Low T, Low DHEA, High Free T- what to do?

[fyronix]

I had a reoccurrence of gynecomastia about 7 weeks ago and wasn’t feeling great on high amounts of test, so I made the decision to drop my testosterone dosage down to HRT levels from now on to avoid estrogenic side effects and eliminate the need for aromatase inhibitors. I feel like I’m close to getting things dialed in, but I was hoping for some more input from you all.

I was on about 30mg test cyp EOD when these were drawn and had dropped my Arimidex about 2.5 weeks prior. My total T is low, but I wanted to start low on the dose and work up if need be. As you can see, my free T is high, but I’m assuming this is because I have abnormally low SHBG of about 4.1nmol/L (range is 16.5-55.9). Also, my DHEA is very low as well, so I’m assuming supplementation would be the move there.

My libido, elections, and sleep have all been below average lately, so I’m hoping with some tweaks I can get to feeling good. The sleep has been killing me, since I can only sleep 2-3 hours before waking up and having to fall back asleep.

I’m wondering what you all think would be the next best adjustment(s) to make are. My thoughts would be to increase the testosterone dose to around 160-180mg/week to bring up my T and e2, and to add DHEA in at 50-100mg/day. Any advice is much appreciated.

 

[brutus69]

is that your trough numbers?

 

[fyronix]

is that your trough numbers?

I pin EOD to keep levels more stable. I had these drawn 48 hours after the last pin.

 

[Thebigone]

Your total testosterone is 43% of max value and you’re free is 85%. That’s very good that means you are utilizing your testosterone. This is occurring because of your frequent injections. If you did 15mg ED vs 30mg EOD I wouldn’t be surprised if you’re free testosterone increased another 20% or so. It’s not uncommon to have low DHEA on HRT so I would recommend supplementing with DHEA. Neurosteroids like dhea, progesterone and pregnenolone Play huge role in libido and they can be altered negatively from HRT. I would get a blood test for progesterone and pregnenolone and see if you need to supplement with those as well. Your libido should be fixed once you balance your neurosteroids.

Almost everyone on doses higher than true HRT will have low SHBG. Sticking at the dosage you’re on now should significantly increase your SHBG but it can take a long time up to a good six months. If you add AAS or increase the dose it’s just going to drop the levels again. Hgh and peptides will not impact it so those are fine.

 

[Stewie]

Direct immunoassy for free testosterone can be highly inaccurate. So I wouldn't bank on it.

Are you taking any other supplements (biotin specifically) or any other meds, either scripted or not, such as metformin, ect?

Do you monitor your glucose or have any knowledge of your HbA1c?



We'll work from there.

 

[heman4u]

Direct immunoassy for free testosterone can be highly inaccurate. So I wouldn't bank on it.

Are you taking any other supplements (biotin specifically) or any other meds, either scripted or not, such as metformin, ect?

Do you monitor your glucose or have any knowledge of your HbA1c?



We'll work from there.

What has Metformin to do with here?

 

[Stewie]

What has Metformin to do with here?

Can lower DHEA-S levels.

 

[fyronix]

Your total testosterone is 43% of max value and you’re free is 85%. That’s very good that means you are utilizing your testosterone. This is occurring because of your frequent injections. If you did 15mg ED vs 30mg EOD I wouldn’t be surprised if you’re free testosterone increased another 20% or so. It’s not uncommon to have low DHEA on HRT so I would recommend supplementing with DHEA. Neurosteroids like dhea, progesterone and pregnenolone Play huge role in libido and they can be altered negatively from HRT. I would get a blood test for progesterone and pregnenolone and see if you need to supplement with those as well. Your libido should be fixed once you balance your neurosteroids.

Almost everyone on doses higher than true HRT will have low SHBG. Sticking at the dosage you’re on now should significantly increase your SHBG but it can take a long time up to a good six months. If you add AAS or increase the dose it’s just going to drop the levels again. Hgh and peptides will not impact it so those are fine.

Thanks for the input! What do you think a good starting point for DHEA supplementation is? What are your thoughts on using HCG?

 

[fyronix]

Direct immunoassy for free testosterone can be highly inaccurate. So I wouldn't bank on it.

Are you taking any other supplements (biotin specifically) or any other meds, either scripted or not, such as metformin, ect?

Do you monitor your glucose or have any knowledge of your HbA1c?



We'll work from there.

Hba1c was last tested at 4.9 (range 4.8-5.6). Only other scripted Med I take is mesalamine for my ulcerative colitis. Not taking any of the supps you mentioned.

 

[Thebigone]

Thanks for the input! What do you think a good starting point for DHEA supplementation is? What are your thoughts on using HCG?

15mg dhea transdermal from Life-Flo
Hcg 250iu EOD or 3x/wk

 

[Stewie]

Hba1c was last tested at 4.9 (range 4.8-5.6). Only other scripted Med I take is mesalamine for my ulcerative colitis. Not taking any of the supps you mentioned.

Don't take this as conclusive, moreso informational.

Given the nature of inflammatory diseases such as Crohn's disease/UC that you're inflicted with. These types of etiologies (diseased state) are mediated by several different types of cytokines, one in particular, Interleukin 1 beta (IL1ß) seems to be the primary culprit for wrecking havoc on hepatic SHBG expression. To add to the mix, inflammatory diseases can also take jabs at the adrenal glands, hindering the biosynthesis of hormones. In your particular case DHEA, therefore decrease DHEA-S. Given all that, DHEA has many functional roles, again in your particular situation (and everyone else's) it's has high immunoregulatory response. When our DHEA levels decline our immune system doesn't have all the support system in place to help stave off infections, inflammatory diseases, neurological deficits, ect.

To sum all this up, look into ways to tame down Interleukin 1 beta responses. There's info out there.

I'd suggest supplementing with either a sublingual DHEA or micronized DHEA. I personally feel 15mg in your particular situation is too low of a dose and start with 25mg upon waking and another 25mg at bedtime.

 

[Thebigone]

Don't take this as conclusive, moreso informational.

Given the nature of inflammatory diseases such as Crohn's disease/UC that you're inflicted with. These types of etiologies (diseased state) are mediated by several different types of cytokines, one in particular, Interleukin 1 beta (IL1ß) seems to be the primary culprit for wrecking havoc on hepatic SHBG expression. To add to the mix, inflammatory diseases can also take jabs at the adrenal glands, hindering the biosynthesis of hormones. In your particular case DHEA, therefore decrease DHEA-S. Given all that, DHEA has many functional roles, again in your particular situation (and everyone else's) it's has high immunoregulatory response. When our DHEA levels decline our immune system doesn't have all the support system in place to help stave off infections, inflammatory diseases, neurological deficits, ect.

To sum all this up, look into ways to tame down Interleukin 1 beta responses. There's info out there.

I'd suggest supplementing with either a sublingual DHEA or micronized DHEA. I personally feel 15mg in your particular situation is too low of a dose and start with 25mg upon waking and another 25mg at bedtime.

Agree!

https://www.selfhacked.com/blog/interleukin-1/

 

[fyronix]

Agree!

https://www.selfhacked.com/blog/interleukin-1/

I’ll defintiely take a look into this!