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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Low SHBG ! Good or bad?
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<blockquote data-quote="Okian" data-source="post: 14304" data-attributes="member: 2810"><p><strong>Low SHBG - by Dr. Mariano , Physician, Psychiatrist </strong></p><p><strong></strong></p><p></p><p><em>'' Testosterone, itself, will drive SHBG down.</em></p><p><em></em></p><p> <em>Estrogen will increase SHBG. </em></p><p><em></em></p><p><em>Thus controlling estradiol will lower SHBG. </em></p><p><em></em></p><p><em>Insulin also will drive SHBG down. Insulin has the strongest effect on SHBG, compared to any other factor. </em></p><p><em></em></p><p><em>Low SHBG is a good sign that a person has insulin resistance or diabetes - with lowers testosterone production. </em></p><p><em></em></p><p><em>Insulin resistance or diabetes greatly increases the risk for cardiovascular disease. </em></p><p><em></em></p><p><em>Realize that SHBG is determined by multiple hormones: Estrogen, Progesterone, Thyroid hormone, Testosterone, DHEA, Growth Hormone, Insulin, etc. </em></p><p><em></em></p><p><em>Thus, whatever SHBG one has - outside of a low level, for which problems with insulin need to be assess, does not tell if something is wrong since the effects of these hormones may cancel each other out.</em></p><p><em></em></p><p><em>Thus, a specific SHBG, outside of diabetes, does not tell much about what is happening with a person.</em></p><p><em></em></p><p><em>I generally do not like driving SHBG too low since testosterone and estrogen won't last long in the body.</em></p><p><em></em></p><p><em>The lower the SHBG, the more likely testosterone level is going to be low since free testosterone has a half-life of only 10 to 100 minutes.</em></p><p><em></em></p><p><em>Without SHBG, nearly all testosterone (unless it is continuously produced) would be gone from the body in less than about 50 minutes to 8 hours, being destroyed by degradative enzymes, such as by those in the liver.</em></p><p><em></em></p><p><em>SHBG makes testosterone last longer. </em></p><p><em></em></p><p><em>The higher the SHBG, the lower the dose of testosterone is needed in treatment.</em></p><p><em></em></p><p><em>Insulin, by reducing SHBG, contributes to hypogonadism in diabetes.</em></p><p><em></em></p><p><em>The lower the SHBG, the more frequent testosterone dosing needs to be done to maintain a given testosterone level.</em></p><p><em></em></p><p> <em>The lower the SHBG, the more rollercoaster a person's experience with testosterone.</em></p><p><em></em></p><p><em>Let's look at what influences SHBG:</em></p><p><em></em></p><p><em><strong>Increases SHBG:</strong></em></p><p><em></em></p><p><em>Estrogens (particularly Estradiol)</em></p><p><em>Progesterone (by increasing Estrogen receptors)</em></p><p><em>Thyroid Hormone (particularly Hyperthyroidism)</em></p><p><em>Liver Disease</em></p><p><em>Anorexia, Starvation</em></p><p><em>Hypoglycemia (low insulin)</em></p><p><em></em></p><p><em><strong>Reduces SHBG:</strong></em></p><p><em></em></p><p><em>Insulin (and insulin resistance)</em></p><p><em>Testosterone</em></p><p><em>Growth Hormone</em></p><p><em>DHEA</em></p><p><em>Other Androgens</em></p><p><em>Obesity</em></p><p><em>Hypothyroidism</em></p><p><em>Excessive Cortisol (Cushing's Syndrome or Disease)</em></p><p><em>Progestins (such as by blocking progesterone's effects)</em></p><p><em>Excessively high SHBG may indicate factors increasing SHBG may be in excess in thus should be addressed. For example, an excess of Estrogen to testosterone may result in high SHBG.</em></p><p><em></em></p><p><em>Since SHBG is determined by several hormones, it is not generally a good component to address directly. </em></p><p><em></em></p><p><em>Rather the influences affecting SHBG should be addressed independently of SHBG.</em></p><p><em></em></p><p><em>Testosterone replacement alone will drive down SHBG. </em></p><p><em></em></p><p><em>Low SHBG, high free testosterone but LOW total testosterone is common in diabetes. </em></p><p><em></em></p><p><em>From my point of view, overly focusing on SHBG when trying to improve libido once total testosterone is raised to at least 650 ng/dL is a fairly narrow point of view.</em></p><p><em></em></p><p><em>Free Testosterone is only a fraction of Testosterone signaling.</em></p><p><em></em></p><p> <em>Free Testosterone too often does not determine libido. </em></p><p><em></em></p><p><em>One can use Bioavailable Testosterone as a measure of testosterone's signaling strength.</em></p><p><em></em></p><p> <em>I, myself, consider total testosterone more important. </em></p><p><em></em></p><p><em>Testosterone which isn't free - but is bound to SHBG - also has signaling function on SHBG receptors.</em></p><p><em></em></p><p><em>To take this function into account, I use total testosterone as a clearer measure of testosterone signaling.