More on How SHBG Really Works

[PeakT]

higher SHBG is better anyway.

Your take on this:

I've seen a number of higher SHBG guys - say 55+ - who don't feel good.  Coincidence?  Lack of treatment? 

I always assumed that they were having some kind of underlying (and poorly understood liver/hormonal) issue?

[Dr. John Crisler]

higher SHBG is better anyway.

Your take on this:

I've seen a number of higher SHBG guys - say 55+ - who don't feel good.  Coincidence?  Lack of treatment? 

I always assumed that they were having some kind of underlying (and poorly understood liver/hormonal) issue?

Pre-TRT? Not enough left over to have enough to use.

After-TRT? Same as above, and/or Estrogen was too low.  The SHBG was gobbling it all up.

[vvs1]

higher SHBG is better anyway.

Your take on this:

I've seen a number of higher SHBG guys - say 55+ - who don't feel good.  Coincidence?  Lack of treatment? 

I always assumed that they were having some kind of underlying (and poorly understood liver/hormonal) issue?

Pre-TRT? Not enough left over to have enough to use.

After-TRT? Same as above, and/or Estrogen was too low.  The SHBG was gobbling it all up.

Is there a non-TRT protocol for high shbg for younger guys that have good T levels? 

My shbg has increased from mid 30s to 80, yet no real change in symptoms, so I know there's something else to the puzzle.

[Dr. John Crisler]

From that same lecture:

SHBG

Sex Hormone Binding Globulin
Produced by liver (et al)
Binds sex hormones– androgens and estrogen,  androgens>estrogen
↑ by E, liver failure, growth hormone, hyperthyroidism, Thyroid Tx, working out
↓ by androgen, IGF-1, insulin
No real way to manipulate

[Bravo5]

From that same lecture:

SHBG

Sex Hormone Binding Globulin
Produced by liver (et al)
Binds sex hormones– androgens and estrogen,  androgens>estrogen
↑ by E, liver failure, growth hormone, hyperthyroidism, Thyroid Tx, working out
↓ by androgen, IGF-1, insulin
No real way to manipulate

Guys with high SHBG are almost always slim/on the underweight side. Do you think increasing carbohydrates/lower GI has a chance to lower SHBG significantly?

[Dr. John Crisler]

From that same lecture:

SHBG

Sex Hormone Binding Globulin
Produced by liver (et al)
Binds sex hormones– androgens and estrogen,  androgens>estrogen
↑ by E, liver failure, growth hormone, hyperthyroidism, Thyroid Tx, working out
↓ by androgen, IGF-1, insulin
No real way to manipulate

Guys with high SHBG are almost always slim/on the underweight side. Do you think increasing carbohydrates/lower GI has a chance to lower SHBG significantly?

In thinking about this more, my recollection it is actually INFLAMMATION that decreases SHBG, rather than insulin per se.

Again, there is no practical way to alter SHBG.

[PeakT]

In thinking about this more, my recollection it is actually INFLAMMATION that decreases SHBG, rather than insulin per se.

Again, there is no practical way to alter SHBG.

Interesting comment.  Notice that this study concludes insulin is the prime driver.  However, inflammation falls with weight loss as well - not just insulin - something they don't appear to account for or measure in this study.  However, insulin has been shown in vitro to stimulate SHBG and so these researchers conclude it is an independent stimulator:

https://www.ncbi.nlm.nih.gov/pubmed/7962291

"It is known that there is an inverse relationship between the serum levels of insulin and sex hormone-binding globulin (SHBG) in women, but the relationship in men has not been reported...During weight loss, insulin levels decreased at an average rate of 6.1 microU/mL per unit decrease in BMI, a much higher slope than the positive slope vs. BMI in weight stable men. During weight loss, SHBG levels increased at an average slope of 0.43 nmol/L per unit decrease in BMI, much higher than the negative slope of 0.2 nmol/L per unit increase in BMI in weight-stable men. Values for the SHBG vs. insulin coordinates in the weight-losing subjects did not differ significantly from those expected from the SHBG vs. insulin equation in weight-stable subjects. The stability of the SHBG-insulin relationship during weight loss despite the profoundly altered relationship of each separate component to BMI strongly suggests a close metabolic link between SHBG and insulin. As SHBG is not known to alter the production or metabolism of insulin, whereas insulin has been shown in vitro to decrease the synthesis of SHBG, it seems a reasonable conclusion that the predictable inverse relationship between serum insulin and SHBG indicates that insulin controls SHBG synthesis in vivo."

[PeakT]

Okay, this gets really interesting really fast.  Could one make a case that SHBG is actually anti-inflammatory (like testosterone)?  Well, I don't know about that.  To me it looks like it's a middle man, but you never know...

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5457423/

"Although both TT and SHBG levels are significant predictors for the risk of MetS in our initial analyses, only SHBG retains its significance after adjustment of both TT and SHBG levels. Some studies have reported SHBG as a dominant predictor for prevalent and incident MetS, independent of TT, while TT lost its significance as a predictor for the risk of MetS after adjustment of SHBG16, 17. In our study, we also found that serum SHBG levels were significantly correlated with adiponectin and leptin levels even after controlling for age, lifestyle factors, BMI and TT level. Both adiponectin and leptin levels were significantly associated with all individual MetS components.

