Low SHBG ! Good or bad?

[SuperDutyDave]

I have low SHBG 20. I also am a hyper-metabolizer I therefore inject my t-Cyp EOD This seems to work well for me and witha decently high dosage I stay in upper range and feel pretty good

 

[Nelson Vergel]

People with lower SHBG and Vitamin D have fatty liver

 

[ERO]

I think that perhaps in people with normal SHBG levels, taking a ton of Vitamin D may lower it a bit, but for those of us with low SHBG it doesn't matter, or it does but not to a degree that would matter. I have tested SHBG after stopping Vitamin D for 3 months and again after taking 5000iu a day for 3 months and found no difference. Everybody is different, but I have found that many of the "low SHBG truths" to not apply. (E.G., if you have low SHBG you are fat and diabetic, you convert a ton to E2, that T3 increases SHBG to a useful level, etc...)

 

[Vestpocket]

I think that perhaps in people with normal SHBG levels, taking a ton of Vitamin D may lower it a bit, but for those of us with low SHBG it doesn't matter, or it does but not to a degree that would matter. I have tested SHBG after stopping Vitamin D for 3 months and again after taking 5000iu a day for 3 months and found no difference. Everybody is different, but I have found that many of the "low SHBG truths" to not apply. (E.G., if you have low SHBG you are fat and diabetic, you convert a ton to E2, that T3 increases SHBG to a useful level, etc...)

I would mirror ERO's assertion. If you have genetically low SHBG: T3 will absolutely not increase it, clomid will absolutely not increase it, diet will absolutely not increase it and estrogen will absolutely not increase it. Nothing will increase it. Production is genetically limited.

It's like asking a red headed person to produce more melanin.

 

[JMP]

Vestpocket, I would disagree with one of your assertions. Clomid definitely does or at least can increase SHGB. I personally run at a low to mid 20's normal SHBG, however after 5-6 months of clomid, my labs came back SHBG 49. Fast forward, stopped clomid for 6 months, got labs before starting TRT 6 weeks ago and my SHBG was 22.

 

[JMP]

Which makes me wonder if there would be a way to use clomid (instead of HCG) in guys with low shbg to raise it and make them feel better. But not sure of the longer term effect on bloodwork/estradiol. Now before anyone tells me that clomid doesn't work like HCG and its normal function is blocked while on TRT, I am not making any claims in that regard. I am only speculating on how the low SHBG guy would feel with a higher SHBG level in comparison.

 

[Vince]

I'm just wondering if someone with low SHBG would become a true (healthy eating - no junk food) vegetarian. What would happen to their SHBG levels.

 

[ERO]

I'm just wondering if someone with low SHBG would become a true (healthy eating - no junk food) vegetarian. What would happen to their SHBG levels.

Speculation only: I would guess that if they had low SHBG because they were overweight and diabetic, eating healthy perhaps going vegetarian and loosing weight would help. If they have low SHBG due to genetics, then I doubt it would make a meaningful difference. I eat healthy do not eat junk food, don't smoke, rarely drink and when I drink its like one glass of wine with dinner, I am not overweight or pre-diabetic and my SHBG ranges between 7 and 12 no matter what.

 

[Jason Sypolt]

Which makes me wonder if there would be a way to use clomid (instead of HCG) in guys with low shbg to raise it and make them feel better. But not sure of the longer term effect on bloodwork/estradiol. Now before anyone tells me that clomid doesn't work like HCG and its normal function is blocked while on TRT, I am not making any claims in that regard. I am only speculating on how the low SHBG guy would feel with a higher SHBG level in comparison.

Has anyone tried this? Clomid while on TRT does not work for the purposes of what Clomid is intended for. But could Testosterone + Clomid raise SHBG?

 

[ERO]

Has anyone tried this? Clomid while on TRT does not work for the purposes of what Clomid is intended for. But could Testosterone + Clomid raise SHBG?

Clomid is known to raise SHBG - for guys with normal SHBG expression. If one is genetically low, I seriously doubt it would help enough to matter. If your SHBG is at 10 and you raised it, say 25% you are still at 12.5.

 

[Jason Sypolt]

Clomid is known to raise SHBG - for guys with normal SHBG expression. If one is genetically low, I seriously doubt it would help enough to matter. If your SHBG is at 10 and you raised it, say 25% you are still at 12.5.

It seems as though E2, T3, Vitamin D have no effect for me as well. My last SHBG result was 17. It was 18 before starting TRT. You have a good point. I saw some claims of Clomid raising SHBG by 30%, but that really wouldn't mean anything.

