Need help dealing with low Free T

[peabody]

I'm 60, 5'10", 170, still athletic and fit, gym every day, but increasingly having low-T-like symptoms - mood, energy, and libido/sexual issues. I won't waste your time with the details, but pretty much all the classic low-T symptoms.

Here are my recent 2012 LabCorp test results via LEF (the standard E2 test was used):

Total T ------------ 693 (398-1197) [37th percentile]
Free T - direct ---- 11.6 (6.6-18.1 for age 60+, 9.3-26.5 for age 20-29)
SHBG --------------- 50 (19.3-76.4 for age 50+, 16.5-55.9 for age 20-49)
Estradiol ---------- 16.8 (7.6-42.6)
DHEA-S ---------- 112.9 (33.6-249.0)

Values from August, 2008 test, with no symptoms:

Total T ------------ 763 (241-827) [89th percentile]
Free T - direct ----- 17.1
Estradiol ----------- 21

I've never been on TRT, but have taken a low dose of Arimidex for many years to reduce high (47 originally) estradiol that I believe resulted from taking diltiazem, a CCB, for blood pressure - it worked when nothing else did, but apparently slows down the removal of E2 from the body by inhibiting the relevant CYP-450 enzyme(s). I've tested for E2 every four months, and the dose needed to keep it at about 20 has dropped many fold over the years. The dose which produced the above 16.8 was 1/800 mg per day via very diluted liquid, which is one mg of Arimidex spread over two years.

Total T has dropped from 763 to 693 in the last four years, but because of a change in the range, total T has dropped from the 89th percentile to the 37th percentile, which appears to be a more significant drop. But I don't know if the range change is meaningful, and, you know, it's still 693, which isn't horrible.

What gets my attention is what appears to be low free T caused by high SHBG. While 11.6 looks fairly mid-range for men 60-100 years old, the LEF protocol says I should be in the top third of the range for 20-29, which would be the lower 20's, roughly double where I am now. And Dr. Morgentaler's book says free T below 15 should be considered low if there are symptoms.

But since my total T is 693, the question arises whether I could arrive at a solution by reducing SHBG, which would raise free T. I've been doing a lot of reading, and the possible options I've found are:

1. Do nothing. T is not low. But then, what about the symptoms?

2. Some combination of avena sativa, nettle root, and muira puana to lower SHBG. But I can't find any strong evidence that any of these produce a really significant effect on SHBG, and nettle root in particular has the disadvantage of also reducing DHT, which could be counter-productive.

3. Take DHEA. I've found nothing that shows a reliable effect on either Test or SHBG from doing this. But I believe Dr. Crisler does prescribe it to his patients, along with pregnenolone. Not sure why. Also, I don't know whether my 112.9 is actually low.

4. Take low-dose Danazol to reduce SHBG. Apparently this IS reliable for reducing SHBG (Shippen and perhaps others use this, but not Crisler), but with uncertain side effects, such as reducing total T production. It appears the dose is 20-25 mg per day.

5. Do TRT. My guess is that Dr. Crisler would pick this one. However, I normally get my medical care at the VA, which will take one look at my numbers and tell me to take a hike since everything is within range. So the entire TRT expense of the civilian doctor visits, the meds and the lab tests will fall on me, and I'm concerned that by the time you add up the T-gels and HCG shots, the cost may be prohibitive. So if there's a way to raise free T short of full blown TRT, I'd like to find it.

So I'd like to get everyone's thoughts as to whether the lab results indicate I may have low T, and I'd like to get your opinion on the options listed above, or any others I may have left out. And basically, what do you think I should do?

I do have a civilian doctor that I see occasionally (he charges, and the VA doesn't) but I'm going to ask him to do cortisol and thyroid tests, and anything else that comes to mind, to see if there may be another explanation for the symptoms. But I kinda suspect those will be normal. Recent B12 and prolactin tests have been normal. PSA has been stable at around 1.7 for some time.

Meanwhile I have stopped the near-homeopathic dose of Arimidex for baseline purposes. I did that for six weeks last year, and E2 went up to 26, and I felt worse. I didn't test for T then, but assume it dropped.

Thanks very much for any help.

 

[HondaV65]

First of all - you have GOOD T-Levels for a 60 year old man imo. Think about how many kids in their 20's post on this board about having Test in the 200's. You made it to 60 and your T-Levels are almost 700 ng/ml - and that's a damned accomplishment!

Second, mood and energy levels aren't necessarily caused by low T. I went in to my Doc because I thought I had low T just because of those symptoms - she came back and THREW the blood tests at me ... Total Test - 950 / Free - 35. So it was NOT a testosterone problem.

Sexual issues - well you need to elaborate on that. Men, as they get older, get this "organic" kind of erectile dysfunction that's more due to nerve and blood vessel damage caused by free radicals, smoking, other bad habits, or just generally because the pipes get old. In the age of Cialis - this should no longer be a concern to anyone though (although you DO want to prevent organic ED in the first place if you can). I take about 6 grams of ALCAR / 4 grams of PLCAR / and about 2 grams of Alpha Lipoic Acid to keep all this stuff in shape. I think it works but it takes months - maybe 6 months to see it really kick in. One thing I do know - the ALCAR makes me think like a teenager - since I finally can understand "Psychobilly" music and even some of the other music kids (especially weird ones) listen to these days.

