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Blood Work feedback/interpretation

rkriekle

New member
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Joined
Oct 27, 2020
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Background: 40 year old male. Ran heavy steroid cycles from 20-26 or so (never came off), 4 back surgeries requiring lots of narcotics over the years. This combo as well as perhaps genetics has left me with low testosterone levels naturally. I live in Canada and through an endo I have been put on TRT for the rest of my life as my normal test levels were around 6nmol total over 3 different tests and I had basically all the symptoms present.

Now for the last 6 months I have been on 100mg Test E weekly, split into 2 subQ shots. With only 100mgs weekly my last 2 blood tests came back with very high free test, average total and very low shbg. I am confused as to why my free is so high and total somewhat normal, I realize shbg plays a huge role here but I didnt think it would be this drastic. My doc bases doses directly off free test rather than total, so he wants to drop my dose down to 70-80mgs a week. Is this the correct approach? I feel great at 100mgs.

Latest test results (Canada so units may be different than yours:)):

Total Test: 15.8nmol Range: 5.8-28nmol
Free Androgen Index: 143.6 Range: 14.8-94.8
SHBG: 11nmol Range: 13-71nmol

Thanks for any insight. Also, this is kind of a blast from the past as I was a fairly active member here 18 or so years ago under a different name. Wasn't sure if this site was still alive :)
 
Your SHBG is high because you have high free Test and vice versa. They play off each other for balance. A lot of us have low SHBG and higher free Test levels and there isn't much you can do except lower the dosage. 10mgs daily with an insulin syringe might treat you very well. Emeric has a few threads about it.

Also, most men function decent with high free Test but lower serum levels but for me if my serum is too low I feel crappy overall. I consistently have high free Test.
 
with your lower SHBG your clearance is going to be quicker and pharmkin is gonna be varied compared to some.

In my opinion free test should be interpreted with total however in your situation is probably a good approach to base dosing off of free.

With a low SHBG many guys benefit from smaller more frequent dosing. If it were me....id probably break it up to 3x a week dosing an repeat. if still high free test then maybe drop dose a bit if you are striving for range TRT. I just dont like every day dosing but some guys make out well with that.
 
I wouldn't worry about SHBG at all, it will vary with dose and high or low won't have a huge effect (it doesn't even work as most people think anyhow).
 

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