Great info. SHBG is commonly misunderstood. Too many people think the lower the SHBG, the better because it means higher free T. The optimal range is the right amount.
Beautiful I get it now .. don’t know for sure yet I’m waiting on bloodwork , but daily trt flat out didn’t work and took all the benefits away .. if I had to guess shbg is probably higher and I do respond really well to exogenous hormones ..
what do you do with 50 year old, fit and healthy patient, whose test levels are fine, but SHBG 70/80 and free test in the 1 or 2 ng/dl !!! When Boron, diet and sleep have done nothing, is TRT the only way to treat symptoms of low T, IN SPITE of the good "total test"?
If your free T level is low due to raised SHBG then TRT can be worth trying as it reduces SHBG levels. Only worth trialling if you have low T symptoms!
I don’t know if it’s video worthy. But I’m curious as to what you guys think of using testosterone propionate daily for TRT. My thought process is it would mimic the diurnal rhythm if taken before bed. Your levels would climb in your sleep, peak 8-12 hours post injection and then begin to fall and be lowest when you go to bed. Similarly too a natural. I got the idea from people who take sustanon daily, a lot of them really seem to like it and notice a boost everyday. I would imagine what they’re feeling is the daily spike due the propionate in the sustanon. They actually have a significant daily trough and spike compared to other more common esters like enanthate and cypionate which really don’t allow a significant swing with daily injections. The ideas being: 1. You’re more likely to feel it every morning and probably find it easier to relax at night. 2. You could probably use less testosterone because you’re just trying to get a high peak, like 900-1200ng/dL and not worrying about the trough. 3. It more naturally mimics testosterone which is *POSSIBLY* healthier, though I have nothing to support that besides lower TRT doses generally being less risk adverse.
Purposely introducing variation over a 24h window to more closely mimic natural testosterone production (which can vary by 30 - 40% from morning to night in healthy young men) is an extremely interesting premise which does potentially have merit. However: The issue with propionate is that the purported three-to-four-day half-life seems to be a vast, vast overestimate. In consequence, even when it’s administered daily, trough serum testosterone levels tend to drop back down into hypogonadal territory well before the next injection is due. In addition, there is no actual data demonstrating that purposely introducing more variation to serum testosterone produces improved clinical outcomes compared to the current model of regular cyp/enanthate injections. Accordingly, whilst this is again an interesting idea, it’s hard for our doctors to change clinical practice based upon what is, at this stage, nothing more than mechanistic theory - at least until more concrete evidence becomes available. Interestingly we have had some patients come to us trying this protocol when self-medicating - they often have a total testosterone of 10nmol/l by the morning after their injection.
@@OptimaleTRT I agree that there’s no evidence showing it would be beneficial, however it really hasn’t been studied either and likely will not be unless it’s just like an observational study done by a clinic. So I can see why doctors wouldn’t recommend it. Basically my 2 main thought processes were that because you could possibly use less due to just wanting a high peak, 900-1200ng/dL, it would be more forgiving on someone’s hematology and cholesterol compared to someone who is on enanthate/cypionate who has a constant 900-1200ng/dL level 24/7. And then like I said potentially the patient can feel the difference every morning because the body isn’t used to a constant high level. Obviously if you were to do it, you would have to measure your daily peak post injection, as waiting 24 hours after the shot would result in 25-50% of the testosterone being left, like you mentioned those guys testing at 10nmol/L. I’m assuming they weren’t taking their shot 8-12 hours before the test. Are you aware of what the Tmax is for propionate? I don’t think I’ve ever actually found a number, so I’m just guessing based on the half life that peak is probably 8-12 hours or possibly sooner, I really don’t know.
Hi John, you are right, it might work effectively and help a man's haematology. However, if levels are dropping to 10nmol/l by the next day then this is far from ideal and may lead to a return of symptoms. It also isn't a particularly natural diurnal pattern - in natural men the difference is around 30% from am - pm. The Tmax I believe is about 14H for propionate. It would certainly be interesting to see the effect of daily injections.
Great video, thank you. I've always had low total T but free T has always been normal or just above reference range. I'm on week 5 of TRT (100mg/wk, IM injection) and my latest check still showed high free (30.7pg/ml) and low total (267ng/dL) My doctor never checked shbg. I suspect I might have low shbg levels. Would you suggest I ditch the physician and go to a hormone clinic to crack this down? FYI I felt great first two weeks on treatment then kind of crashed after my body stopped producing naturally.
