Low T and Low SHBG Despite Nebido Injections

[Dmarq]

Hi,

I'm hoping to get some advice, brief infodump is testicular cancer back in 2009, one testicle removed, two rounds of BEP chemotherapy and ever since I've had consistent problems with keeping testosterone at a healthy level. I tried testogel first which didn't increase my levels by much at all and in the last year and a half I've moved on to Nebido injections which are stil barely raising my levels. My latest lab results for Total t, SHBG and albumin taken just before my nebido injection (repeated every ten weeks)
Total T - 10.1 n/mol
SHBG - 15 n/mol
Albumin - 51 g/l
Which according to a web calculator gives free testosterone of 0.256 nmol and bioavailable of 7.07 nmol (I am unsure how to assess these values so any help is appreciated).

Can anyone advise how I should proceed with this? Other recent health issues which may play into it are repeated low cortisol (but no addisons), sleep apnea, and I think my blood sugar may be out of whack as I'm getting crazy cravings to eat at night. I'm also on amitryptaline for neuropathic pain.

Any advice is welcome as I feel exhausted most of the time, cramp easily, occasional difficulty urinating, frequent IBS-d and generally just a strong feeling of wrongness if that makes sense?

Thanks to anyone who takes the time to read this!

​Damien

[biwi]

How do you know what your normal levels were previously? Do you have any specific testosterone related symptoms? Your numbers are on the low end of normal, at the low point of your treatment, and actually quite similar to mine. I am on Aveed, basically the same 10 week injection. You don't necessarily have a T problem if you have no testosterone related symptoms. Your health issues may or may not be attributed to T, and you should probably attack them individually. You getting enough nutrition? Enough sleep? Happy with your work life? Happy with your personal life? Cancer+surger+chemo does a number on our bodies and minds, it isn't a stretch to think it could be related to that vs T.

[Dmarq]

Thanks for the reply biwi, unfortunately no matter what point my testosterone is tested it didn't go above around 12 or 13. The symptoms that may be low t related are the sleep apnea (treated with cpap), low mood, libido low, infrequent erections, and more body fat despite exercise. There's always another possibility for each of the symptoms I've given, but with the testosterone on the low end I thought it was worth checking.

The low shbg is what you'd expect as a reaction to low total testosterone, but it's below the reference range (I think it's around 16 g/l at the lowest point). You're right that there may be other factors, however even when the period between nebido injections was reduced to six weeks to try and increase the baseline that it falls to right before the injection, again it never increased beyond 13nmol/l. My endocrinologist checked to see if aromatisation was a factor, but the estrogen was very low.
What seems odd to me, though may make sense to others here is that my body hair has increased and started growing on parts of my back where it never did before, so that reaction to the testosterone therapy is certainly working!
As for stresses or worries unrelated to direct health issues, there's none at present. But I did have a prolonged period (over many years) relating to abuse in childhood, which certainly has contributed to my health issues, though on here I'm hoping to focus more on blood tests and treatment. If you or anyone else here has any insight as to anything else that might be worth looking at I'd appreciate it

[biwi]

Sounds like your endo is at least working to help you. The symptoms in your first post are not really primary low T symptoms, but your follow up post does have some that are potentially directly T related.

Unfortunately I don't have a whole lot more advice to you, I have low normal range levels but that seems to be my normal, I don't really have any noticeable low T side effects right now. I also was a uniballer from birth so my pre-TC levels may have been low normal and my body has just had that as its normal all my life.

[Dmarq]

Thanks again biwi, I appreciate you taking the time to get back to me.