How often to test SHBG?

[Nashtide]

I recently switched protocol from E3.5D to EOD, so I will run labs after about 6-8 weeks. I generally only test T and E2. The last time I ran SHBG was about 6 months ago. I will test it again if necessary, but would rather not spend the $ if it’s unnecessary. Thanks and God bless America!

 

[sh1973]

From what I’ve seen shbg barely ever moves. In the nine years I’ve been on trt mines has never changed more than 6-8 points at various t doses. I only check mine every 3 labs.

 

[BigBamBoo]

How much is the SHBG test? I like as much as a complete snapshot when it comes to labs.

 

[fifty]

$33 on lifeextension

 

[Nashtide]

I use Quest Diagnostics because it’s close to my home and office. I believe they charge around $80.

 

[BigBamBoo]

I order mine through Defy and it is $44.00

 

[Guided_by_Voices]

Once once one is dialed in, I don't see the point of ever testing SHBG...Maybe I'm missing something, but I don't know what action could be taken if it changed, so I have redirected the money to things like hsCRP and insulin. That said, I know that the RenewlifeRX folks think SHBG is a major indicator for getting dialed in so perhaps there is something to it, but if one is stable it seems like the money could be better spent elsewhere.

 

[Vince]

My shbg usually doesn't change, my last Labs it did.

January of this year. SHBG 39.7 range 19.3 - 76.4

June of last year. SHBG 48.8 range 19.3 - 76.4

 

[Vince Carter]

A ten point swing really isn't all that likely to change the landscape of a guys treatment, I know I had read/heard Dr Crisler state as much and that SHBG will swing thru the day.
I run mine periodically but my insurance covers all my labs so I test a lot of things quite often without cost being a factor for me. Once year on a stable protocol should be enough. I know we've seen a rare few guys that have had a more profound change in level, usually up, but was unexplained and for the life of me I can't think that they had anything really change for them, in the end.

 

[Tommy Wall]

Mine was 30,45 in June last year and now sits at 41,64. The only change I has made was quitting HCG for a month be latest lab work

 

[Cataceous]

... I know we've seen a rare few guys that have had a more profound change in level, usually up, but was unexplained and for the life of me I can't think that they had anything really change for them, in the end.

I can serve as one of these rare cases, with SHBG dropping from 32 nMol/L to 12 in less than a month, confirmed by prior and subsequent measurements. Ostensibly this was caused by suspending use of hCG and the subsequent estradiol crash.

 

[Nashtide]

Okay, thanks guys. I am not changing anything except frequency of Tcyp injections. So I won’t test SHBG this time around.

 

[Vince]

A ten point swing really isn't all that likely to change the landscape of a guys treatment, I know I had read/heard Dr Crisler state as much and that SHBG will swing thru the day.
I run mine periodically but my insurance covers all my labs so I test a lot of things quite often without cost being a factor for me. Once year on a stable protocol should be enough. I know we've seen a rare few guys that have had a more profound change in level, usually up, but was unexplained and for the life of me I can't think that they had anything really change for them, in the end.

Both of the labs, I was using the same protocol.

 

[DragonBits]

I recently switched protocol from E3.5D to EOD, so I will run labs after about 6-8 weeks. I generally only test T and E2. The last time I ran SHBG was about 6 months ago. I will test it again if necessary, but would rather not spend the $ if it’s unnecessary. Thanks and God bless America!

If you don't change anything, I don't think it's necessary.

Actually, if I don't change anything, I think yearly blood test is enough even if a doctor / clinic thinks differently.

My shbg stayed between 36-42 for 3 years.

Recently my SHBG went up to 66 then 73 in April, I haven't retested it since April 2019. But I changed many things, HCG, Metformin, DHEA, Pregnenolone, and supplements. My guess is taking LEF's ulfta prostate formula was responsible for the increase.

If your SHBG does change, it should be reflected in FT, E2, DHT for a similar level of total T. What I would do is if FT/E2 changed a lot (without a protocol change), then check shbg.

