Normal T, low Free T, High SHBG - TRT or not?
- 02-03-2013, 04:39 PM
Normal T, low Free T, High SHBG - TRT or not?
As I posted on before with other updated markers, the issue of normal T, low free T, elevated SHBG remains unresolved:
(since I am unable to post a link, please put the www before this link):
Estradiol: 10 [3-70]
Total T: 632.4 [348-1197] - NOT ON TRT
Free T: 8.7 (L) [9.0-46.0]
W. Bound T: 55.0 [40.0-250.0]
SHBG: 66.8 [19.3-76.4]
Again, doc suggested a liver cleanse and to start TRT to bring up free T.
In the meantime, I have started Divanex and Activate Extreme to help boost free T and reduce SGBH.
Another things to keep in mind is that the thyroid hormone (especially T3) I have been running can elevate SHBG.
One of my docs doesn't put much weight on FT and uses TT exclusively to monitor. Many don't agree with his assessment free testosterone, and that it's a "small part" of the total testosterone signal thing.
For me, the decision to move ahead cautiously with TRT I still ponder because my sexual function is fine, so why mess with that. OTOH, if you look at my low free T, age, and inability to recomp no matter how hard I train and eat clean, TRT seems like the missing link.
So, the question is whether I should I take my other doc's advice and try TRT.
- 02-03-2013, 10:58 PM
Where is your LH?
The Labcorp E2 (3-70) test is inaccurate. Spend $50 on PrivateMDlabs FEMALE HORMONE panel.
I went to your posted link...... Great labs......How much SRT3 were you taking??
Where was your TSH before you strarted SRT3 thyroid supplements?
IMO you tested the T4 way too soon, I would give it two months to equalize.
I have used T4, T3, NDT, and I have high SHBG, also. And so far I have not found an
effective way to lower SHBG without killing TT.
My favorite thyroid link.....tiredthyroid.com/rt3.html
- 02-03-2013, 11:50 PM
Find.out why shbg is high other wise you.may be shooting yourself in the foot. Does MCS stand.for multiple chemical sensitivity? if.it does.a lot of these cases Both Male and female i ran into had high shbg. high shbg is usually due to.impacted liver or.gi function. Once one identify these imbalances shbg tends to.return.to.normal.levels over time. Past or current .medications, poor.lifestyle choices from.years ago,.acetylaldehydes from candidate, elevated xenoestrogens or estradiol levels can also.impact shbg. Common occurrence I see in Dr patients is NASH.which gets highly.over looked.I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
02-04-2013, 12:03 AM
I'd further investigate the liver and reason why SHBG is high.
If you dont have a good reason to go on TRT then try to lower your SHBG and take it from there.
I think at this point in your life is more of a lifestyle choice rather than medical reason. If you can bring your free T up a bit then no need for TRT.
On the other hand if you want to get more active in the gym then by all means indulge in the TRT.
02-04-2013, 12:26 PM
02-04-2013, 09:22 PM
Sometimes the cause of this elevated SHBG is inflamation and/or fatty liver. Even drinking green tea or cofffee will elevated it. Paleo diet is good start but I think you also need to look into insulin resistance. If the balance between lipids in the blood is off that's a clue that the liver is dumping fat into the blood stream upseting the balance. Stick with the T3 as it revs up the cell production of ATP and it also absorbs the fat from the blood and use it for energy. Once the balance is restored the liver should start working more efficient and within parameters.
Also, avoid grains like the plague. A leaky gut will cause all sorts of issues with the liver as well.
Stick with paleo for a while is not an easy fix.
How much T3 are you taking and how are you lipid numbers looking like?
02-05-2013, 01:08 AM
02-05-2013, 01:15 AM
02-05-2013, 01:27 AM
fsh 4.9 1.5-12.4 mIU/mL lh 5.3 1.7-8.6 mIU/mL
Reduced T3 to 25mcg daily. Was @ 75mcg sustained-release for 2+ years and as high as 100mcg which sent me into hyperthyroid state. TSH pre-T3 monotherapy averaged 3.5. RT3 was elevated also. Now it's low as well as T4.
My one doc never tested FT only TT. My guess is that I was also low and my SHBG in the higher range and now even higher due to T3 mega-saturation. My sense is that it will normalize, but that doesn't mean TRT is out of the question. Have you looked into TRT?
Thanks for that link. That's a new one I haven't seen!
02-05-2013, 08:09 AM
T3 only killed my DHEAs and raised my cortisol to 120% of range(over entire day).
