How can one increase SHBG when it is too low?

[Nelson Vergel]

ERO

Low SHBG can be caused by insulin resistance even if your blood sugar is normal. Have you had a glucose tolerance test?

 

[ERO]

I have not done that yet because my fasting glucose is always in the mid 80s - I bought a glucose meter last year to be able to monitor and get a baseline and after checking for like 50 days straight its always in the low to mid 80s at the highest.

The glucose tolerance test might be worth a look though to be thorough.

I WISH that the higher free T was as awesome as it looks on paper, but sadly it is not. If it was, nobody on TRT with low SHBG would complain, and me and Vestpocket and the rest would all look like Captain America and be having sex 3 times a day

 

[Nelson Vergel]

I found a few studies about sex hormone binding globulin in men that may be of interest to people in this thread.

This one links high triglycerides with lower SHBG (it makes sense since insulin resistance increases triglycerides. Increased insulin is linked with decreased SHBG)

Atherosclerosis
Volume 133, Issue 2, September 1997, Pages 235–244

Relationships between endogenous steroid hormone, sex hormone-binding globulin and lipoprotein levels in men: contribution of visceral obesity, insulin levels and other metabolic variables

Abstract

Excess visceral adipose tissue (AT) and hyperinsulinemia are important correlates of an altered lipoprotein profile. It has also been reported that testosterone, adrenal C[SUB]19[/SUB] steroids and sex hormone-binding globulin (SHBG) concentrations are associated with plasma lipoprotein levels. The aim of the present study was to investigate the relative contributions of endogenous steroid hormone and SHBG levels, of visceral AT accumulation measured by computed tomography, and of fasting insulin and free fatty acid (FFA) concentrations to the variation of plasma lipoprotein levels in men. For this purpose, plasma concentrations of testosterone, dehydroepiandrosterone (DHEA), androstene-3&#946;,17&#946;-diol (&#916;[SUP]5[/SUP]-DIOL), androstenedione (&#916;[SUP]4[/SUP]-DIONE), estrone and estradiol, as well as SHBG levels were determined in a sample of 76 men covering a wide range of body fatness values. Higher testosterone levels were associated with a more favorable lipoprotein profile as it showed significant correlations with triglyceride (TG), total cholesterol and LDL-cholesterol (LDL-C) concentrations (r=&#8722;0.25, &#8722;0.25 and &#8722;0.27, respectively; P<0.05). Higher plasma adrenal C[SUB]19[/SUB] steroid levels were also associated with a favorable lipoprotein profile as DHEA, &#916;[SUP]4[/SUP]-DIONE and &#916;[SUP]5[/SUP]-DIOL levels were negatively correlated with total cholesterol (r=&#8722;0.24, &#8722;0.33 and &#8722;0.24, respectively; P<0.05) and LDL-C (r=&#8722;0.23, &#8722;0.31 and &#8722;0.28, respectively; P<0.05). SHBG levels were negatively correlated with TG concentrations (r=&#8722;0.33; P<0.005) whereas &#916;[SUP]5[/SUP]-DIOL, testosterone and SHBG were negatively correlated with apolipoprotein B levels (&#8722;0.32&#8804;r&#8804;&#8722;0.43; P<0.005). Statistical adjustment for visceral AT area, fasting insulin, fasting free fatty acid (FFA) levels and total body fat mass eliminated most of the correlations between steroid and lipoprotein levels, while SHBG remained significantly correlated with lipoprotein concentrations after such adjustments. Multivariate analyses revealed that SHBG, &#916;[SUP]4[/SUP]-DIONE, &#916;[SUP]5[/SUP]-DIOL and metabolic variables all contributed to the variance in plasma lipoprotein concentrations (from 10 to 29% of explained variance). Visceral AT, fasting FFA and insulin levels as well as SHBG concentrations appeared to be independent correlates of lipoprotein concentrations. Thus, metabolic and anthropometric variables examined in the present study could have represented important confounding factors in previous studies which have examined the relationship of steroid hormones to plasma lipoprotein concentrations.

This one links low DHT with low SHBG.



