34YO - 2 Sets of Bloodwork - Dr. Giving me choice of TRT - SHBG Thru the Roof

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I'm not very happy with any of the results. Been eating a TON of red meat and lifting heavy, but total test/free test is way down, while SHBG is through the roof! Dr. is offering me any combo of the drugs listed on pg 1 of the most recent blood work.

I need advise... have symptoms of low test (low libido, some ED, low energy). Wife and I don't have kids yet, so worried about TRT, but still need to do something

Just got these back today:

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These are from 03/2016

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I'd love to hear some feedback on the blood work and if you'd consider TRT at my levels? I need to maintain fertility, and to my understanding HCG can help there.

Just FYI, the T dose was just a starting point of 50mgs/week. I can go higher and I'd be interested to hear your recs on what a good min dosing protocol should look like on Test Cyp
 

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I got offerred 200mgs/week today... thinking about taking it. I'm concerned about my ability to have children in a few years. HCG the answer?
 

sammpedd88

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I got offerred 200mgs/week today... thinking about taking it. I'm concerned about my ability to have children in a few years. HCG the answer?
I haven't looked at your labs, but 200 mgs is too much to start with. Typically guys start out with 100 mgs a week. After 6-8 weeks they get more labs to see how things are as far as T levels, E2, pregnenolone, DHEA, vitamin D3. You should also have your thyroid and complete CBC as well.
HCG is typically added if you want to have kids. Helps keep the natural production up as much as possible.
 

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I haven't looked at your labs, but 200 mgs is too much to start with. Typically guys start out with 100 mgs a week. After 6-8 weeks they get more labs to see how things are as far as T levels, E2, pregnenolone, DHEA, vitamin D3. You should also have your thyroid and complete CBC as well.
HCG is typically added if you want to have kids. Helps keep the natural production up as much as possible.
Thanks for the response! If you get a chance to read thru the labs I'd love to hear your opinion on how the rest of my results stack up

It's sad when people on forums know more than the Dr... and I'm not being facetious
 

sammpedd88

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Thanks for the response! If you get a chance to read thru the labs I'd love to hear your opinion on how the rest of my results stack up

It's sad when people on forums know more than the Dr... and I'm not being facetious
I'm assuming your diet is bad due to the elevated cholesterol. You may want to change your diet and starting a workout plan. How's your sleeping pattern?
 

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I'm assuming your diet is bad due to the elevated cholesterol. You may want to change your diet and starting a workout plan. How's your sleeping pattern?
Lol - I can understand how you'd make that assumption. I've been cutting on a keto diet (mucho red meat) and I wasn't fasted (says that on blood work). I lift heavy 4x a week - free weights with focus on compound movements. I'm 6ft, 208lbs, 15%bf... so no body builder but not a couch potato

I don't drink or do drugs. 7-8 hrs a night of sleep

Was hoping for more of an opinion on any abnormalities in bloods concerning hormones
 
Smont

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Your free test is low but your estrogen is completely crushed. Thats most likely your libido issues. I gotta read through the rest of your labs but that instantly caught my eye. Dont hop on trt. Try to fix the problems first. Y is your dr. Trying to put you on trt without trying to fix the problem first?
 

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I would have to agree with Smont. Fix lifestyle factors first. Probably need to work with a good functional medicine Doc to clean up diet, stress, sleep, and environment. Also, I really like what companies like Strategene are doing.. get DNA test done, and look at SNPs (single nucleotide polymorphisms) and work with Doc to optimize...
I would start a Whole 30 diet plan or any other elimination diet to figure out food intolerances... look at home/work environment for mold and other toxins.. one thing that was/is holding me back is sleep apnea. I'm lean and was really surprised to learn that I stop breathing if I sleep on my back.

With that said.. I have developed a really bad digestive condition (SIBO methane) after a cruise in 2014 and after workign with Doc for the last 3 years my Doc brough in an HRT doc to help.
My blood work in Sept 2016 was not good... postive epstein barr, tanked thyroid, free test was as low as 85 year old, and SHBG was 70. After 3 months of t3 sustained release, .6ml of 200mg test week, small dose of Nandrolone, Stanzolol - my SHBG is down to 46. Doc wants to get to 25 and then start titrating off Stanz.