Have you done 4x saliva cortisol testing???
Why not try LOW dose Clomid? ORAL HCG?(yes, you mix real HCG and put it under your tongue)
02-05-2013, 11:53 AM
02-05-2013, 01:47 PM
I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
02-05-2013, 02:34 PM
02-05-2013, 02:42 PM
Only MTHFR? What about CBS?(ammonia issues)
Maybe not FATTY LIVER, but way over worked liver(toxic byproducts).
Have you used /geneticgenie.org/?
02-05-2013, 02:54 PM
The only test I know that tests for CBS is Yasko. Do you know of others? I have no idea how I could be ingesting toxins. I eat organic and am careful about all the supps I use. Will look into that link.
02-05-2013, 02:58 PM
You feed your downloaded 23andME data into /geneticgenie.org/ and it searches for all the methylation SNPs.
Well, atleast that is what I have read. My 23andME test data is not done yet, so I do not have first hand knowledge.
I try not to post about things I have not done.
02-05-2013, 03:11 PM
02-05-2013, 11:01 PM
It is not uncommon to have elevated LDL on paleo. If the LDL persisits even with taking T3, you need to cut back on the fat intake a little. It is possible as the body burns stored adipose fat, the addition of exhgenous fat might be too much for the amount of exercise you do a day.
At this point since you have a fatty liver i'd say a lot of exercise and not a whole lot of food. I dont believe any detox for the liver works like milk thistle etc. I'd look into using vinegar or balsamic vinegar as it has some properties that may help you.
Also, def check to see your insulin response to carbs. That would make a big difference in the body;s ability to burn fat for energy.
What is your blood glucose fasted, and 3 hours afer a meal?
02-05-2013, 11:46 PM
02-06-2013, 02:06 AM
02-06-2013, 08:06 AM
I am not a medical Dr, please keep in mind that this answer is for information purposes only, and is not intended to diagnose, treat or replace sound medical advice from your physician or health care provider.
02-06-2013, 11:16 AM
02-06-2013, 12:31 PM
02-07-2013, 05:47 PM
As far as zone is concerned I mentioned it because of its inflamation focus and not regarding it's carb content. I should have been more specific. For example, the use of fats I do like their approach of not cooking with olive oil because it created inflamation and so forth. There is info there that can be pulled and used on the paleo diet in this sense.
Just an FYI, sometimes some ppl have a bit a problem with less than 50g of carbs on a low carb diet. Their bodies just doesnt fuction properly. If the adjustment of the fat intake doesnt seem to work you may want to consider going up to 75 g of carbs a day. I personally do less then 50g a day of carbs but there are days when I go to 100 or 75 for few days then back it off and still loose weight. Just play around with it and find your spot.
02-07-2013, 06:19 PM
I cannot figure out the latest weight gain. I have not consumed more calories daily and training and cardio is same. I wonder if it's because of dropping the t3 from 75mcg and my RMR has slowed from feedback shutdown or like a rebound effect. It's the only thing I've changed in the last few weeks. I have never been able to gain lean mass without adding fat, doesn't matter what age. Thing is - I feel better with less t3, but maybe I need to reevaluate and try some NDT. I really have to watch going too high on either t3 or t4 as either will cause palpitations and blood to clot up as it did twice in the last year (after ruling out all other causes).
I still also think TRT and peptides will help me in my fitness goals that diet and training has failed to give me. HRT and reducing calories are only things I have not tried.
A friend told me today I look bloated from weeks back. Pretty discouraging. Back to square one.
I seriously need to recomp:
Fat-free mass: 133
During mid last-year, I made some progress by dropping weight to 168 w/ 19% bf and now I went backwards again. 3 x 30 min cardio does nothing. Same with training 4x/week. I look like I don't even work out.
Desired would be like this:
Fat-free mass: 140
For this point, I can start a clean bulk to 160-165, the cut again. Rinse, repeat.
But it sucks taking this long and never getting anywhere after all the research and effort I've put into fat loss. How farther do I need to drop calories before I go into starvation mode, even slower metabolism & catabolism?
02-07-2013, 10:04 PM
ah, now I have a much better picture of what you did.
First off, you are starting to cross over from HRT to bodybuilding. If you want to lean out like that and build up your physique I think bodybuilding is better suited. You dont have to go crazy but the approach need to be a bit different.
Doing 75 T3 without anabolics most definitely burned muscle unfortunately. You also have a rebounding effect from that so my advice is to slowly cut back on the t3 all the way to nothing and stop it. Let the body bounce back.