Maturitas. Volume 2, Issue 2, July 1980, Pages 109&#8211;118

Interrelationships between sex hormone-binding globulin and testosterone, 5&#945;-dihydrotestosterone and oestradiol- 7&#946; in blood of normal men [SUP]&#9734;[/SUP]

Abstract

Sex hormone-binding globulin (SHBG), testosterone (T), 5&#945;-dihydrotestosterone (DHT) and 17&#946;-oestradiol (E[SUB]2[/SUB]) were measured in 93 men in the age range 36&#8211;80 yr. Assuming that the binding of the steroids to blood albumin and SHBG follows the law of mass action, non-SHBG bound steroid concentrations (T[SUB]n[/SUB], DHT[SUB]n[/SUB], E[SUB]2n[/SUB]) were calculated from the SHBG and the respective total hormone values. The main results were: (1) Mean T[SUB]n[/SUB], DHT[SUB]n[/SUB], E[SUB]2n[/SUB] and SHBG remained on a constant level until the age of 65 yr. In men 66&#8211;80 yr old T[SUB]n[/SUB] and DHT[SUB]n[/SUB] were found to be significantly lower (P<0.001), whereas E[SUB]2n[/SUB] and SHBG were elevated (P < 0.05, P < 0.001, respectively) when compared with men age 36&#8211;55 yr. (2) In contrast to total T and DHT, which correlated positively with SHBG (P < 0.001) in Group I (age 36&#8211;55 yr) and also when eliminating the influence of age (P < 0.05, P < 0.01, P < 0.01 for T, DHT and E[SUB]2[/SUB]) in Group II (age 56&#8211;80 yr), the correlation between T[SUB]n[/SUB] and SHBG was insignificant, whereas a negative correlation between DHT[SUB]n[/SUB] and SHBG (P < 0.01) was present in Group I. (3) The age dependent increase of SHBG in Group II can be best explained by the respective alterations of the E[SUB]2n[/SUB]/DHT[SUB]n[/SUB] ratio. These results are discussed with respect to the relation between the SHBG, the total steroid and the non-SHBG bound steroid concentrations.

This one links higher growth hormone levels with higher SHBG.

Journal of Steroid Biochemistry
Volume 32, Issue 2, February 1989, Pages 327&#8211;334

On the regulation of sex-hormone-binding globulin—A challenge of an old dogma and outlines of an alternative mechanism

Abstract

In this review, the different factors known to affect SHBG levels are discussed with respect to their possible significance in the physiological regulation of this protein: Sex steroids, puberty, nutritional status, thyroid hormones and liver disease. It is concluded that the serum levels of SHBG are related rather to general metabolic factors, nutritional status, growth and ageing than to the estrogen/androgen balance. The authors suggest that SHBG is regulated primarily by growth hormone, somatomedin-C and possibly other growth factors. Growth hormone may promote SHBG synthesis in the liver while somatomedin-C may stimulate its extravasation and uptake in target tissues. It is suggested that sex steroids merely have an indirect, modulating influence.


I wonder if using growth hormone releasing peptides will increase SHGB.

 

[ERO]

These are interesting studies - Thank you for posting them!

 

[Nelson Vergel]

Another interesting one that shows vegans have higher SHBG than omnivores.


Another study showing that removing fat and animal protein may not be best for men's sex hormone binding globulin.


Testosterone, sex hormone-binding globulin, calculated free testosterone, and oestradiol in male vegans and omnivores


British Journal of Nutrition / Volume 64 / Issue 01 / July 1990, pp 111-119
Timothy J. A. Key[SUP]a1[/SUP], Liane Roe[SUP]a2[/SUP], Margaret Thorogood[SUP]a2[/SUP], John W. Moore[SUP]a3[/SUP], Graham M. G. Clark[SUP]a3[/SUP] and Dennis Y. Wang[SUP]a3[/SUP]

[SUP]a1 [/SUP]Cancer Epidemiology Unit, Imperial Cancer Research Fund, Gibson Building, Radcliffe Infirmary, Oxford OX2 6HE
[SUP]a2 [/SUP]General Practice Research Group, Imperial Cancer Research Fund, Department of Community Medicine & General Practice, Gibson Building, Radcliffe Infirmary, Oxford OX2 6HE
[SUP]a3 [/SUP]Clinical Endocrinology Laboratory, Imperial Cancer Research Fund, PO Box 123, Lincoln's Inn Fields, London WC2A 3PX

