Low SHBG: Insulin Resistance?

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Jpin22

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I'm quite positive I'm insulin resistant with an out of range low SHBG and I'm looking into metformin. TRT so far hasn't been anywhere near effective as I thought it'd be and I am realizing that it is most likely (hopefully) because of the low SHBG and insulin resistance.
 
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Defy Medical TRT clinic doctor
How low is your SHBG? Do you have any other labs to help shed light on the question (A1C, glucose)? How long, and what type, of TRT protocol are you administering?
 
It is 'conventional wisdom' that guys with low SHBG are insulin resistant, but I have low SHBG and I am not, nor are many folks with low SHBG. Get tested before you assume. That and FWIW, I have been taking Metformin for a year now for life extension purposes and it has not helped my low SHBG nor my TRT one bit. Sorry, wish I had better news.
 
It is an article of faith in some circles that low SHBG=insulin resistance. My own doctor has said she finds it to be an interesting marker that ought to be eliminated, but hardly the diagnostic key many hold it to be.
 
Last edited:
CoastWatcher said:
How low is your SHBG? Do you have any other labs to help shed light on the question (A1C, glucose)? How long, and what type, of TRT protocol are you administering?
Click to expand...

Is there a reason you deleted me quoting Nelson? I know he had been interested in this issue and may have learned more knowledge on the question since.

I forget the reference range for SHBG but My SHBG is about 6 or 7 from being in range(whatever the unit of measurement is).

I also have an elevated fasting insulin level. I had below in range testosterone for over 2 years and grew quite intolerant of sugar even though I craved it. I consume almost no sugar now eating a largely ketogenic diet and my fasting levels are still in the 90s.

I had normal SHBG levels before all of this happened so I'm quite certain I'm not one of these people with chronically low SHBG levels their whole lives.

I have elevated triglycerides, below 30 HDL and elevated LDL. So pretty much I have metabolic syndrome by its very definition. Which from what I've read is largely a testosterone and insulin resistance issue.


I'm addressing testosterone with My TRT protocol is 80mg 2x a week but I've only been on it for 10 weeks or so. Next is fixing the insulin resistance.
 
What is the testing protocol for this insulin resistance? Fasting glucose? I, too, get a case of the angers when not just insulin resistance, but diabetes, is mentioned as though it's a given with SHBG. Those two things are serious business and are needlessly tossed around. My fasting Glucose has always been in the 80s
 
From what I've read fasting insulin levels is the gold standard. Normal Fasting glucose levels does not mean you don't have insulin resistance.
 
You are correct, but the treatment for insulin resistance is a better diet and Metformin (among other things) many of us with low SHBG have used Metformin for months or even years with no useful improvement in SHBG numbers so it becomes somewhat of a moot point.
 
ERO said:
You are correct, but the treatment for insulin resistance is a better diet and Metformin (among other things) many of us with low SHBG have used Metformin for months or even years with no useful improvement in SHBG numbers so it becomes somewhat of a moot point.
Click to expand...

But were you taking metformin because you had diagnosed insulin resistance or just because you had Low SHBG in hopes it would raise it ? I thought I remember you being in the latter category but I could be wrong.
 
I am taking it mainly for life extension but had hoped that it would help my low SHBG. No such luck in my case...

There are many things said to raise SHBG, and I have tried them all and found that they all may raise it a tiny bit, but that is not enough to be of any help. For example, on a recent test my SHBG was 7...raising that 10% is meaningless...I need something that raises it like 300% and nothing out there will do that.
 
Jpin22 said:
Is there a reason you deleted me quoting Nelson? I know he had been interested in this issue and may have learned more knowledge on the question since.

I forget the reference range for SHBG but My SHBG is about 6 or 7 from being in range(whatever the unit of measurement is).

I also have an elevated fasting insulin level. I had below in range testosterone for over 2 years and grew quite intolerant of sugar even though I craved it. I consume almost no sugar now eating a largely ketogenic diet and my fasting levels are still in the 90s.

I had normal SHBG levels before all of this happened so I'm quite certain I'm not one of these people with chronically low SHBG levels their whole lives.

I have elevated triglycerides, below 30 HDL and elevated LDL. So pretty much I have metabolic syndrome by its very definition. Which from what I've read is largely a testosterone and insulin resistance issue.


I'm addressing testosterone with My TRT protocol is 80mg 2x a week but I've only been on it for 10 weeks or so. Next is fixing the insulin resistance.
Click to expand...

Have you ever had your ApoE checked, you sound like an ApoE 2?
 
Nelson Vergel said:
You could run a fasting insulin and A1C test to find out if indeed you may have issues with insulin resistance:

http://www.discountedlabs.com/choose-your-test/
Click to expand...

My original post was edited but it was more of a "have you seen any further research on metformin raising low SHBG caused by insulin resistance". As mentioned in my other posts I do have elevated fasting insulin so it's more of a where do I go from here to correct the resistance and raise SHBG and I know you had had an interest in Metformin and whether it could actually raise SHBG
 
Beyond Testosterone Book by Nelson Vergel
Effects of diet and metformin administration on sex hormone-binding globulin, androgens, and insulin in hirsute and obese women
Abstract

Evidence suggests that hyperinsulinemic insulin resistance may increase serum levels of ovarian androgens and reduce sex hormone-binding globulin (SHBG) levels in humans. The present study was conducted to assess the effect of administration of the biguanide metformin, a drug commonly used in the treatment of diabetes mellitus, on androgen and insulin levels in 24 hirsute patients. The patients selected for the study were obese, with a body mass index higher than 25 kg/m2 and high fasting insulin (> 90 pmol/L) and low SHBG levels (< 30 nmol/L). All patients were given a low calorie diet (1500 Cal/day) and randomized for either metformin administration at a dose of 850 mg or a placebo, twice daily for 4 months, in a double blind study. In the placebo group, diet resulted in a significant decrease in body mass index (30.8 +/- 1.0 vs. 32.7 +/- 1.5 kg/m2; P < 0.0001), fasting insulin (127 +/- 11 vs. 156 +/- 14 pmol/L; P < 0.01), non-SHBG-bound testosterone (0.19 +/- 0.02 vs. 0.28 +/- 0.03 nmol/L; P < 0.02), androstenedione (5.8 +/- 0.5 vs. 9.0 +/- 1.1 nmol/L; P < 0.03), and 3 alpha-diolglucuronide (8.6 +/- 1.1 vs. 11.7 +/- 1.9; P < 0.005) plasma concentrations and a significant increase in the glucose/insulin ratio (0.047 +/- 0.005 vs. 0.035 +/- 0.003; P < 0.001) and plasma concentrations of SHBG (26.0 +/- 3.3 vs. 19.1 +/- 1.9 nmol/L; P < 0.001) and dehydroepiandrosterone sulfate (8.7 +/- 1.5 vs. 8.4 +/- 1.3; P < 0.05). Beneficial effects of diet were not significantly different in the patients who were given metformin instead of placebo. These results confirm that weight loss induced by a low calorie diet is effective in improving hyperinsulinemia and hyperandrogenism in obese and hirsute women. With our study design, metformin administration had no additional benefit over the effect of diet.
 
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