Procure some test and HGH if you want to get into it like that and do a cycle. Once on the cycle you can do;
250mg of test per week
1IU GH daily (5on 2 off)
25 T3 daily (optional) but recomnded with GH
And yes, you may have to lower your food intake for a while till thyroid is bouncing back if you dont want to get too fat.
With the diet already in check and cardio you should have some nice results.
02-07-2013, 11:53 PM
Well, actually, my only HRT was running T3 if you conisder that HRT. That's it. The goal was to optimize thyroid function and metabolism by clearing out excess rT3 and suppressing TSH - both accomplished finally after 2.5 years of taking sustained-release T3, and then straight T3 as of late. As far as BBing - I've been resistance training since the age of 24 when I was my leanest and lightest. Had pretty good definition and vascularity. But I never trained hard enough and had many stumbling blocks, problems with diet, food allergies, gut infections, etc. and then major business-related stress - all of which took me off course from really getting into training. Now that all that crap is behind me - with the exception of some manageable health issues - I am back full circle, picking BBing back up where I left off in my mid-20s - but now at 53.
I have a buddy doing a GHRP-2/GHRP-6/Mod-GRF stack per my suggestion. He was previously running rHGH @ 2IUs and then stopped and started the peptide combo when I convinced him (and myself even though I'm not on anything as of yet) that it's much more effective and safe to use secretagogues that stimulate the pituitary to makes it's own GH in a pulsatile fashion as opposed to injecting frank rHGH daily (many may disagree and tell me to go with the real deal, but there are many sides with it). My buddy's baseline IGF-1 was sub 200. On rHGH it raised to mid 200s. On the peptide combo, it spiked to mid 400s! He's also running a test cyp/prop/phenylprop combo once every couple weeks (but his E2 is too high and his TT shot down from 1500 to 350! He is getting HPTA suppression, I'd say. Should be using some HCG or Clomid, shouldn't he? He's 9 years younger than me and his bf is 13%.
Have you run any of the GHRPs and GHRHs and compared body comp with using rHGH? Some argue that peptides aren't as effective for older guys like me, but I think they're referring to sermorelin which is pretty much useless by itself since the GH spike last only seconds.
In any case, yes, I was ALWAYS concerned over the catabolic effects of T3 and that you should never run it w/o AAS. But my "specialty" doc didn't say much to that, probably because he doesn't know this. My local HRT doc, however, loves test cyp, takes it himself (as well as HGH), and prescribes it with a small dose of deca (nandrolone). He has been suggesting it for a while and especially with my almost non-existent FT - as has every friend of mine.
But again - looking at my normal TT and my pathetic FT levels (see my first post)- and taking into account the fact that there is no way in hell I can build the body I want no matter how hard I train and eat clean when the chemistry (FT) isn't available for adding lean mass and burning fat. You agree? Same goes for my IGF-1 which is around 200. Everything I've read says that TT levels needs to be at as close to 1000 and FT levels at the top of the range in order to add lean mass. My E2 is too low right now. That will change when I cycle up. I have some adex, but never had to use it.
I never went full-bore on HRT (TRT and GHRT). I think I'm well past the point of needing to go for it. Heck, I'm 53, after all. Yes, my TT is not bad hovering between the mid 400s to 600s - but that means nothing if the FT is too low which it is. BUT - I've been reluctant to go on TRT because I'm paranoid I will permanently screw up something that needs no help: my libido and my sexual function. I think running HCG as Dr Crisler recommends would be the way to go to prevent testicular atrophy, hair loss, and long-term axis suppression. Also, exogenous T is know to suppress adrenal and thyroid function. Everybody jokes that I'm a professional procrastinator, but I just want to be very cautious because I've had a lot of health issues plague me over the years and I certainly don't need to do some irreparable harm to myself.
What do you think?
02-08-2013, 09:38 PM
Honestly I think you should go the BBing approach and do a 10week cycle thus keeping yourself away from TRT but still riping the benefits of aas.
There are some interesting thoughts you went through but the difference between your body making something and taking externally is like night and day. If you want higher IGF levels take IGF-LR2, if you want higher test levels take test. The problem with stimulating your own body to produce something in excess is that there are feedback mechanisms that will prevent that from happening on a large scale. For this reason I really was never interested in any other peptides than HGH and IGF. Those 2 I can say, especially HGH made the biggest difference in growth.