Abstract

Total testosterone (T), total oestradiol (E2) and sex hormone-binding globulin (SHBG) concentrations were measured in plasma samples from fifty-one male vegans and fifty-seven omnivores of similar age. Free T concentration was estimated by calculation, in comparison with the omnivores, the vegans had 7% higher total T (P = 0.250), 23% higher SHBG (P = 0.001), 3% lower free T (P = 0.580), and 11% higher E2 (P = 0.194). In a subset of eighteen vegans and twenty-two omnivores for whom 4 d diet records were available, there were statistically significant correlations between T and polyunsaturated fatty acids (r 0.37), SHBG and fat (r 0.43 for total fat, 0.46 for saturated fatty acids and 0.33 for polyunsaturated fatty acids), and SHBG and alcohol (r&#8211;0.39). It is concluded that a vegan diet causes a substantial increase in SHBG but has little effect on total or free T or on E2.

 

[Vestpocket]

I wonder if using growth hormone releasing peptides will increase SHGB.

Not for me. I've been on them for over a year. No bump whatsoever from 100mcg ipamorelin + 100mcg mod GRF 1-29.

 

[Vestpocket]

Most of the studies related to increasing SHBG are pretty disappointing:

50 mcg of T3 will double it. However, this requires that you become hyperthyroid, and this was only shown with men who had normal SHBG to start. (25 mcg per day made me hyperthyroid (elevated T3 per lab range) but had zero effect on SHBG.))

Coffee will increase it by tiny percentage. Except, you have to be female, start with normal SHBG and drink enough that you get 400mg of caffeine, minimum.

Flax seed will boost it. The caveat is that you have to start with normal SHBG and that the only reason it increases is that lignans bind to and inactivate SHBG, so the body responds by making more since it is being taken out of use (if the body is able.) Essentially, it makes the blood test unreliable, because the test includes lignan bound SHBG.

Beyond thyroid, I've never seen a study that shows an adequate increase that would remedy a situation that either myself or ERO find ourselves in.

------------
Sex hormone binding globulin deficiency due to a homozygous missense mutation.

Vos MJ, Mijnhout GS, Rondeel JM, Baron W, Groeneveld PH
J Clin Endocrinol Metab. 2014 Jun 17:jc20142055

We identified a man with an undetectable SHBG concentration in combination with a low total testosterone. He presented with a seven-year history of muscle weakness, fatigue and a low libido. Objectives To determine the cause of the SHBG deficiency we both employed genetic analysis of the SHBG gene and transgene SHBG expression.
[...]
The female patient was asymptomatic, but the male patient presented with symptoms of sexual dysfunction, poor concentration, depressed mood and muscle weakness, raising the possibility of a role for a SHBG in some sex steroid actions (e.g. in brain and muscle).

 

[Vestpocket]

I bumped my T up from 80mg/wk to 200mg per week.

With a >5% FT ratio, I'm going to have insane FT values.

Having insane free testosterone might be the only way to make low SHBG work, per some people who have found success.

 

[ERO]

Good point!. I know that doctors often want guys with low SHBG to be treated with very low levels of total T and of course that leaves you basically with low T all over again - which was why we went on TRT to begin with. While I never feel most of the benefits of TRT, I definitely feel better on 200 a week (split into 2 injections) than 100 a week or lower. I still don't have any real libido and still cannot really build muscle, but my energy is good and no more brain fog at least at the higher level.

 

[dallas101346]

Good point!. I know that doctors often want guys with low SHBG to be treated with very low levels of total T and of course that leaves you basically with low T all over again - which was why we went on TRT to begin with. While I never feel most of the benefits of TRT, I definitely feel better on 200 a week (split into 2 injections) than 100 a week or lower. I still don't have any real libido and still cannot really build muscle, but my energy is good and no more brain fog at least at the higher level.

What is your training and diet like? There are rare people that can't build any muscle with the correct diet/training. That being said, a natural lifter will gain 5-10 lbs of lean body mass a year, in the beginning, and only 1-2 lbs a year after 8-10 years of training. So you may just not notice.