To keep my "young man" game in bed I also use Goji Berry Extract, Maca, Fenugreek,

As far as test issues go though ...

1. Take DAA or "Intimidate". It WILL increase your levels above 700 bra and there's really no reason not to take it imo.

2. Bulbine (you can try it anyway)

3. Estrogen "Reducers" ... (1) Erase (or Erase Pro). (2) Grape Seed Extract (900 mg's per day - great anti-oxidant you don't need to cycle it and take it right alongside Erase or any other E2 inhibitor). (3) Endosurge - I like it, yeah it's got stinging nettle root in it but I don't notice it ****ing with my libido. It'll help lower SHBG. (4) Formasurge - it's a suicide inhibitor and works transdermally.

4. Build more muscle - it increases testosterone, keeps it high. You don't want to use AAS unless you can help it - but you COULD use Ostarine in low doses to help with that. And - if you don't want to - then don't.

5. Creatine Monohydrate - there's one study out there that says it increases DHT levels fairly nicely.

 

[peabody]

> Second, mood and energy levels aren't necessarily caused
> by low T. I went in to my Doc because I thought I had
> low T just because of those symptoms - she came back and
> THREW the blood tests at me ... Total Test - 950 / Free
> - 35. So it was NOT a testosterone problem.

But your free T was 35, not 11 like mine. And - what turned out to be the cause of your symptoms if not related to T?

> Sexual issues - well you need to elaborate on that.

Very low libido, difficulty getting and maintaining erections - not much helped by Cialis, difficulty reaching orgasm, and when I do, not much comes out. It's like the whole sexual system has been stomped on.

As for the other things you mentioned, I'm afraid I'm new to this and don't know what they are. So I'll have to do some research. But it seems the only one directly related to SHBG was Endosurge, which is mostly nettle.

Thanks very much for your input.

 

[vassille]

what i have noticed that you mentioned was high blood pressure....why you have high blood pressure you seem very fit
BTW, high blood pressure could interfere with sexual functions im sure you know that.
Also have you prolactin checked?

 

[peabody]

what i have noticed that you mentioned was high blood pressure....why you have high blood pressure you seem very fit
BTW, high blood pressure could interfere with sexual functions im sure you know that.
Also have you prolactin checked?

The high blood pressure began in my mid 40's. It was two years AFTER I quit smoking. Exercise/diet doesn't make any difference as far as I can tell. Neither does sodium. Also, it's been well controlled from the beginning, so I don't think it has caused any damage so far. In any case, I can see how it could affect erections, but not the other things - libido, etc. What's peculiar about my high blood pressure is that it responds well to calcium channel blockers, but not at all to ACE inhibitors, ARB's, or Tekturna. So all the renin/angiotensin/aldosterone stuff seems irrelevant. I've always thought that peculiarity should provide a hint as to why I have hypertension, but no doctor I've consulted had a clue.


Prolactin was 8.3 (4.0 - 15.2)
Ferritin was 42 (don't have the range, but 42 is quite low)

I think what it comes down to is whether a Free T level of 11.6, with low-T symptoms present, warrants a trial of TRT - unless some other cause can be found for the symptoms.

 

[rfarns01]

The high blood pressure began in my mid 40's. It was two years AFTER I quit smoking. Exercise/diet doesn't make any difference as far as I can tell. Neither does sodium. Also, it's been well controlled from the beginning, so I don't think it has caused any damage so far. In any case, I can see how it could affect erections, but not the other things - libido, etc. What's peculiar about my high blood pressure is that it responds well to calcium channel blockers, but not at all to ACE inhibitors, ARB's, or Tekturna. So all the renin/angiotensin/aldosterone stuff seems irrelevant. I've always thought that peculiarity should provide a hint as to why I have hypertension, but no doctor I've consulted had a clue.

Prolactin was 8.3 (4.0 - 15.2)
Ferritin was 42 (don't have the range, but 42 is quite low)

I think what it comes down to is whether a Free T level of 11.6, with low-T symptoms present, warrants a trial of TRT - unless some other cause can be found for the symptoms.

As others have said t levels are good, look into other issues such as thyroid. Have you switched blood pressure meds those damn things can cause you sexual problems, I blame them for my low t to this day. Never had any problems til I started on an ACE.

 

[EasyEJL]

2. Some combination of avena sativa, nettle root, and muira puana to lower SHBG. But I can't find any strong evidence that any of these produce a really significant effect on SHBG, and nettle root in particular has the disadvantage of also reducing DHT, which could be counter-productive.

there is fairly good evidence these do drop SHBG significantly. Its difficult to say how much of a disadvantage lowering DHT really is, but you can find products just have the others in it. Id think this is worth a shot, amongst your easiest to try. TRT would not be a great option as most doctors would only be looking at your age putting your total T close to where it is now.