The story with GH is that our bodies seem to always bounce back from using it much better than testosterone. Not sure really why but it does. Thyroid seem to do the same.
The part that you really need to pay close attention is the fatty liver and your diet. Now, just because you can tolerate low carb doesnt mean you shouldnt eat some fruit, veggies and occasional starch once in a while. I think youhave 2 goals right now, immediate goal is to pay close attention to your diet and liver values and longer term to loose body fat and change body composition.
You def doing the research which is a great start.
I really dont see the need for you to mess with those peptides you have mentioned or HCG. Those peptides are for ppl who cant afford or cant get real growth hormone imho. No offense to anybody
Im sure they swear it works and what not but Im one of those ppl who looks at measuring results and sticks with compounds which are able to deliver time and time again and it's easy to control and understand.
Those peptides are hardly researched and can cause more harm than good.
02-08-2013, 09:47 PM
02-08-2013, 11:47 PM
Testosterone therapy is keeping levels within normal ranges. In bodybuilding, doing a cycle one would go beyond the normal ranges in order to accelerate the progress. That's why a cycle is only 10 weeks long then you would let your body normalize.
When you say safer, based on what science? You stimulating an organ to produce something so in the scheme of things you still disrupting the normal function of the respctive body part. Dont be fooled by the up talk of some of these compounds as being safer, they are not.
For example HCG, ok it stimulates the testies to make more testosterone so on paper is an great thing but is it? No it's not.It is very disruptive.
The thing is that once you get into using these compounds yourself things are not as they appear to be on paper.
02-09-2013, 02:05 AM
test prop; 1cc im/per 7 days for 4wks then 1cc per 5 days for 3wks then 1cc per 3 days for 3wks then back to 1cc per 5 days for 3 weeks and then back to 1cc per 7 days...still there. The pyramid avoids the need for estrogen blockers.
I hear what you're saying with some compounds, however, if I had to pick the lesser of two evils, I still think it would be peptides. Why? Because synthetic 22kDa GH has excessive duration and thus is vastly less healthy and safe than GHRH/GHRP. Again, the main pro argument on peptides is that they seem to enhance the body's own natural production of GH vs taking exogenous GH. It pulses as your body does naturally, so your body isn't doing anything unnatural. The con is that many report peptides being nowhere near as effective in recomping when compared to rHGH. Peptides themselves are not GH, and have a different side effect profile from actual GH itself in a bleed pattern. However it stands that those sides (cortisol, prolactin, hunger, gastric motility in some cases) are negligible in most people unlike synthetic GH sides. Peptides like Mod Grf (1-29)/GHRP allow for our bodies to release GH in the natural ordered pulsatile manner; rHGH, especially in high amounts, can keep systemic levels of GH elevated for prolonged periods of time. It is in this scenario that one could begin to experience unwanted signs and symptoms (CTS, antibodies to GH, water retention, elevated glucose, etc.). Also, with GH ,you are not getting the complete gh hormone, only part of it. Dat's forum is probably the most extensive for peptide research.
Also - don't you mean IGF1LR3? Never heard of IGF1LR2.
Then there are SARMs as a better alternative to T (no androgenic sides). Any thoughts on this as well?
At the end of the day, this is all a science done through experimentation - and each of us has to commit to being the lab rat or not. Sounds like I will have to go through a long process to find out what works best for me, hopefully not at the expense of my health, as that would be defeating the very purpose of what I'm trying to do here.
02-09-2013, 10:15 AM
yes igflr3 and the more potent one igf-des. Got the number wrong.I think they do have an LR2 but that's not what I meant regardless.
THat cycle is very inneficient. I can understand the approach about the no need of an AI but the ups and downs would be irritating to say the least.
About GH, synthetic gh is fine if used correctly. I really didnt see any sides or damage from its use. Benefits have been awesome. It is also noted that injecting GH sub-q or IM does affect absorbtion rates and it is very easy to mimic the normal pulsing effect the body.
As far as sarms, they work ok to rise test levels a little but from a bodybuilding perspective not strong enough. They also have their sides. Im not a fan of them but occasionally are a good bridge.
I think, like you said you need to weigh the pros and cons of every approach and decide if the bodybuilding approach or HRT is a better fit for you. In the end, both have their challanges, and it's up to you how you want to mitigate the risks and rewards part of the equation.