 

[ERO]

I am very careful to get at least one gram of protein per pound every day, I eat low carb and only occasionally have a glass of wine. Never smoked and I am on a 3 day split weight routine where I hit each body part hard once a week. I have always been a hard gainer, even when I was in high school so its probably just me.

 

[dallas101346]

Right, but what about total calories. Low carb is generally pretty bad for building muscle anyway. What is your height and weight. Protein, isnt the end all be all for muscle growth.

 

[Vince Carter]

I was/am the same way, my free T (on a 24hr peak) is just over 3%, and TT over 1400, I really can't see taking less than 60mg/3x week. My shbg floats 12-15. One thing to keep in the mix is that it's tougher to manage E2, low SHBG equates to free E2, also. I have to take anastrozole with my injections but it's just .20mg.

 

[ERO]

I am 6.0 and 215 with 20% bodyfat that I am trying to get down to 15%. My total calories average around 3000/day. I have tried upping my calories, carefully, to build muscle, but the extra calories just turn to fat, so now I need to cut some body fat to get back under where I am now. I don't expect to build muscle while I am cutting, I am speaking in a general sense. I have been on TRT for 4 years and on paper, with high free T and high-normal total T, I should be able to build muscle. But it never happens. I have been lifting for years, off and on (mostly on) since high school and I am 50 now, so I don't expect to look like a bodybuilder just because I am on TRT and lift, but being able to build some additional muscle would be nice.

 

[Vince Carter]

I was always a hard gainer until TRT. IN my younger years I had to eat over midnight, and basically everything else in sight and I'd be pretty good to get 1lb a week. When I graduated basic training, 5' 9", 135lbs. But this last year, gained 25lbs, really since I got on injectables. I've been lifting since high school, but things totally changed for me.

 

[ERO]

Wow, you are getting some great results!

 

[Vestpocket]

I've been lifting on an off with incredible FT values, but low SHBG.

Like ERO, I eat 3,000 calories per day. I'm 185 lbs @ 16% BF, but all of the calories go straight to my gut. Not even to "fat" -- but just straight to the gut. I am FAT-FREE on arms and legs and face. How people end up with fat shoulders, arms and legs, I will never understand.

I never get results from workouts. I did Strong Lifts 5x5 for the last two years and did get my squat from bar-weight up to 240lbs x 5. I got my pull-ups from 3 at full bodyweight to 9 at full bodyweight. My incline bench press went from 90 x5 to around 140 x 5. Alas, that's my peak. My body refuses to grow any further. I don't even look like I workout. I look the same as a 21 year old male that never stepped inside of a gym (I am 33) and has skinny fat syndrome. It's intensely frustrating and depressing.

NO diabetes, NO insulin resistance.

My FT% is > 5%. My FT should now be close to 60 with the reference range being [5-21]. Does absolutely nothing. Not even a stray boner.

 

[Vince Carter]

I've almost discovered an entirely new way that I'm lifting, I have a ton more confidence and I workout with A LOT more intensity that I ever have. I know I lifted weights for 25 years but I don't think I ever was knocking it out like I have been for a year. I use a serious preworkout for the boost, whey post session. My only bothersome point anymore is the stubborn midsection that seems impossible to lean out. I know I'm more bulking than trying to get lean but the midsection isn't as lean as the rest of me.
Im getting started with Defy and hope some growth hormone therapy will be in order, I read other men having success in the belly fat when they get on Sermorelin(?).

 

[Vestpocket]

This thread got way off topic.

Does anyone have any clues as to how one can increase SHBG output to normal levels, or how to use normal TRT doses in combination with chronically low SHBG?

 

[Vince Carter]

This thread got way off topic.

Does anyone have any clues as to how one can increase SHBG output to normal levels, or how to use normal TRT doses in combination with chronically low SHBG?

Neither one is effective. low SHBG can't really be raised and normal TRT doses (100mg/week?) most of us low SHBG guys don't feel good on those and need higher doses more frequently. This is personal experience and much reading of other low SHBG guys. You can't really change, you have to tailor your TRT dose and regimen to work with it.