Does anyone know.. for the OP... can you lower SHBG significantly without something like Stanz? I know there are studies that show Boron can lower 10-20%.. maybe this is where the HRT doc can help. Find out root cause with funcitonal med doc, then maybe HRT doc can help you run a cycle or two to lower SHBG?
 
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My results were almost identical to yours. Total T was 430 but free T was only 4.7 and with symptoms qualified me for treatment. Went on 100mg/wk test cyp weekly and 250 mcg hcg twice weekly. Symptoms only slightly better. Labs hardly budged. Total T now 456 and free T 7.2. It was presumed I had high SHBG gobbling everything up. Inccreased to 200mg test cyp weekly and 250mcg hcg twice weekly. Felt much better. Total T 850 and free T 16.9. My clinic treats everyone with hcg and adds clomid when trying to conceive. Get yourself treated. Having no sex drive is no good for making babies!
 
The Matrix

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Best advice I have seen...
Do the simple stuff first,
SHBG is due to lack of insulin
Your TSH is also rising as well may be an indicator of thyroid issues - Should be 1-1.5
Stratagene is good for sure, but one can get lead down the rabbit hole of biochemical pathways losing sight of the bigger picture.
I have done several of Stratagene's reports they provide good information, but one can tell gene expression from history, labs, and symptoms as reports just reinforce what is already known

If one try to use danazol as as a stand alone, it will only lower testosterone. It needs to be used in conjunction with TRT
 

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Oh and by the way -- the exogenous test will raise your E2 but if your labs respond like mine the SHBG will buffer. On 200 mg test my E2 is up to 20 with no aromatase inhibitor. I think super high SHBG is a unique condition. Sounds like your lifestyle is not the cause .
 
kenpoengineer

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There are a couple of websites that have great TRT information as well as the good advice above. ExcelMale, Peaktestosterone dot com. FB page called Testosterone Replacement Therapy Discussion.
 
kenpoengineer

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Recommend this app to track your bloodwork:

myBloodTracker
https://appsto.re/us/vvMndb.i

-All tests stored locally on your iPhone/iPad
-Features over 200 blood tests with customizable ranges and units.
-Full male/female hormone panels
-Once you enter the test results, it instantly indicates if you are in or out of range.
-With a touch of the button it graphs all your test results to indicate if you are trending high or low.

It really is your answer to keeping bloodwork organized.
 

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Thanks for the tip kenpoengineer. I downloaded this app.
 
kenpoengineer

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mccollums

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Best advice I have seen...
Do the simple stuff first,
SHBG is due to lack of insulin
Your TSH is also rising as well may be an indicator of thyroid issues - Should be 1-1.5
Stratagene is good for sure, but one can get lead down the rabbit hole of biochemical pathways losing sight of the bigger picture.
I have done several of Stratagene's reports they provide good information, but one can tell gene expression from history, labs, and symptoms as reports just reinforce what is already known

If one try to use danazol as as a stand alone, it will only lower testosterone. It needs to be used in conjunction with TRT


You are right. stay simple.

I just wanted to mention Stratagene to spread the word.. I think it has a lot of potential. It has definitely helped me NOT buy a few supplements that i have read about... I've been guilty in the past of reading about a supplement and buying it.. after learning a little bit from Strategene classes I realized that I could be helping one thing but throwing something else out of whack... "blind supplementation"...lol
 
trn450

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Looking at your bloodwork, I have questions about your body composition. What is your BMI (bodyweight / height can tell me if you don't know) and estimated percentage body fat?

Your cholesterol is pretty darn bad, and given that's almost always driven by lifestyle/obesity in the context of your elevated SHBG which is also driven by obesity, I'd argue you may be able to fix some of your problems just by losing weight.
 