I'll recheck shbg whenever I get around to it or if some Doc tells me I have to.

 

[fifty]

Be careful calculating shbg backwards from garbage direct free t data.

 

[Nashtide]

I have never tested DHT. I guess I’ll add it to my next set of labs. I never saw the need. Been bald since I was in my 30’s and have a strong libido.

 

[Cataceous]

...
If your SHBG does change, it should be reflected in FT, E2, DHT for a similar level of total T. What I would do is if FT/E2 changed a lot (without a protocol change), then check shbg.
...

It's different when on TRT. In these cases, if only SHBG changes then total testosterone is what changes. Free testosterone should stay pretty constant so that the testosterone clearance rate continues to match the rate of absorption.

 

[DragonBits]

It's different when on TRT. In these cases, if only SHBG changes then total testosterone is what changes. Free testosterone should stay pretty constant so that the testosterone clearance rate continues to match the rate of absorption.

I was basing my post on the labs I took.

Total T 690: 6 months later > 638
Free T 20.7: 6 months later > 9.6
E2 20.3: 6 months later > 12.3
DHT 74: 6 months later > 43.6
SHBG 41.1: 6 months later > 66.2

One could make a case my total T of 638 was lower than one would have expected, but it wasn't far out of line, and it also isn't that easy to predict as I take Nebido which has a very long half life, what week I test makes a very big difference. The total T of 638 was 54 days after an injection of Nebido.

DHEA also declined a lot since I stopped supplementing it, but I had never noticed DHEA causing any changes in anything other than DHEA levels.

As I mentioned, a lot of things changed, I also stopped taking HCG, along with pregnonolone and stated LEF Ultra Prostate.

These conversions of total T > E2 and DHT depend not only on the amount of T available, they depend on enzymes and other molecules in the body to work, so there are many possible reasons levels could change. In the past before this time with TRT when I was taking no hormones at all, I saw supplementing with boron increase my free T and E2 by 40% and 100% respectively without any real change in total T. FT and E2 were still low, but a lot higher than the previous test.

I saw your tread about testosterone clearance rate and SHBG, but I didn't see if that was based on theory or actual lab tests where SHBG was raised or lowered then affecting Total T.

 

[DragonBits]

I have never tested DHT. I guess I’ll add it to my next set of labs. I never saw the need. Been bald since I was in my 30’s and have a strong libido.

The only reason I first tested DHT was because Defy wanted that test.

The only reason I retested DHT was because my PSA level went up, and it seemed from DRE exams my prostate had grown. I wanted to check DHT as it could be involved.

 

[Cataceous]

I was basing my post on the labs I took.
...

Six months is too much time elapsed to assume other variables have not changed significantly. The T/E2 ratios are inconsistent, due either to measurement variations/errors or changes in aromatase. [Edit: missed the part about hCG; that explains the E2]

...
I saw your thread about testosterone clearance rate and SHBG, but I didn't see if that was based on theory or actual lab tests where SHBG was raised or lowered then affecting Total T.

The idea is based mainly on theory, but it also seems to be supported by my recent lab results.

The hypothesis is pretty easy to explain: On TRT you are absorbing testosterone at a rate that is independent of existing hormonal parameters. For simplicity, assume it's constant. Now suppose SHBG suddenly drops. What happens after things have settled down—within a few hours? Because it's a new steady state, the clearance rate of testosterone must still be equal to the absorption rate—otherwise testosterone would be increasing or decreasing. The clearance rate is proportional to free testosterone, therefore free testosterone must return to it's previous value at steady state. With lower SHBG, achieving the same free testosterone implies lower total testosterone. The predicted changes can be determined with a free T calculator.

Estradiol will behave the same way, with free estradiol returning to its starting value while total estradiol adjusts to account for the new SHBG.

This assumes other parameters related to MCR(T) remain constant, which of course may not hold over longer periods of time.