 

[T-Bone]

You said you go to the gym everyday. Over-training can lower testosterone and cause problems with libido and in the bedroom.

 

[vassille]

The high blood pressure began in my mid 40's. It was two years AFTER I quit smoking. Exercise/diet doesn't make any difference as far as I can tell. Neither does sodium. Also, it's been well controlled from the beginning, so I don't think it has caused any damage so far. In any case, I can see how it could affect erections, but not the other things - libido, etc. What's peculiar about my high blood pressure is that it responds well to calcium channel blockers, but not at all to ACE inhibitors, ARB's, or Tekturna. So all the renin/angiotensin/aldosterone stuff seems irrelevant. I've always thought that peculiarity should provide a hint as to why I have hypertension, but no doctor I've consulted had a clue.



Prolactin was 8.3 (4.0 - 15.2)
Ferritin was 42 (don't have the range, but 42 is quite low)

I think what it comes down to is whether a Free T level of 11.6, with low-T symptoms present, warrants a trial of TRT - unless some other cause can be found for the symptoms.

Have you tried over the counter meds supplements for the blood pressure? Hawthornberry comes to mind..not sure about spelling.
Might be worth droping the the meds and see. OR just go off the meds for a period of time and see if anything happens.
Another issue I see if you go on TRT with your blood pressure it might get worse.
How bad is your BP anyway?
I dont think your T-levels are to blame here. Besides the T-levels will vary slightly from day to day but they look good regardless.

 

[T-Bone]

Hypertension can be genetic, doesn't matter how great shape you are in. Also I would DEFINITELY NOT recommend going off your blood pressure medication and using hawthorn berry. That's just laughable and would be a disaster waiting to happen. Bad advice.

 

[vassille]

Hypertension can be genetic, doesn't matter how great shape you are in. Also I would DEFINITELY NOT recommend going off your blood pressure medication and using hawthorn berry. That's just laughable and would be a disaster waiting to happen. Bad advice.

Relax cowboy,
Only mentioned it for a temporary discontinuation to zero in if the meds are causing the issue and it depends how high the blood pressure is anyway. It;s hard to identify an issue without eliminating potential cause.
Do you have a better idea?

 

[peabody]

Thanks for the responses. So, nobody thinks free T of 11.6 is low enough to warrant TRT? Well that's very interesting. LEF thinks it is (they recommend 20-26 for any age). Dr. Morgentaler thinks it is (less than 15 is low if there are symptoms). But both of them basically say total T doesn't matter. But it seems you guys disagree with that. And I'm still struck by the fact that four years ago, when I didn't have these symptoms, free T was 17.1, and now, with symptoms, it's 11.6. Just coincidence?

As for the BP meds, I've been on them a long time, and it's only in the last year that I've started to get these symptoms. There's no question the meds cause an increase in E2, but I've been controlling that with low-dose Arimidex. So I think it's unlikely that's the problem. But of course it's not impossible. Without the meds, I would be in the 150's systolic.

My gym routine is 20 minutes of fast walking, 20 minutes on an eliptical machine, and 20 minutes of weights. I do upper body one day, and lower body the next. I do one set of each lift, 20 reps, so, you know, not that strenuous. It's a good workout, but really nowhere close to overtraining. And, as with the other stuff, it's basically the same routine I've been doing for years.

Well, I see my doctor Thursday. I'm sure he will tell me that I'm just getting old, and I need to accept it. But you know, the whole point of TRT is not just accepting it. Anyway, we'll do a bunch of lab work (I'm gonna suggest cortisol and a thyroid panel) to see if we can find some non-T explanation for the symptoms. I strongly suspect that will all come up negative, but I could be surprised.

 

[vassille]

Thanks for the responses. So, nobody thinks free T of 11.6 is low enough to warrant TRT? Well that's very interesting. LEF thinks it is (they recommend 20-26 for any age). Dr. Morgentaler thinks it is (less than 15 is low if there are symptoms). But both of them basically say total T doesn't matter. But it seems you guys disagree with that. And I'm still struck by the fact that four years ago, when I didn't have these symptoms, free T was 17.1, and now, with symptoms, it's 11.6. Just coincidence?

As for the BP meds, I've been on them a long time, and it's only in the last year that I've started to get these symptoms. There's no question the meds cause an increase in E2, but I've been controlling that with low-dose Arimidex. So I think it's unlikely that's the problem. But of course it's not impossible. Without the meds, I would be in the 150's systolic.

My gym routine is 20 minutes of fast walking, 20 minutes on an eliptical machine, and 20 minutes of weights. I do upper body one day, and lower body the next. I do one set of each lift, 20 reps, so, you know, not that strenuous. It's a good workout, but really nowhere close to overtraining. And, as with the other stuff, it's basically the same routine I've been doing for years.

Well, I see my doctor Thursday. I'm sure he will tell me that I'm just getting old, and I need to accept it. But you know, the whole point of TRT is not just accepting it. Anyway, we'll do a bunch of lab work (I'm gonna suggest cortisol and a thyroid panel) to see if we can find some non-T explanation for the symptoms. I strongly suspect that will all come up negative, but I could be surprised.

