficiency. I have a list of studies bookmarked, but I'll have to follow up to this post to link some of them. I'm short on time, but I'd like to answer as much of your questions as I can before I go.
Also, given how many things you've tried that have failed, I'd think you'd be willing to accept a mild increase in DHT to give this treatment a try. A temporary increase in DHT is not going to magically make you go bald, but quite frankly it sounds like your priorities are not aligned. Regardless, ketoconazole scrub ought to prevent any unwanted effects of DHT on the scalp.
My FT and DHT both rose astronomically when I was on Androgel. To give you an idea of what an SHBG deficiency can to do a male that attempts traditional HRT:
A standard dose of Androgel brought TT up to 850ng/dL. This would have been within that particular lab's range. Meanwhile, FT was DOUBLE the highest end of that particular lab's range. Needless to say, that did not lead to anything except a ton of hair falling out in the shower.
rs#? Would like to know more details of this. His point was that taking drugs that increase libido is going to get you nowhere, which is why you have to go after other TRT methodologies or SHBG itself.
I have the rs#'s in the studies that I mentioned. Again, I'll post them as soon as I can.
OK, is there any evidence for any of this actually increasing SHBG? I see a few things here that have evidence along those lines, but some of this seems a little "out there".
Yes, the green tea, caffeine, a vegan diet, dietary fiber, soy isoflavones and phytoestrogens have all been shown in studies to raise SHBG. Low SHBG is strongly correlated with insulin resistance and PCOS in females.
FWIW, both my mother and sister have very serious cases of PCOS (low SHBG in females causes female beard growth, insulin resistance, the same messed up lipid profile that I have, etc.)
Low SHBG is a very common side effect of insulin resistance, and some studies claim to have shown a /causal/ link between low SHBG and insulin resistance. That is to say, increasing SHBG alone was able to restore glucose metabolism in women with insulin resistance.
Low SHBG is a very common side effect of insulin resistance, and some studies claim to have shown a /causal/ link between low SHBG and insulin resistance. That is to say, increasing SHBG alone was able to restore glucose metabolism in women with insulin resistance. It was previously assumed that the excess insulin from insulin resistance was lowering SHBG. It is now more widely believed that SHBG is lowered by improper glucose metabolism in the liver and that the SHBG itself affects the way sugar is brought into muscle tissue. (Cells have receptors for SHBG. It's not just a binding protien. Also, SHBG binding is required to bring androgens into certain tissues.)
Can you masturbate? Have any drugs ever helped with this?
At present, I can only masturbate a "semi" to a mostly sensationless orgasm. Every few weeks, randomly, my libido returns and I am able to masturbate normally. I attribute this to the rollercoaster of metabolic clearance that the inadequate SHBG creates.
Drugs have not helped. Even Cialis before masturbation is worthless. I once tried some of the sublingual testosterone suspension drops, plus Cialis. No dice.
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Originally Posted by THE-DET-OAK