What is the optimum ratio between total testosterone, free testosterone, dht, estrogen, SBSH? I take oral Dutasteride (.5mg/day) for hair loss but after 14 months, I'm still losing ground. I'm 51, 13% body fat, total T is 565 ng/dl, free T is 75 pg/ml, Estrogen is 175 pg/ml, Dihydrotestosterone LC/MS/MS is 7 ng/dl, free DHT is .53 pg/ml, SHBG is 38 nmol/L. I can't quite figure out why Dutasteride isn't stopping my hair loss so wondering if something in these bloodwork markers if off. All other bloodwork is normal including Iron, Ferritin, Vitamin D, etc. Thoughts?
I've had elevated SHBG which gave me low T symptoms, I was very low carb when my symptoms first started, but I've been back on carbs for some time now but still not back in the normal range yet. Do you have any suggestions for getting SHBG back in range or just more time on carbs? Thanks Paul
@Celestial Moon hello mate, I've heard of it, but levels have started to head in the right direction, so I'm gonna get tested again in 3 months. Have you had elevated SHBG?
@@paulkelly6726 yes, all symptoms of low T. It was only when I discovered I should try Mesterolone which is Proviron that I had an excellent response almost from day one. For me this Androgen has made me realise how Low T for several years was so destructive. The change was remarkable but I am in my 50's. I have been taking Proviron for around 2 years and will take it long term as I know I need it.i micro dose with one tablet 25 mg every 2 or 3 days which allows for continuous use. I amba different person. Improved well-being, confidence, libido and potency. I never believed that out there was an oral Androgen that could restore the quality of life. I hope everything works out well for you...
@Celestial Moon I really appreciate this information, I'm 43 and I think this all came about from low carb or too much intermittent fasting, so I'm hoping that my numbers improve with some dietary/lifestyle changes. Do you know the cause of yours? My total T is really good, I'm in the U.K, what about yourself? Do you get proviron prescribed from your doctor? Sorry for sale the q's?
Great info. SHBG is commonly misunderstood. Too many people think the lower the SHBG, the better because it means higher free T. The optimal range is the right amount.
How does someone manage low SHBG - Mine is extremely low and I’ve never found a way to increase it.
what level of SHBG is concerned optimum?
brother can you please analyze
im 24 years old
albumin : 51.2 g/l
total t : 751 ng/dl
free t : 15.8 ng/dl
SHBG : 32.3 nmol/l
Beautiful I get it now .. don’t know for sure yet I’m waiting on bloodwork , but daily trt flat out didn’t work and took all the benefits away .. if I had to guess shbg is probably higher and I do respond really well to exogenous hormones ..
Absolutely the best video on SHBG! Thank you
what do you do with 50 year old, fit and healthy patient, whose test levels are fine, but SHBG 70/80 and free test in the 1 or 2 ng/dl !!! When Boron, diet and sleep have done nothing, is TRT the only way to treat symptoms of low T, IN SPITE of the good "total test"?
If your free T level is low due to raised SHBG then TRT can be worth trying as it reduces SHBG levels. Only worth trialling if you have low T symptoms!
Have you tried taking Proviron ( Mesterolone) ?
I don’t know if it’s video worthy. But I’m curious as to what you guys think of using testosterone propionate daily for TRT.
My thought process is it would mimic the diurnal rhythm if taken before bed. Your levels would climb in your sleep, peak 8-12 hours post injection and then begin to fall and be lowest when you go to bed. Similarly too a natural.
I got the idea from people who take sustanon daily, a lot of them really seem to like it and notice a boost everyday. I would imagine what they’re feeling is the daily spike due the propionate in the sustanon. They actually have a significant daily trough and spike compared to other more common esters like enanthate and cypionate which really don’t allow a significant swing with daily injections.
The ideas being:
1. You’re more likely to feel it every morning and probably find it easier to relax at night.
2. You could probably use less testosterone because you’re just trying to get a high peak, like 900-1200ng/dL and not worrying about the trough.
3. It more naturally mimics testosterone which is *POSSIBLY* healthier, though I have nothing to support that besides lower TRT doses generally being less risk adverse.
Purposely introducing variation over a 24h window to more closely mimic natural testosterone production (which can vary by 30 - 40% from morning to night in healthy young men) is an extremely interesting premise which does potentially have merit. However:
The issue with propionate is that the purported three-to-four-day half-life seems to be a vast, vast overestimate. In consequence, even when it’s administered daily, trough serum testosterone levels tend to drop back down into hypogonadal territory well before the next injection is due.
In addition, there is no actual data demonstrating that purposely introducing more variation to serum testosterone produces improved clinical outcomes compared to the current model of regular cyp/enanthate injections. Accordingly, whilst this is again an interesting idea, it’s hard for our doctors to change clinical practice based upon what is, at this stage, nothing more than mechanistic theory - at least until more concrete evidence becomes available.
Interestingly we have had some patients come to us trying this protocol when self-medicating - they often have a total testosterone of 10nmol/l by the morning after their injection.