I can see your point and I've been on TRT for many years and there are times when libido is not that great either. It's fine for a while but sometimes is hit or miss. If you dont have to be on TRT dont, see if there is another root cause of the issue you have. Once on TRT you are going to run into a new set of issues and if you find that you didnt really need it that would be bad.
THe thing is that TRT will keep your test levels around where your are now...if you go higher then you looking at other side effect: high blood pressure, DHT levels, prostate issues if you prone to that etc. So you have to weigh the pros and cons at this point I guess and see what you comfortable with going forward.
By no means settle on the idea that you geting old, is nonesense just be smart about it. If my normal test levels were like yours there is no way I would be on HRT. I;ll find a way to increase my free test without HRT!

 

[vassille]

Thanks for the responses. So, nobody thinks free T of 11.6 is low enough to warrant TRT? Well that's very interesting. LEF thinks it is (they recommend 20-26 for any age). Dr. Morgentaler thinks it is (less than 15 is low if there are symptoms). But both of them basically say total T doesn't matter. But it seems you guys disagree with that. And I'm still struck by the fact that four years ago, when I didn't have these symptoms, free T was 17.1, and now, with symptoms, it's 11.6. Just coincidence?

As for the BP meds, I've been on them a long time, and it's only in the last year that I've started to get these symptoms. There's no question the meds cause an increase in E2, but I've been controlling that with low-dose Arimidex. So I think it's unlikely that's the problem. But of course it's not impossible. Without the meds, I would be in the 150's systolic.

My gym routine is 20 minutes of fast walking, 20 minutes on an eliptical machine, and 20 minutes of weights. I do upper body one day, and lower body the next. I do one set of each lift, 20 reps, so, you know, not that strenuous. It's a good workout, but really nowhere close to overtraining. And, as with the other stuff, it's basically the same routine I've been doing for years.

Well, I see my doctor Thursday. I'm sure he will tell me that I'm just getting old, and I need to accept it. But you know, the whole point of TRT is not just accepting it. Anyway, we'll do a bunch of lab work (I'm gonna suggest cortisol and a thyroid panel) to see if we can find some non-T explanation for the symptoms. I strongly suspect that will all come up negative, but I could be surprised.

So I took a look of my blood work and her is some food for thought :
Im one of those ppl who have very low SHBG. Mine tested at <10. Range 20-60!
THis may explains this(here a a bunch of testes of free test)

Test level 634 ---free test 29 Range 8-25 (off the chart)
392----free test 17 Range 8-25 ok
989----free test 376 Range 52-280 (off the chart)
411----free test 140 Range 52-280 ok even at this low range
280----free test 10 Range 8-25 now it's low but it's as much as yours at 700!!

I dont take anything to lower my SHBG so not sure what is going.
So it seems that your issue is not test production but more high SHBG you have. If you can lower SHBG your free test can go off the chart at your current testosterone levels .
Hope this might shed some light

 

[peabody]

I think I've read most of the SHBG-lowering threads here, and as far as I can tell, when everything has settled out, the only thing that results from lowering SHBG is lowering total T. Free T may go up temporarily, but in the end you end up with FreeT pretty much where you started. I haven't found a single person here who says his Free T was elevated long term from taking nettle or the other herbs, or even Danazol for that matter.

Now that's not the same as eliminating a *cause* of high SHBG, such as hyperthyroidism, which apparently can result in permanent higher Free T.

So I see my doctor Thursday, and the first step is to look for those causes. I'm going to start a new thread on what lab tests to do. But if all the known causes come back normal, then I don't see any alternative to TRT - unless, of course, someone says his experience demonstrates that I'm wrong about nettle, etc., not working in the long run.

 

[EasyEJL]

But trt won't work. Given what your total test to free test ratio is, you are looking to have a doctor take your total test over 1400 to reach your free goal, and most doctors will not do that, as it brings with it increased e2 and dht

 

[vassille]

I think I've read most of the SHBG-lowering threads here, and as far as I can tell, when everything has settled out, the only thing that results from lowering SHBG is lowering total T. Free T may go up temporarily, but in the end you end up with FreeT pretty much where you started. I haven't found a single person here who says his Free T was elevated long term from taking nettle or the other herbs, or even Danazol for that matter.

Now that's not the same as eliminating a *cause* of high SHBG, such as hyperthyroidism, which apparently can result in permanent higher Free T.

So I see my doctor Thursday, and the first step is to look for those causes. I'm going to start a new thread on what lab tests to do. But if all the known causes come back normal, then I don't see any alternative to TRT - unless, of course, someone says his experience demonstrates that I'm wrong about nettle, etc., not working in the long run.

I def see your point and what has me wodering is that your body produces testosterone but seems to be nulled out by the high SHBG. Most ppl on HRT have low testosterone period. I never looked into SHBG since I didnt need to but i could have a condition that's just lowers it..not sure.
I do have a faster methabolism , I can eat a lot on a daily basis without puting on fat so maybe I do have a touch of hyperthyrodism.