Adiponectin and leptin are two important cytokines secreted from adipose tissues that play important roles in the pathogenesis of MetS. Adiponectin has been found to have antidiabetic, anti-atherogenic, and anti-inflammatory properties, while leptin can regulate body weight by modulating appetite and energetic balance, and upregulate proinflammatory cytokines that are associated with insulin resistance and endothelial dysfunction5, 25. Aside from our study, only limited epidemiologic studies have evaluated the relationships among SHBG, adiponectin and leptin in men26–28. Gannage´-Yared et al. first reported that serum SHBG level was positively correlated with adiponectin level and negatively correlated with leptin level in men26. The relationship between SHBG and adiponectin persisted after adjustment for waist or BMI, while SHBG lost its relationship with leptin after adjustment for BMI26. "

[PeakT]

Is there is a insulin inflammation connection?  Sure and it is exemplified in adult onset diabetes:

https://www.webmd.com/diabetes/type-2-diabetes-guide/inflammation-and-diabetes#1

"How could carrying extra weight and sofa-sitting be connected to higher levels of inflammatory chemicals in the body and the development of diabetes?

Researchers discovered that in people with type 2 diabetes, cytokine levels are elevated inside fat tissue. Their conclusion: Excess body fat, especially in the abdomen, causes continuous (chronic), low levels of abnormal inflammation that alters insulin's action and contributes to the disease."

[vvs1]

In thinking about this more, my recollection it is actually INFLAMMATION that decreases SHBG, rather than insulin per se.

Again, there is no practical way to alter SHBG.

Interesting comment.  Notice that this study concludes insulin is the prime driver.  However, inflammation falls with weight loss as well - not just insulin - something they don't appear to account for or measure in this study.  However, insulin has been shown in vitro to stimulate SHBG and so these researchers conclude it is an independent stimulator:

https://www.ncbi.nlm.nih.gov/pubmed/7962291

"It is known that there is an inverse relationship between the serum levels of insulin and sex hormone-binding globulin (SHBG) in women, but the relationship in men has not been reported...During weight loss, insulin levels decreased at an average rate of 6.1 microU/mL per unit decrease in BMI, a much higher slope than the positive slope vs. BMI in weight stable men. During weight loss, SHBG levels increased at an average slope of 0.43 nmol/L per unit decrease in BMI, much higher than the negative slope of 0.2 nmol/L per unit increase in BMI in weight-stable men. Values for the SHBG vs. insulin coordinates in the weight-losing subjects did not differ significantly from those expected from the SHBG vs. insulin equation in weight-stable subjects. The stability of the SHBG-insulin relationship during weight loss despite the profoundly altered relationship of each separate component to BMI strongly suggests a close metabolic link between SHBG and insulin. As SHBG is not known to alter the production or metabolism of insulin, whereas insulin has been shown in vitro to decrease the synthesis of SHBG, it seems a reasonable conclusion that the predictable inverse relationship between serum insulin and SHBG indicates that insulin controls SHBG synthesis in vivo."

I wonder if insulin injections would lower my shbg?

They always say to find the root cause, but regular doctors don't really know what to do or recognize it as a problem even if your free t % is low and out of range.

[PeakT]

I wonder if insulin injections would lower my shbg?

They always say to find the root cause, but regular doctors don't really know what to do or recognize it as a problem even if your free t % is low and out of range.

Well, probably, but that's risky as heck, right?

[Dr. John Crisler]

In thinking about this more, my recollection it is actually INFLAMMATION that decreases SHBG, rather than insulin per se.

Again, there is no practical way to alter SHBG.

Interesting comment.  Notice that this study concludes insulin is the prime driver.  However, inflammation falls with weight loss as well - not just insulin - something they don't appear to account for or measure in this study.  However, insulin has been shown in vitro to stimulate SHBG and so these researchers conclude it is an independent stimulator:

https://www.ncbi.nlm.nih.gov/pubmed/7962291

"It is known that there is an inverse relationship between the serum levels of insulin and sex hormone-binding globulin (SHBG) in women, but the relationship in men has not been reported...During weight loss, insulin levels decreased at an average rate of 6.1 microU/mL per unit decrease in BMI, a much higher slope than the positive slope vs. BMI in weight stable men. During weight loss, SHBG levels increased at an average slope of 0.43 nmol/L per unit decrease in BMI, much higher than the negative slope of 0.2 nmol/L per unit increase in BMI in weight-stable men. Values for the SHBG vs. insulin coordinates in the weight-losing subjects did not differ significantly from those expected from the SHBG vs. insulin equation in weight-stable subjects. The stability of the SHBG-insulin relationship during weight loss despite the profoundly altered relationship of each separate component to BMI strongly suggests a close metabolic link between SHBG and insulin. As SHBG is not known to alter the production or metabolism of insulin, whereas insulin has been shown in vitro to decrease the synthesis of SHBG, it seems a reasonable conclusion that the predictable inverse relationship between serum insulin and SHBG indicates that insulin controls SHBG synthesis in vivo."

Taking anti-inflammatory supplements increases SHBG. In fact, more than 2 cups of green tea per day will do it.

They took my SHBG over 90!

[sh1209]

So with all this information and everything that’s been said, ultimately what is the best way to treat a high shbg guy?

[BBkingbluesking122]

I wonder if insulin injections would lower my shbg?

They always say to find the root cause, but regular doctors don't really know what to do or recognize it as a problem even if your free t % is low and out of range.

Well, probably, but that's risky as heck, right?

Funny

[PeakT]

So with all this information and everything that’s been said, ultimately what is the best way to treat a high shbg guy?

The only way we have seen it on here from what I remember is a low T guy going on TRT.  You can also see if you have some underlying condition causing the problem and then try to correct it although no one has done that to date:

http://www.peaktestosterone.com/high_shbg.aspx