T Nation

SHBG Article - Claims High Levels are Not so Bad

Any thoughts on this?
I have elevated shbg and am trying to lower it - which I am but it is also crushing my Test so I found this article very interesting, although I am highly skeptical.

i have 79 (high) and doc put me on clomid -.-

Did your shbg go up? What about T?

what i meant to say is,my shgb was already super high but he still put me on clomid to raise testosterone since its low (50 mg eod. i think he didnt even look at shgb

If you u estrogen is high lowering that can lower shbg

What we know here is roughly discussed below. From a practical point of view in the TRT context, we can only work with common lab data presented in this forum and how guys seem to be affected - experienced based learning.

The article is long winded, lacks a few things and is really not providing anything new that that bears on TRT. Do other cells react to SHBG? Does that matter to what we are doing - I think not.

SHBG scavenges sex hormones to be metabolized in the liver. SHBG is made in the liver and that makes sense. Male hormone control systems are only a slight deviation from the female master blueprint. Increased testosterone lowers SHBG and increased estrogens increase SHBG. So that makes sense as the master estrogen control system, as all control systems needs a source and a sink, where the liver is the sink in this case. We do see expected SHBG changing with TRT as T and E2 are changed in many cases.

SHBG+estrogens are not tightly bound and the estrogens are still bio-available to some extent. SHBG+estrogens can be considered a carrier of estrogens.

SHBG+T is tightly bound and not bioavailable. SHBG is not a carrier of T. Many “sources” do not make this distinction.

However SHBG+[estrogens | T] is a carrier to the liver where the hormones are metabolized via enzymes. There of course must be cells in the liver that interact with these SHBG bound hormones.

Variability: We do see some guys quite often who have very low or very high SHBG that is unexplainable by the typical causes. So there is some genetic variability and perhaps some epigenetic changes going on and some epigenetic changes can be multi-generational. It is frustrating for those guys and closes some opportunities to improve their state.

Went a guy has very low SHBG, % free T [FT] fraction is very high and we see a poorly understood problem where they can’t easily feel balanced. Might be good to note that FT drives FT–>E2 production rates that might be a factor. Very low SHBG can be indicating diabetes in some cases and is thus can be a symptom.

When a guy has high SHBG, FT is consumed and can be very low, FT–>E2 is low and E2 can sometimes be seen low, but there are other factors for that. So we have a lot of SHBG+T and TT levels are inflated as bio-T is lower. These guys can have good TT levels and be very hypo with low libido and everything else we then expect.

We often do labs for TT, FT and E2 and from these we can infer that SHBG is high or low.

When we have TT, FT, E2 and SHBG tested everything can fit the expected pattern. When we have TT, E2 and high SHBG we can infer that FT is lower.

So SHBG lab results and the above relationships are very useful.

There are medical conditions that are associated with high/low SHBG states. “We” try to watch for those. We did flag one guy with very low SHBG as possible diabetes and he did follow that up and was diagnosed at such.

There is a general trend in men of increasing SHBG with age and it is pointed out that this decreases Bio-T. However aromatase also increases leading to more estrogens and increased E2:T ratios that will increase SHBG. So it is complicated and no one single generalization is adequate. Guy on well managed TRT with E2 controlled might not fit this age related increase in SHBG, so there are fine points to be considered. Increased SHBG then appears to not be causative but an outcome of age related changes to sex hormones. You will find many statements that will provide the wrong impression.

@KSman so wait. what you are saying is, if i have low testosterone (268) and high SHGB (79) and clomid increases testosterone then clomid can actually work by increasing t and decreasing shgb?

Thanks for the responses. I figured for my purposes the article wouldn’t help much.

Tricky as often we see Clomid dosed too high causing very high E2 that increases SHBG even as increased T trys to lower it. So not so simple.