 

[vassille]

But trt won't work. Given what your total test to free test ratio is, you are looking to have a doctor take your total test over 1400 to reach your free goal, and most doctors will not do that, as it brings with it increased e2 and dht

True, it seems that overcoming the high SHBG will require a higher amount of injectable test. There have been instances where ppl have been put on as much as 400mg of weekly test to bring free test levels within range.

 

[peabody]

But trt won't work. Given what your total test to free test ratio is, you are looking to have a doctor take your total test over 1400 to reach your free goal, and most doctors will not do that, as it brings with it increased e2 and dht

My understanding is that raising the level of testosterone (TRT) reduces SHBG, so that free T will be a higher percentage of a larger number. In posts on his forum, Dr. Crisler says that this does in fact take place, and that, in effect, the solution to high SHBG is TRT.

Apparently Dr. Shippen sees things the same way, except that he adds a small dose of Danazol which reduces SHBG convincingly. Any tendency of Danazol to reduce T production under normal circumstances is irrelevant because you're on TRT in the first place. But that allows you to significantly raise free T without having to raise total T so much. Crisler seems to think that it's better to just go ahead and raise total T to whatever you need, and let SHBG do what it's going to do. The advantage to that is that it may avoid having to deal with high E2 - as he says, lower SHBG also means higher free E2. So he likes to leave SHBG high.

But unfortunately, using Danazol while NOT on TRT doesn't work - it just crashes total T instead of increasing free T. And I'm concerned that nettle and similar natural stuff would have the same result in the end. But I have to say, I think your suggestion to at least give that a try is a good one, and I will probably do that, maybe in combination with taking modest doses of pregnenolone and DHEA.

But first, I need to see if there's a dectable cause for the high SHBG. Maybe I'm hyperthyroid, or something like that. If something like that shows up, then a really easy fix might open up.

 

[vassille]

pls post up if you find anything with the thyroid. Im curious about this

 

[The Matrix]

My understanding is that raising the level of testosterone (TRT) reduces SHBG, so that free T will be a higher percentage of a larger number. In posts on his forum, Dr. Crisler says that this does in fact take place, and that, in effect, the solution to high SHBG is TRT.

Apparently Dr. Shippen sees things the same way, except that he adds a small dose of Danazol which reduces SHBG convincingly. Any tendency of Danazol to reduce T production under normal circumstances is irrelevant because you're on TRT in the first place. But that allows you to significantly raise free T without having to raise total T so much. Crisler seems to think that it's better to just go ahead and raise total T to whatever you need, and let SHBG do what it's going to do. The advantage to that is that it may avoid having to deal with high E2 - as he says, lower SHBG also means higher free E2. So he likes to leave SHBG high.

But unfortunately, using Danazol while NOT on TRT doesn't work - it just crashes total T instead of increasing free T. And I'm concerned that nettle and similar natural stuff would have the same result in the end. But I have to say, I think your suggestion to at least give that a try is a good one, and I will probably do that, maybe in combination with taking modest doses of pregnenolone and DHEA.

But first, I need to see if there's a dectable cause for the high SHBG. Maybe I'm hyperthyroid, or something like that. If something like that shows up, then a really easy fix might open up.

I have listed causes of HIGH Shbg many times. Number one cause is environmental estrogen, and the livers inablity to process them, Its also can be found with endogenous waste material from inflammation with in the GI tract or even from NASH. elevated Thyroid is also an issue, low cortisol, low carb dieting, malabsorptoion of nutrients.

 

[peabody]

Well I saw my doctor today, and he was very down on the idea of TRT for me. He basically knows nothing about it - has never used HCG or Arimidex, just does the T shots or gel on rare occasions when a man is below the lower limit of the range for his age. But, he says my levels are within the range for my age, so he's unwilling to do TRT. Says it's dangerous. Want's to put me on an antidepressant instead. Right. That sure would help with ED and delayed orgasms.

But meanwhile, tomorrow morning I do a bunch of lab tests, including a thyroid panel and cortisol. And we're doing the T tests again. I asked for E2 as well, but "why would you want to test that?" I insisted, and he finally agreed, just to humor me. I had checked prolactin through LEF a month ago, so not doing that again.

So maybe the tests will point to something other than low T. Something treatable. I hope so.

Anyway, so now I think I need to inhale a bunch of those herbs that supposedly lower SHBG - nettle-like stuff, and I'm also wondering if I should take pregnenolone and DHEA. Not sure about what do to, or how much to take. I'm less thrilled with the idea of taking test "boosters". I guess I always suspected there was nothing to them, at least in the long run.

By the way, I had a long discussion with a doctor at LEF this morning to review the lab test results. Of course he thought my free T was low, and also said my DHEA should be three times as much. We talked a bit about finding a doctor, but he had nobody in his database for my area.

 

[The Matrix]

Well I saw my doctor today, and he was very down on the idea of TRT for me. He basically knows nothing about it - has never used HCG or Arimidex, just does the T shots or gel on rare occasions when a man is below the lower limit of the range for his age. But, he says my levels are within the range for my age, so he's unwilling to do TRT. Says it's dangerous. Want's to put me on an antidepressant instead. Right. That sure would help with ED and delayed orgasms.