@@OptimaleTRT I agree that there’s no evidence showing it would be beneficial, however it really hasn’t been studied either and likely will not be unless it’s just like an observational study done by a clinic. So I can see why doctors wouldn’t recommend it.
Basically my 2 main thought processes were that because you could possibly use less due to just wanting a high peak, 900-1200ng/dL, it would be more forgiving on someone’s hematology and cholesterol compared to someone who is on enanthate/cypionate who has a constant 900-1200ng/dL level 24/7. And then like I said potentially the patient can feel the difference every morning because the body isn’t used to a constant high level.
Obviously if you were to do it, you would have to measure your daily peak post injection, as waiting 24 hours after the shot would result in 25-50% of the testosterone being left, like you mentioned those guys testing at 10nmol/L. I’m assuming they weren’t taking their shot 8-12 hours before the test.
Are you aware of what the Tmax is for propionate? I don’t think I’ve ever actually found a number, so I’m just guessing based on the half life that peak is probably 8-12 hours or possibly sooner, I really don’t know.
Hi John, you are right, it might work effectively and help a man's haematology. However, if levels are dropping to 10nmol/l by the next day then this is far from ideal and may lead to a return of symptoms. It also isn't a particularly natural diurnal pattern - in natural men the difference is around 30% from am - pm.
The Tmax I believe is about 14H for propionate. It would certainly be interesting to see the effect of daily injections.
Great video, thank you. I've always had low total T but free T has always been normal or just above reference range. I'm on week 5 of TRT (100mg/wk, IM injection) and my latest check still showed high free (30.7pg/ml) and low total (267ng/dL) My doctor never checked shbg. I suspect I might have low shbg levels. Would you suggest I ditch the physician and go to a hormone clinic to crack this down? FYI I felt great first two weeks on treatment then kind of crashed after my body stopped producing naturally.
What ended up happening with you?
What is the optimum ratio between total testosterone, free testosterone, dht, estrogen, SBSH? I take oral Dutasteride (.5mg/day) for hair loss but after 14 months, I'm still losing ground. I'm 51, 13% body fat, total T is 565 ng/dl, free T is 75 pg/ml, Estrogen is 175 pg/ml, Dihydrotestosterone LC/MS/MS is 7 ng/dl, free DHT is .53 pg/ml, SHBG is 38 nmol/L. I can't quite figure out why Dutasteride isn't stopping my hair loss so wondering if something in these bloodwork markers if off. All other bloodwork is normal including Iron, Ferritin, Vitamin D, etc. Thoughts?
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I've had elevated SHBG which gave me low T symptoms, I was very low carb when my symptoms first started, but I've been back on carbs for some time now but still not back in the normal range yet. Do you have any suggestions for getting SHBG back in range or just more time on carbs? Thanks Paul
If your SHBG is still high and your having symptoms of low T have you tried Proviron ( Mesterolone ) ?
@Celestial Moon hello mate, I've heard of it, but levels have started to head in the right direction, so I'm gonna get tested again in 3 months. Have you had elevated SHBG?
@@paulkelly6726 yes, all symptoms of low T. It was only when I discovered I should try Mesterolone which is Proviron that I had an excellent response almost from day one. For me this Androgen has made me realise how Low T for several years was so destructive. The change was remarkable but I am in my 50's. I have been taking Proviron for around 2 years and will take it long term as I know I need it.i micro dose with one tablet 25 mg every 2 or 3 days which allows for continuous use. I amba different person. Improved well-being, confidence, libido and potency. I never believed that out there was an oral Androgen that could restore the quality of life. I hope everything works out well for you...
@Celestial Moon I really appreciate this information, I'm 43 and I think this all came about from low carb or too much intermittent fasting, so I'm hoping that my numbers improve with some dietary/lifestyle changes. Do you know the cause of yours? My total T is really good, I'm in the U.K, what about yourself? Do you get proviron prescribed from your doctor? Sorry for sale the q's?
@@paulkelly6726 im on my way to work so ill reply tomorrow morning if I don't get the time tonight. Ill give you some useful information...
My shbg is 5, should I be worried? I feel great
My SHBG is high and because of this my free T ia low, I just started trt and thought to add 25 mg a day proviron, what are your thoughs about it?
Are you still on TRT ? How do you feel now?
Good content this. Direct and covers a lot on the single topic.
How can you raise SHBG?
Proviron
Fasting, low carb, training
@@JolieVanZyl no this lowers it
I live in the US. I am on therapy. How could I send you my test results to get your opinion about my test panel?
Google optimale clinic email
This was a great video, very interesting
Best informative video I've seen yet. Thatnk you. I'm currently having somewhat low SHBG while being on TRT for about 2.5 months.