He is using enclomiphene citrate, not clomiphene. Are these the same?
Your Estradiol has increased because of your increase in testosterone. Increased Estrogenic activity could also lead to a rise in SHBG. Have you been prescribed aromatase inhibitor like anastrozole to lower Estradiol yet?
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Has anyone here used TRT cream? I’m experimenting swapping from scrotal application to shoulder. Might be placebo but I feel more energy on shoulder application. From what I’ve read there is more 5AR on the scrotal skin, so if that is true theoretically by applying to the shoulder I would have more testosterone and less DHT possibly giving more energy.
From what I’ve read that is true, but I’m speaking to someone who says that is a myth and that 5AR activity is the same across all skin.
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Why would testosterone injections increase free testosterone when you’re already measuring 1300+?
It sounds like you should take something to bring down SHBG. Boron might help.
Do you have a source for this?
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I used T cream a few years back. After applying it to the scrotum for a while, I checked my DHT levels out of curiosity because my prostate problems seemed to be getting worse. My DHT was 160 ng/dL (well over the reference range of 30-85) even though I was taking 5mg daily finasteride (!!!)
I stopped applying to the scrotum after that, but I still ended up needing a TURP surgery to unclog my prostate.
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Wow that’s actually crazy.
Where did you apply it after that? Did that resolve the DHT issue?
I stopped using it after that, until well after my TURP. Now I do subcutaneous TRT, take finasteride 2.5 mg daily and DHT is very low.
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Any side effects from finasteride?
Something I’ve noticed is you don’t hear a lot of guys who use finasteride for prostate enlargement complaining about PFS symptoms. There might be something to that. Prostate enlargement might be a more critical sign of DHT problems and indicate you would be less likely to respond negatively to finasteride.
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Finasteride reduces my sex drive when used alone, but with TRT that’s not an issue. The two go really well together.
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I tried subQ a few times and had persistent bumps. I got injection site reactions quite often from intramuscular as well.
I hope I can make cream work I really find it simple.
I actually had so much energy today, I honestly attribute a lot of it to changing location of cream application. Maybe DHT is overrated for mental benefits. I can’t say I feel the same way about all hormones that are transformed by 5AR.
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I have never measured my DHT, but my T runs at the top of the reference range and my free T is in the middle of the reference range. I felt the effect of 1mg finasteride on libido and erections within the first 48 hours. The difference was unmistakable and prompt in my experience.
NB: I am in my early forties, so maybe not an “older man.”
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Did you discontinue or change dose?
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I have only been on finasteride a short time, so I might change my mind, but this appetite reduction is novel for me at the moment. After thirty years of being on a hair trigger, having a little distance is not so bad.
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Shady
#180
Yes, pubmed clomiphene and SHBG. Effect is present in several papers. Men and women. Mechanism of action as well as clinical practice. It’s very predictable and why T at 1000 with clomiphene does not equal T at 1000 with subq injections.
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https://onlinelibrary.wiley.com/doi/10.1111/andr.13146
This meta-analysis/review shows an increase of SHBG across studies as
21.55 → 29.48
22.26 → 23.14
26.1 → 29.5
22 → 26
23 → 22
30 → 32
Unfortunately they did not do an analysis on this variable, but clearly there is an increase, 10-20% on average. Average SHBGs are well within range, smack dab in the middle. Hard to see how this would impact treatment efficacy, but it certainly could for outliers. Standard deviation is ~10, so if you moved from two standard deviations below the mean to two standard deviations above it, that would certainly have an effect (ie 10 → 50, assuming a normal distribution). Even one standard deviation could be impactful.
Conversely, I found in my research that testosterone injections actually suppresses SHBG by 10%-40%, with greater effects tending to be seen on those with high SHBG, often normalizing it.
Based on this one study and my cursory research on TRT’s effects on SHBG, I’d argue that
- T at 1000 with clomiphene/enclomiphene is the same as TRT at 1000 if SHBG is normal before (and during) treatment.
- People who find relief with T but not clomiphene/enclomiphene may have high SHBG, and the solution is possibly due more to suppressing SHBG than increasing total T.
This might be true. We would need more evidence. TRT certainly does lower SHBG. A lot of people new to trying to increase their testosterone wrongly focus only on total testosterone and not free which is tied to SHBG.
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