But meanwhile, tomorrow morning I do a bunch of lab tests, including a thyroid panel and cortisol. And we're doing the T tests again. I asked for E2 as well, but "why would you want to test that?" I insisted, and he finally agreed, just to humor me. I had checked prolactin through LEF a month ago, so not doing that again.

So maybe the tests will point to something other than low T. Something treatable. I hope so.

Anyway, so now I think I need to inhale a bunch of those herbs that supposedly lower SHBG - nettle-like stuff, and I'm also wondering if I should take pregnenolone and DHEA. Not sure about what do to, or how much to take. I'm less thrilled with the idea of taking test "boosters". I guess I always suspected there was nothing to them, at least in the long run.

By the way, I had a long discussion with a doctor at LEF this morning to review the lab test results. Of course he thought my free T was low, and also said my DHEA should be three times as much. We talked a bit about finding a doctor, but he had nobody in his database for my area.

Like I said you need to get down and dirty to find out what is going on, but many dr's are too lazy to look..

 

[PumpAddict69]

I'm surprised nobody is recommending proviron. That is what you need, rather than the bitch of having to do TRT. Proviron binds to shbg, increases free testosterone, and will decrease your E2 slightly as well. Studies show that proviron does not lower LH or FSH in men with normal serum levels even at 125mg/day. Even 1 tab (25mg) a day could get you noticable benefits.

 

[peabody]

On paper, Proviron looks very good, even for those not on TRT. But has anyone here actually used it when not on TRT or doing "cycles"? It would be nice to find at least one example of someone not on TRT who has used Proviron successfully to increase free T, with lab work to prove it.

And by the way, is there a source most use for it? Apparently it's not officially available in the US at all. PM if that's better.

 

[vassille]

I'm 60, 5'10", 170, still athletic and fit, gym every day, but increasingly having low-T-like symptoms - mood, energy, and libido/sexual issues. I won't waste your time with the details, but pretty much all the classic low-T symptoms.

Here are my recent 2012 LabCorp test results via LEF (the standard E2 test was used):

Total T ------------ 693 (398-1197) [37th percentile]
Free T - direct ---- 11.6 (6.6-18.1 for age 60+, 9.3-26.5 for age 20-29)
SHBG --------------- 50 (19.3-76.4 for age 50+, 16.5-55.9 for age 20-49)
Estradiol ---------- 16.8 (7.6-42.6)
DHEA-S ---------- 112.9 (33.6-249.0)

Values from August, 2008 test, with no symptoms:

Total T ------------ 763 (241-827) [89th percentile]
Free T - direct ----- 17.1
Estradiol ----------- 21

I've never been on TRT, but have taken a low dose of Arimidex for many years to reduce high (47 originally) estradiol that I believe resulted from taking diltiazem, a CCB, for blood pressure - it worked when nothing else did, but apparently slows down the removal of E2 from the body by inhibiting the relevant CYP-450 enzyme(s). I've tested for E2 every four months, and the dose needed to keep it at about 20 has dropped many fold over the years. The dose which produced the above 16.8 was 1/800 mg per day via very diluted liquid, which is one mg of Arimidex spread over two years.

Total T has dropped from 763 to 693 in the last four years, but because of a change in the range, total T has dropped from the 89th percentile to the 37th percentile, which appears to be a more significant drop. But I don't know if the range change is meaningful, and, you know, it's still 693, which isn't horrible.

What gets my attention is what appears to be low free T caused by high SHBG. While 11.6 looks fairly mid-range for men 60-100 years old, the LEF protocol says I should be in the top third of the range for 20-29, which would be the lower 20's, roughly double where I am now. And Dr. Morgentaler's book says free T below 15 should be considered low if there are symptoms.

But since my total T is 693, the question arises whether I could arrive at a solution by reducing SHBG, which would raise free T. I've been doing a lot of reading, and the possible options I've found are:

1. Do nothing. T is not low. But then, what about the symptoms?

2. Some combination of avena sativa, nettle root, and muira puana to lower SHBG. But I can't find any strong evidence that any of these produce a really significant effect on SHBG, and nettle root in particular has the disadvantage of also reducing DHT, which could be counter-productive.

3. Take DHEA. I've found nothing that shows a reliable effect on either Test or SHBG from doing this. But I believe Dr. Crisler does prescribe it to his patients, along with pregnenolone. Not sure why. Also, I don't know whether my 112.9 is actually low.

4. Take low-dose Danazol to reduce SHBG. Apparently this IS reliable for reducing SHBG (Shippen and perhaps others use this, but not Crisler), but with uncertain side effects, such as reducing total T production. It appears the dose is 20-25 mg per day.

5. Do TRT. My guess is that Dr. Crisler would pick this one. However, I normally get my medical care at the VA, which will take one look at my numbers and tell me to take a hike since everything is within range. So the entire TRT expense of the civilian doctor visits, the meds and the lab tests will fall on me, and I'm concerned that by the time you add up the T-gels and HCG shots, the cost may be prohibitive. So if there's a way to raise free T short of full blown TRT, I'd like to find it.