 

[ERO]

It seems as though E2, T3, Vitamin D have no effect for me as well. My last SHBG result was 17. It was 18 before starting TRT. You have a good point. I saw some claims of Clomid raising SHBG by 30%, but that really wouldn't mean anything.

Sadly, I would need something that would raise my SHBG 300% just to get to a level of 30.

 

[Nelson Vergel]

Can Low SHBG Serum Concentration Be A Good Early Marker Of Male Hypogonadism In Metabolic Syndrome?

Introduction: In men suffering from metabolic syndrome, accompanying insulin resistance may result in a lowering of sex hormone–binding globulin (SHBG) plasma levels and cause changes in their androgenic status.

Aim: The objective of the research was to assess selected androgens and SHBG plasma levels in males meeting diagnostic criteria for MS compared to healthy males.
Patients and methods: The group consisted of 65 men aged between 40 and 70 years old fitting IDF metabolic syndrome criteria and 84 controls. Dehydroepiandrosterone (DHEA) and its sulphate (DHEA–S), total and free testosterone and SHBG serum levels were evaluated. Calculated free and bioavailable testosterone were estimated using an algorithm proposed by the International Society for the Study of the Aging Male.

Results: Men diagnosed with MS showed a statistically significant decrease in plasma levels of DHEA in comparison to healthy ones: 11.579 (8.39–15.56) vs 14.014 (9.611–17.125) ng/mL; p = 0.0350, SHBG: 47.46 (35.78–62.83) vs 71.965 (54.45–91.56) nM/L; p<0.0001 and total testosterone: 5.2 (3.8–6.5) vs 6.3 (5.4–8.25) ng/mL; p = 0.0001 (values presented as a median with Q1–Q3).

Conclusion: The results suggest that SHBG is a good early marker for metabolic dysregulation in MS, considering its strength of association and significance is comparable to, or better than, those of MS criteria.

Keywords: MS, DHEA, testosterone, CRP, cholesterol, androgens

Source: [Full text] Can Low SHBG Serum Concentration Be A Good Early Marker Of Male Hypogo | DMSO

 

[Nelson Vergel]

Association between sex hormone-binding globulin and kidney function in men: results from the SPECT-China study - PubMed

Lower serum SHBG levels were significantly associated with lower eGFR and a higher prevalence of low eGFR in Chinese men independent of demographics, lifestyle, metabolic-related risk factors, and testosterone. Large prospective cohort and basic mechanistic studies are warranted in the future.

pubmed.ncbi.nlm.nih.gov

 

[eli]

Low shbg here and 100% healthy, in shape, zero diseases.

 

[Nelson Vergel]

When people say "low SHBG" does that mean that they have very low SHBG without using TRT?

 

[eli]

When people say "low SHBG" does that mean that they have very low SHBG without using TRT?

Yeap.
Always had high igf1, high dhea and low shbg. Good cholesterol low too,
It's just genetics

 

[TRicker]

I have low SHBG (I range from 7 to 13, with the normal scale usually being between 20-70) and I have been on TRT for 4 years. It has been very disappointing, as I never really feel the benefits of TRT. I do have a bit more energy but I still have low libido, ED, I am unable to gain muscle, etc...Also it should be noted that I am not a lot overweight, (I could stand to loose 10 pounds), diabetic or pre-diabetic and I have tried every protocol out there, with the exception of pellet injections and Nebido, which I believe is only available in Europe. Daily injections, twice weekly injections, weekly injections, with HCG, without HCG, with Anastrozol, without - it all feels the same, which mostly feels the same as having low T overall. Oh, and my E2 is in range as is my Prolactin. I am in good heath overall and not on any BP meds, have never smoked and I workout 5-6 days a week, every week.

@ERO Have you found anything that works for you yet?

I found it interesting what Dr Mariano states, from @Okian post above:

He states that high shbg guys need lower doses of testosterone, because SHBG prolongs testosterone's action. Would this imply low SHBG guys actually need higher doses (the opposite of current advice)?
He also states that he considers total testosterone more important than free t, because total t indicates more signaling capacity (also the opposite of current advice). He stated that free testosterone often times does not determine libido.

I also have low shbg, and definitely felt better when I began TRT with the typical clinic protocol of 200mg test cyp 1x/week, hcg, anastrozole. I didn't feel awesome, but better compared to lower dosages, split 2x/week dosages, 3x/week subq (subq for me really brought my t numbers down quite a bit).
My T Clinic has thousands of patients, and I'm one of their few problem cases. They probably are a "typical T mill", but I guess their approach is working for a lot of guys.