</em></p><p><em></em></p><p><em>If one focuses on the factors that determine SHBG and focus on optimizing them or treating the disease condition involved, then one hardly needs to measure SHBG at all. </em></p><p><em></em></p><p><em>High or low, SHBG indicates something is wrong but does not tell you what is wrong. Thus, alone, it is not a useful measure. </em></p><p><em></em></p><p><em>SHBG within the reference range also doesn't tell if something is wrong. Factors that influence SHBG can cancel each other out, thus SHBG will be in the reference range.</em></p><p><em></em></p><p><em>Thus, one still has to optimize each factor that influences SHBG separately.</em></p><p><em></em></p><p><em>As a result of these considerations, SHBG is a minor player. I would look at the other issues that influence SHBG instead in their own right as more important considerations. ''</em></p></blockquote><p></p>
[QUOTE="Okian, post: 14304, member: 2810"] [B]Low SHBG - by Dr. Mariano , Physician, Psychiatrist [/B] [I]'' Testosterone, itself, will drive SHBG down. Estrogen will increase SHBG. Thus controlling estradiol will lower SHBG. Insulin also will drive SHBG down. Insulin has the strongest effect on SHBG, compared to any other factor. Low SHBG is a good sign that a person has insulin resistance or diabetes - with lowers testosterone production. Insulin resistance or diabetes greatly increases the risk for cardiovascular disease. Realize that SHBG is determined by multiple hormones: Estrogen, Progesterone, Thyroid hormone, Testosterone, DHEA, Growth Hormone, Insulin, etc. Thus, whatever SHBG one has - outside of a low level, for which problems with insulin need to be assess, does not tell if something is wrong since the effects of these hormones may cancel each other out. Thus, a specific SHBG, outside of diabetes, does not tell much about what is happening with a person. I generally do not like driving SHBG too low since testosterone and estrogen won't last long in the body. The lower the SHBG, the more likely testosterone level is going to be low since free testosterone has a half-life of only 10 to 100 minutes. Without SHBG, nearly all testosterone (unless it is continuously produced) would be gone from the body in less than about 50 minutes to 8 hours, being destroyed by degradative enzymes, such as by those in the liver. SHBG makes testosterone last longer. The higher the SHBG, the lower the dose of testosterone is needed in treatment. Insulin, by reducing SHBG, contributes to hypogonadism in diabetes. The lower the SHBG, the more frequent testosterone dosing needs to be done to maintain a given testosterone level. The lower the SHBG, the more rollercoaster a person's experience with testosterone. Let's look at what influences SHBG: [B]Increases SHBG:[/B] Estrogens (particularly Estradiol) Progesterone (by increasing Estrogen receptors) Thyroid Hormone (particularly Hyperthyroidism) Liver Disease Anorexia, Starvation Hypoglycemia (low insulin) [B]Reduces SHBG:[/B] Insulin (and insulin resistance) Testosterone Growth Hormone DHEA Other Androgens Obesity Hypothyroidism Excessive Cortisol (Cushing's Syndrome or Disease) Progestins (such as by blocking progesterone's effects) Excessively high SHBG may indicate factors increasing SHBG may be in excess in thus should be addressed. For example, an excess of Estrogen to testosterone may result in high SHBG. Since SHBG is determined by several hormones, it is not generally a good component to address directly. Rather the influences affecting SHBG should be addressed independently of SHBG. Testosterone replacement alone will drive down SHBG. Low SHBG, high free testosterone but LOW total testosterone is common in diabetes. From my point of view, overly focusing on SHBG when trying to improve libido once total testosterone is raised to at least 650 ng/dL is a fairly narrow point of view. Free Testosterone is only a fraction of Testosterone signaling. Free Testosterone too often does not determine libido. One can use Bioavailable Testosterone as a measure of testosterone's signaling strength. I, myself, consider total testosterone more important. Testosterone which isn't free - but is bound to SHBG - also has signaling function on SHBG receptors. To take this function into account, I use total testosterone as a clearer measure of testosterone signaling. If one focuses on the factors that determine SHBG and focus on optimizing them or treating the disease condition involved, then one hardly needs to measure SHBG at all. High or low, SHBG indicates something is wrong but does not tell you what is wrong. Thus, alone, it is not a useful measure. SHBG within the reference range also doesn't tell if something is wrong. Factors that influence SHBG can cancel each other out, thus SHBG will be in the reference range. Thus, one still has to optimize each factor that influences SHBG separately. As a result of these considerations, SHBG is a minor player. I would look at the other issues that influence SHBG instead in their own right as more important considerations. ''[/I] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Low SHBG ! Good or bad?
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