So I'd like to get everyone's thoughts as to whether the lab results indicate I may have low T, and I'd like to get your opinion on the options listed above, or any others I may have left out. And basically, what do you think I should do?

I do have a civilian doctor that I see occasionally (he charges, and the VA doesn't) but I'm going to ask him to do cortisol and thyroid tests, and anything else that comes to mind, to see if there may be another explanation for the symptoms. But I kinda suspect those will be normal. Recent B12 and prolactin tests have been normal. PSA has been stable at around 1.7 for some time.

Meanwhile I have stopped the near-homeopathic dose of Arimidex for baseline purposes. I did that for six weeks last year, and E2 went up to 26, and I felt worse. I didn't test for T then, but assume it dropped.

Thanks very much for any help.

took another look at this post and something i noticed...you said that when your E2 went to 26 you felt worse. Normally when SHBG goes up so does estrogen. Could it be that 26 is high for you and lowering it to lets' say 10 is more in the range for your body?
Another thing, are you sure your prostate is ok? THere is evidence that prostate issues will increase SHBG along with thyrodism.
I personally think there is somehting wrong with you with one of the things I've mentioned above. It is also possible your nutrition might play a role as well which might create inflamation of the gut flora or liver which in return will cause the SHBG to go up. Normally SHBG will go up with age just not sure this is age related.
I understand you want HRT but it doesnt make much sense to go on it when you might have an underlying problem .

 

[peabody]

took another look at this post and something i noticed...you said that when your E2 went to 26 you felt worse. Normally when SHBG goes up so does estrogen. Could it be that 26 is high for you and lowering it to lets' say 10 is more in the range for your body?
Another thing, are you sure your prostate is ok? THere is evidence that prostate issues will increase SHBG along with thyrodism.
I personally think there is somehting wrong with you with one of the things I've mentioned above. It is also possible your nutrition might play a role as well which might create inflamation of the gut flora or liver which in return will cause the SHBG to go up. Normally SHBG will go up with age just not sure this is age related.
I understand you want HRT but it doesnt make much sense to go on it when you might have an underlying problem .

Thanks for your input. My E2 went up because I stopped taking Arimidex. But the problem with taking it too low is the bad side effects re osteoporosis, etc. I've tried to keep it in the low 20's for that reason, and wouldn't want to be lower than that for any length of time, even if it made me feel better.

So far as I know, my prostate is fine. PSA is low, and no prostate symptoms. I'm not aware of prostate problems raising SHBG.

As for nutrition, I don't know how I would determine whether I have gut or liver inflamation, except for the usual liver labs, which I'll get back next week. Do you have in mind any more specific links between diet and SHBG?

 

[vassille]

Thanks for your input. My E2 went up because I stopped taking Arimidex. But the problem with taking it too low is the bad side effects re osteoporosis, etc. I've tried to keep it in the low 20's for that reason, and wouldn't want to be lower than that for any length of time, even if it made me feel better.

So far as I know, my prostate is fine. PSA is low, and no prostate symptoms. I'm not aware of prostate problems raising SHBG.

As for nutrition, I don't know how I would determine whether I have gut or liver inflamation, except for the usual liver labs, which I'll get back next week. Do you have in mind any more specific links between diet and SHBG?

If your PSA is good then that's fine.
I believe that there could be inflamation in the liver and gut without you even know it. I cant talk for others but from my experience certain foods can cause inflamation thus restricting nutrient intake to the body. Subsequently, the liver missing key nutrients will start to faulter and create issues and even hormon production in other parts of the body.
Do some research for the food supply like grains and such and you will find how many ppl cant properly digest it.
What I personally run into is for the lack of a better term malnutrition. I ate a high carb/low fat diet for a long time. The first clues of poor digestion appeared in the gym recovery. I could only train 3 days a week regardless how I ate, slept or trained.
After a major overhaul of my diet I can train 5-6 days a week without any recovering issues. My sex life has veru much improved keeping testosterone in the 500-900 range. Regardless if my total testosterone is 500 or 900 my sex drive is the same. sex drive is great even at 400.
Now my SHBG is low allowing for a higher free test to float around and I can feel the difference.
I feel that a diet which creates inflamation and is low in fat can cause hormone deficiency. THat's my feeling about it and my experience backs that up.
I do eat yogurt regulary now to maintain the good bacteria and eat limited grains which has helped my stomach immensely to digest food properly.