The_Old_Guy

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That Testosterone price is out of control (unless I'm reading it wrong). You can get a 10ml vial of 100mg/ml *or* 200mg/ml for $27 and $44 respectively, at Walgreens - using a GoodRx coupon. that's 20-40 weeks at 50mg/week.
 
dondon

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Be careful of too much red meat, with TRT and red meat you're building too much plaque in your arteries, if you remember who Mike Matarazzo was, he consumed too much red meat and by 49 years of age he died because his heart only had 20% capacity. Granted he was a Mr Olympia competitor and took crazy amounts of gear, but plaque is plaque. I'm not trying to scare you but fruits and vegetables do wonders at balancing hormones naturally and make you feel 10x better. Red meat does not raise test level btw.
 

mccollums

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Be careful of too much red meat, with TRT and red meat you're building too much plaque in your arteries, if you remember who Mike Matarazzo was, he consumed too much red meat and by 49 years of age he died because his heart only had 20% capacity. Granted he was a Mr Olympia competitor and took crazy amounts of gear, but plaque is plaque. I'm not trying to scare you but fruits and vegetables do wonders at balancing hormones naturally and make you feel 10x better. Red meat does not raise test level btw.

??? - What's the mechanism behind red meat putting plaque in your arteries?

I do agree that too much muscle meat can be problematic for some people, but that is more of a balance of amino acids. It takes a lot though.
 
The_Old_Guy

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Be careful of too much red meat, with TRT and red meat you're building too much plaque in your arteries, if you remember who Mike Matarazzo was, he consumed too much red meat and by 49 years of age he died because his heart only had 20% capacity. Granted he was a Mr Olympia competitor and took crazy amounts of gear, but plaque is plaque. I'm not trying to scare you but fruits and vegetables do wonders at balancing hormones naturally and make you feel 10x better. Red meat does not raise test level btw.
Yea, it was meat, and not the truck-load of daily drugs that killed him....

Pretty sure science has proven everything you posted above, incorrect:

https://examine.com/search/?q=red+meat

The only thing I agree on as far as meat goes - is that Hot Dogs and bags of Pepperoni are poison and will kill you. But a grass fed cow is one of the healthiest things on the planet, you could eat - that's what those sharp, pointy teeth in your mouth are for, BTW.
 
dondon

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Yea, it was meat, and not the truck-load of daily drugs that killed him....

Pretty sure science has proven everything you posted above, incorrect:

https://examine.com/search/?q=red+meat


The only thing I agree on as far as meat goes - is that Hot Dogs and bags of Pepperoni are poison and will kill you. But a grass fed cow is one of the healthiest things on the planet, you could eat - that's what those sharp, pointy teeth in your mouth are for, BTW.
Did you read what I wrote? I said "granted he was on a lot of gear" and for the fact, meat especially red meat is a carcinogen, you have to start reading literature outside the biased fitness industry, there's a wealth of information on what I said, from cardiologists to group tests from around the world doctors, scientists are showing overwhelming reports of our western diet vs healthier heart disease free nations. Where do you think heart disease comes from? Diabetes cancer etc. and now it's even linked to kidney failure and breast cancer, these studies have been years in the making. Our nation is the most unhealthy of the modern world, we over consume too much of one thing, and too much of anything is not good whether it be meat, supplements or whatever. We overindulge in red meat because protein? Is it killing us? Even the American institute of cancer research has said this.

http://www.medicalnewstoday.com/articles/311664.php

https://www.sciencedaily.com/releases/2016/07/160714193627.htm

https://www.hsph.harvard.edu/news/features/red-meat-consumption-and-breast-cancer-risk/

http://www.aicr.org/reduce-your-cancer-risk/recommendations-for-cancer-prevention/recommendations_05_red_meat.html

The sharp pointy teeth mean nothing btw, lol. If you're saying we're natural born meat eaters then let me see you go bite into a deer and eat it raw and see what happens. Either one of two things will happen, either you'll die or you'll get sick. If you mention that's why we discovered fire and cook it before consuming...then my point is argued, we are NOT naturally born meat eaters, we have to clean it and cook it.
 