As a side note: I was on enclomiphene-only for 5 months for fertility purposes, and although in definitely increased my sperm count, my total testosterone never got above 300. Interestingly, after 8 weeks of enclo my shbg was around 18, after 12 weeks my shbg was around 18, BUT after 16 weeks on enclo my shbg jumped up to 30. Maybe TRT plus clom/enclo could raise shbg?

@Jason Sypolt have you tried adding clomiphene/enclomiphene to your protocol?
If you don't mind, can you say what protocol your on now and what's working for you with low shbg?

Thank you in advance for any suggestions!

 

[Nelson Vergel]

"SHBG concentrations are decreased with obesity, type 2 diabetes mellitus, polymorphisms in the SHBG gene, hypothyroidism, acromegaly, nephrotic syndrome, advanced liver disease, and treatment with androgens, progestins, and glucocorticoids."

I have posted about genetic factors associated with low SHBG. This article mentions that.

Low Testosterone in Men: Recommendations on the diagnosis, treatment and monitoring

ABSTRACT The relative proportional increase of the elderly population within many countries will become one of the most significant social transformations of the twenty-first century and, for the first time in history, persons aged 65 or above outnumbered children under five years of age...

www.excelmale.com

 

[GreenMachineX]

Found this article which says .. '' low SHBG is often a sign of many of the worst chronic diseases that we face in modern, civlized societies.

1. Obesity and Being Overweight. Low SHBG is associated with obesity. [1] The reason is probably due to a loss of insulin sensitivity as we'll discuss below.


2. Lower Insulin Levels. There is evidence that increasing insulin lowers SHBG. [2] Studies have found this both in vitor and in vivo as well, i.e. on human subjects and male ones at that. [3] Therefore, SHBG is often a flag or warning signal of insulin and blood sugar issues. In other words, SHBG does not cause insulin resistance but does indicate it.


3. Cardiovascular Disease, Diabetes, Metabolic Syndrome and Decreased Longevity. Due to #1 and #2, mumerous studies have shown that low SHBG can actually indicate decreased longevity. For example, one study found:
"Low SHBG and IGFBP-1 were both associated with an increased prevalence of abnormal glucose tolerance and the metabolic syndrome, but only SHBG was associated with diabetes mellitus. SHBG was less influenced by body mass index than IGFBP-1. Low SHBG indicated increased cardiovascular and coronary disease mortality; the association remained after adjustment for abnormal glucose tolerance, but not after adjustment for prevalent cardiovascular disease." [1]

This is about as ugly as it gets. Low SHBG is correlated with three of the biggest killers of men: heart disease, diabetes and Metabolic Syndrome. A more recent and larger scale study verified the above results but did find that all mortality risk was due to its association with diabetes, lowered HDL and weight gain. So SHBG does not seem causative, but rather often a sign that something else is wrong. By the way, it was "ischemic heart disease" risk that was associated with lowered SHBG in this case, which basically means accelerated arteriosclerosis and decreased blood supply to the heart.


4. Apnea. I document in my link on Apnea and Testosterone how apnea can affect your baseline testosterone levels by 30 percent or more. Other studies have shown that SHBG significantly lowers SHBG as well. [7] So if you have low testosterone and low SHBG, this is something to consider.


5. Obesity. Because weight gain can lead to loss of insulin sensitivity, low SHBG values are correlated to extra weight.


6. Inflammation. One study (in women) found that lowered SHBG was associated with elevated CRP (C-Reactive Protein), one of the "gold standard" markers of systemic inflammation that is linked to heart disease, dementia and autoimmune disorders. [8]


7. Hypothyroidism. One study found that low SHBG was associated with hypothyroidism and could even be reversed by correcting the underlying thyroid issue. [9]


8. Elevated Triglycerides. Several studies have found that elevated triglycerides, which are a risk factor for both heart disease and erectile dysfunction, are also tied in with low SHBG. [10] Of course, this should be no shock since elevated triglycerides usually come from eating meals with an overly high glycemic load and refined carbohydrates.
NOTE: HRT will lower SHBG some and steroid usage even moreso.''


My SHBG is currently 6.95 nmol/L (14.5-48.4) nmol/L , my endocrinologist checked my thyroid,said it`s all good , I have never been overweight,tiglycerides last time checked were 0.6mmol/L (0.00-2.30mmol/L) ,haven't check the other ones : diabetes ,etc..

What are your toughts on this one please? Any help appreciated.

This is interesting to me. I have shbg of 18, but crp is great, insulin sensitivity great, mildly overweight supposedly (according to Inbody scan, but people laugh when I say my 24%), thyroid treated and good levels, no sleep apnea (tested twice), triglycerides good and low...no explanation for my low shbg. Just frustrating to deal with on TRT.