 

[The Matrix]

If your PSA is good then that's fine.
I believe that there could be inflamation in the liver and gut without you even know it. I cant talk for others but from my experience certain foods can cause inflamation thus restricting nutrient intake to the body. Subsequently, the liver missing key nutrients will start to faulter and create issues and even hormon production in other parts of the body.
Do some research for the food supply like grains and such and you will find how many ppl cant properly digest it.
What I personally run into is for the lack of a better term malnutrition. I ate a high carb/low fat diet for a long time. The first clues of poor digestion appeared in the gym recovery. I could only train 3 days a week regardless how I ate, slept or trained.
After a major overhaul of my diet I can train 5-6 days a week without any recovering issues. My sex life has veru much improved keeping testosterone in the 500-900 range. Regardless if my total testosterone is 500 or 900 my sex drive is the same. sex drive is great even at 400.
Now my SHBG is low allowing for a higher free test to float around and I can feel the difference.
I feel that a diet which creates inflamation and is low in fat can cause hormone deficiency. THat's my feeling about it and my experience backs that up.
I do eat yogurt regulary now to maintain the good bacteria and eat limited grains which has helped my stomach immensely to digest food properly.

Excellent said...wish people would follow the common sense first before jumping on HRT bandwagon.

 

[peabody]

Well, I think I'm already doing all the right things that I know to do. I adjusted my diet some years ago to elminate grains and lower carbs in general, and increase healthy proteins and fats - particularly olive oil and tree nuts. And I've been eating plain yogurt with berries every day for years. And I go to the gym every day, and am not overweight. So while it may be "common sense" I just don't see anything specific that I could do to make things better.

 

[The Matrix]

Well, I think I'm already doing all the right things that I know to do. I adjusted my diet some years ago to elminate grains and lower carbs in general, and increase healthy proteins and fats - particularly olive oil and tree nuts. And I've been eating plain yogurt with berries every day for years. And I go to the gym every day, and am not overweight. So while it may be "common sense" I just don't see anything specific that I could do to make things better.

GEt rid of yogurt...
You can always make things better....Tree nuts have high risk of toxic mold..and you think you are eating healthy LOL..

 

[vassille]

Well, I think I'm already doing all the right things that I know to do. I adjusted my diet some years ago to elminate grains and lower carbs in general, and increase healthy proteins and fats - particularly olive oil and tree nuts. And I've been eating plain yogurt with berries every day for years. And I go to the gym every day, and am not overweight. So while it may be "common sense" I just don't see anything specific that I could do to make things better.

What do you eat on a daily bases if you dont mind me asking..and how much?

When I changed my diet I turned my body into using fat for energy rather than glucose. I didnt just add some healthy fats to my diet I eat fat for energy that's what I meant by diet overhaul. I ate some healthy fats in the past too it didnt really helped untill I changed the diet more drastically.I also eat as much organic foods as I can which seems to help as well. I've never felt better in my life.
Now I sort of reversed the FDA food pyramid... Lots of fat at the bottom, protein, and carbs spearingly. Works wondefully.

 

[vassille]

GEt rid of yogurt...
You can always make things better....Tree nuts have high risk of toxic mold..and you think you are eating healthy LOL..

I dont really see issues with plain full fat yogurt...what issue you see with it?
As for the nuts I do agree some test funky which could explain some mold. There are plenty of good nuts out there though

 

[The Matrix]

I dont really see issues with plain full fat yogurt...what issue you see with it?
As for the nuts I do agree some test funky which could explain some mold. There are plenty of good nuts out there though

Dairy ia highly inflammatory to bowel...trust me he's not.making his own from raw organic milk from a2 cows then id.say it.might.be ok. I do.not eat.milk.products. My clients have notice significant improvement over all in Removal of dairy products

 

[peabody]

I got back the results from the lab work my doctor ordered. He retested total and free T via ARUP labs, and while the tests appear to be completely different from Labcorp's, the results are pretty much the same:

Total T 502 (300-720 for age 60+)
Free T 75.2 (47-244 for age 18+)

The Labcorp values had been:

Total T 693 (348-1197 for age 20+)
Free T 11.6 (6.6-18.1 for age 60+)

SHBG was 49 versus 50 at Labcorp
Estradiol was 14 versus 16.8 at Labcorp

So free T in the latest test was at the 14th percentile for all men, versus Labcorp's 43rd percentile for men over 60.

It appears that with these numbers nobody will do TRT for me unless I go to Crisler or Morgentaler, or of course one of the Cenegenics mills.

Other test results showed no problem with thyroid (TSH, free T4 and free T3 were right in the middle) or fasting blood sugar, but morning cortisol was a bit high - 20.6 (3.7 - 19.4).

I'm going to follow up with the doc to see if perhaps the 24-hour urine test for cortisol is in order, but actually, my reading tells me that it is LOW cortisol that raises SHBG. So it appears if my cortisol were lower, my SHBG would be even higher. So that's not an explanation for my high SHBG, nor does it offer a route to lowering it.


I'm going to try nettle, avena sativa and muira puana, plus modest doses of pregnenonlone and DHEA, to see what happens, and maybe do more research on Proviron.

 

[vassille]

Checkout dostinex or cabergoline if you run out options. It is known to increase libido.

 

[vassille]

Dairy ia highly inflammatory to bowel...trust me he's not.making his own from raw organic milk from a2 cows then id.say it.might.be ok. I do.not eat.milk.products. My clients have notice significant improvement over all in Removal of dairy products

Interesting...if I eat grains milk products bother me but if I dont eat grains Im perfectly fine eating as much as I want.