The_Old_Guy

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Did you read what I wrote?
Yes. Eating shjt food and not exercising is what's causing the problem, not red meat (as in grass fed beef, etc...). As many links as you put up saying one thing, I can put up saying the other. So I'll use the middle 6 teeth of the human upper and lower jaw as my guide - they ain't for grinding grass and I'm pretty sure Wooly Mammoths would be considered red meat.
 
dondon

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All I'm saying is limit yourself, too much of anything is not good, whether it alcohol, coffee, etc. To counter to my links you'd need the cancer institute who is the most financially funded research group in the world to side with you...which won't happen. Grass fed is the better choice, but throw in some plant based meals to balance the body, it's good now when you're young but it's like a credit card with a big limit, you keep spending and spending and then one day you're hit with debt. Same thing when you consume known foods that will contribute to your overall health. Also, colon and rectal cancers are in the rise in young people, correlation? Absolutely. I'm not trying to scare you, if I can help a bro out with some knowledge or at least create awareness then it's worth it, even if it sits in the back of your head.
Peace.
 
hazard12

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I think yall are forgetting about sugar...The western diet has the highest sugar consumption paired with high fat intake. Its not 1 single ingredient that is making us unhealthy, its the combination of factors in the wrong amounts. But yeah the point still stands, you should have a balanced diet which includes as much red meat as YOUR BODY can handle safely, lots of veggies, lots of water, a small amount of healthy fats and fibrous carbs and as little as sugar as possible (sugar is the one thing you DONT NEED AT ALL, yet we consume it like its water. Your argument would have made more sense if you focused on sugar but as I said, the point still stands). There is also a growing consensus that the sugar industry falsified and cherry picked data over the years to blame all of the downfalls of the western diet on fat which lead to low fat items which havent fixed anything...why? Because there is still sugar and theres actually more than before because of the lower fat.
 
dondon

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I agree, sugar is a huge problem, it feeds cancer. Beef should be limited, even grass fed, sugar should be eliminated because what value does it offer? Interestingly, France refuses our beef imports because of the hormones, Trump is retaliating with them because of fair trade. The government of France has to foot the bills for their government run healthcare so they look out for their best interests. Our meat is so highly toxic that other nations flat out refuse it, what does that tell you? But whatever, there are many factors in cancer, but with all the cascade of studies, red meat is a huge factor and no doubt sugar as well.
 

mccollums

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Did you read what I wrote? I said "granted he was on a lot of gear" and for the fact, meat especially red meat is a carcinogen, you have to start reading literature outside the biased fitness industry, there's a wealth of information on what I said, from cardiologists to group tests from around the world doctors, scientists are showing overwhelming reports of our western diet vs healthier heart disease free nations. Where do you think heart disease comes from? Diabetes cancer etc. and now it's even linked to kidney failure and breast cancer, these studies have been years in the making. Our nation is the most unhealthy of the modern world, we over consume too much of one thing, and too much of anything is not good whether it be meat, supplements or whatever. We overindulge in red meat because protein? Is it killing us? Even the American institute of cancer research has said this.

The sharp pointy teeth mean nothing btw, lol. If you're saying we're natural born meat eaters then let me see you go bite into a deer and eat it raw and see what happens. Either one of two things will happen, either you'll die or you'll get sick. If you mention that's why we discovered fire and cook it before consuming...then my point is argued, we are NOT naturally born meat eaters, we have to clean it and cook it.
First link - news article giving a brief summary. China study with 64000 people. How do you think they can do a study that large? It's called a questionairre type study. Sorry, but I am not believing any study that makes assocations from questionaires.
"In China, the primary red meat is pork, accounting for 97 percent of red meat intake. Other popular protein sources included eggs, dairy, shellfish, fish, soy, legumes, and poultry"

2nd link - article talking about the SAME study as the first link

3rd link- This quote sums up the validity of that study "We found that women who ate the most red meat in adolescence or early adulthood had an increased risk of developing breast cancer later in life".
Please - I sure hope these women kept a food diary.

4th link- this is the only link that actually contains data that is correct. It mentions the cooking method - which can increase carcinogens .. I will not dispute that grilling at a high temperature and/or smoke can add carcinogens... that's a fact. However, we did co-evolve with fire so we are reasonably adapted to this. This can be mitigated as well.

That's why I asked - what is the mechanism behind red meat and cancer? There's only 1 that is likely and it's the cooking method... so therefore it's not the red meat. And, it would take a hell of a study to figure out how much additional risk a certain type of cooking method would add to your cancer risk. You know what? There's no money in that type of study so it will never happen.

The much bigger issue in this country is low grade systemic inflammation which is caused by a multitude of factors... stress, lack of sleep, toxins, diet, gut issues, infections, lack of movement etc.etc.. not red meat. not any 1 thing.

If there's any meat in this country people overeat it's chicken...
 

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