Regardless of the approach, if you look at the body as a full circle, at some point either approach will tap into that balance somewhere. With that said, my approach has been to tap at the tail end of this balance much like the finished product such as testosterone,GH, IGF. You want to tap into the signaling between hypothalmus and pituitary or somewhere around that area. To be honest the jury is still out on that, as far as the dosage and how safe that would be. Im not sure how easy would be to burn receptors on the pituitary or hypothalumus with peptides. For this reasons I dont touch stuff I dont know the full effect and the mechanism by which it works.
02-09-2013, 03:59 PM
Can you post some links about the rHGH absorption rates and that it can mimic the natural pulsatile rhythms? The problem is the long bleed of GH:
"SubQ injects (as the doctor would tell you to take your GH) creates a prolonged release pattern that can lead the user towards type II diabetes, due to chronic elevations in blood glucose. GH should be pulsed every 4-5 hours, using IM injections, whith at least one day off, every other day. The side effects of GH use can be ameliorated by utilizing the correct dosing protocol."
This is a major contraindication against rhGH and is again the basis for why I was sold on peptides as a replacement, as a good GHRP/GHRH combo does not create this problem. Secretagogue peptides pose no long-term risk to pituitary gland function, nor is there any risk of overdose.
02-09-2013, 07:44 PM
02-10-2013, 09:41 AM
One way is to take a lower amount over extended periods of time (6-whatever months), the other is to take a greater amount over a shorter period (4-6 weeks).
Im injections I find to be the best regardless, by trial and error and monitorting blood glucose one can see how the GH relesease.
Problem is this, GH works well to preserve mass under low food intake. What ppl do is take GH and eat up a storm which brings the blood glucose into the equation as possible side effect. In that case, insulin can be used to deal with that issue but that's a more complicated matter all together.
I think that some ppl dont understand the ramifications of these compounds in how it affects the body. When designing a cycle all these factors need to be considered. THat's why I think there is a lot of confusion about of what protocol works best.
I dont save stuff I read about, it's from trial and error that I make my decissions on how I design cycles, and feedback from some ppl I know.
02-10-2013, 09:47 AM
Typical cycle 4-5 weeks and that's on top of taking HG along side. There is no PCT. It works better taking in conjunction with HGH, that's basically the PCT.
02-10-2013, 01:20 PM
Also - when on T and/or GH, I need to watch the following:
- both exogenous T and GH can depress hormone and adrenal function
- definitely the glycemic response to exogenous GH
02-10-2013, 03:54 PM
With the right combination of anabolics, exercises and a diet that matches your needs a lot of progress can be made and in time the bloat will go away as body fat decreases.
What cycle are you thinking of doing?
02-10-2013, 06:46 PM
Basically, paleo/keto. I do a 18hr IF & train fasted. I agree diet is 90%. Despite all this, I'm still SOFT. You would think with that low carb & keto, I'd be ripped. Neither I nor any of my friends can understand. I don't think age is as much a factor since I've been like this since my 30s. Could never get dry and hard no matter what I eat. The only thing I can think of that I haven't done is count calories so as to be certain I am at a deficit. Other than that, I have no idea what could be allowing me to store so much bodyfat other than consistently having a lack of free T for all this time. For some reason my metabolism must still not be partitioning macros efficiently otherwise I wouldn't be holding onto fat, let alone creating bodyfat with this type of diet. My gut feeling is that even if I consumed no more than 1000 calories a day - which is not sustainable as an ongoing diet - I still would not get my bf to even 15%. This tells me it's other factors. My first thought was that it was from having a sluggish thyroid. So even when I got my TSH down to the lowest it's ever been and my rT3 cleared using T3, the fat would quickly drop off. It didn't. Very frustrating. What's next? Sometimes I think I'm just screwed genetically.
I would start test cyp possibly with a small dose of deca ( my doc actually prescribes this combo). Still not sure I'd do rhGH until giving the peptides a shot first. I heard the deca will help with tissue injury (shoulder bursitis) as well as T and GH, of course.
02-10-2013, 10:13 PM
I understand your frustration. Sometimes it's like a puzzle trying to figure this whole thing out.
Bloat will go away with fat loss it's not a big deal however uncomfortable it may seem now.
I believe that you are insulin resistant and have been for sometime now. At the same time, as the fat deposits grew larger it also impeded your body's ability to produce and use the right amount of hormones.
From that food breakdown you dont eat a lot. This tells me that cells inside your body are shut down to normal nutrient partitioning as you mentioned, and that is a big problem. Normally, t3 does have an effect on geting them moving but perhaps is just an worse case of cellular damage than other cases.
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