SHBG and Free Testosterone - Everything You Need to Know

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Nelson Vergel

Founder, ExcelMale.com

Table of Contents​




When people hear about testosterone, they immediately think about muscles, alpha males, confidence, and probably sports cars. This is the most important male sex hormone and one of the most important hormones in the human body.

However, this hormone has several fractions. It is influenced by your lifestyle and it can influence how you think and how you feel. For example, too much sex hormone-binding globulin (SHBG) can decrease free testosterone which can lead to low libido and other symptoms. That is why some men search for ways to decrease SHBG levels.

If you are interested in testosterone fractions and how to naturally increase this sex hormone in your body then keep reading. You will find out more about the bioavailability of testosterone and why it plays a vital role in your health. You will also find out how to decrease SHBG levels.

Testosterone Fractions in Men​


If you do a testosterone test, your doctor will mention your average levels. For example, the generally accepted healthy levels of testosterone for men are between 350 ng/dl and 1,100 ng/dl. If you have a total testosterone level under 350 ng/dL, you might be diagnosed with hypogonadism (testosterone deficiency).

However, this is the total testosterone level in your bloodstream. This hormone is made up of several fractions and they are important too. For example, there are bound testosterone (bound) and free testosterone (non-bound) levels that circulate through your blood. Total testosterone is made up of these two types of testosterone.

Free testosterone makes up for about 2% of your total testosterone levels. This is the one that goes to your muscles, brain, and influences other organs and tissues in your body. The bound testosterone usually attaches to two substances - albumin or SHBG.

The amount of testosterone that is bound to albumin is about a third of your total testosterone. The amount of testosterone that is bound to SHBG is approximately two-thirds of your total testosterone. Albumin is a protein and it carries your testosterone through the bloodstream and releases it as it is needed.

You often hear the term "bioavailable testosterone". This refers to the amount of testosterone that can be used by your body. Luckily, testosterone bound to albumin can detach if necessary and get used as free testosterone. The one bound to SHBG cannot do that.

In this case, the bioavailable testosterone in your body is the sum of free testosterone and albumin-bound testosterone.

How SHBG Influences Free Testosterone​


It's a well-known fact that the levels of albumin in your blood are generally stable. This protein doesn't have massive spikes in quantity for a male adult. On the other hand, SHBG levels can increase and decrease based on various factors.

Most importantly, the levels of SHBG influence how much free testosterone you have in your blood. High levels of SHBG are usually associated with low levels of free testosterone. Less testosterone is available for muscles, the brain, and organs.

The vice-versa is also true. Lower levels of SHBG are associated with higher levels of free testosterone. This can positively influence your mood and libido.

What Factors Influence Your SHBG Levels?​


Multiple types of factors influence how much SHBG there is in your bloodstream. Aging is one of the most important factors. As men age, their SHBG levels will naturally go up while the free testosterone levels will go down.

However, you can do something about the other factors. For example, liver problems can increase SHBG levels in men of all ages. If you have a fatty liver due to chronic alcohol consumption or other reasons, chances are that your SHBG levels are also higher than normal. This is true for other liver problems such as cirrhosis or cancer.

Thyroid problems can also increase SHBG levels. If your thyroid gland is less active or hyperactive, you might start to feel the symptoms of this health issue. Too much estradiol in your body is also responsible for increasing SHBG levels.

Obesity and high triglyceride levels are commonly associated with an increase in SHBG levels in the blood. If you are overweight and your lipid profile is not very good, chances are that your overall testosterone levels might drop.

Finally, inflammation is another factor that could increase SHBG levels and decrease free testosterone ones. Acute inflammation is good for the body to help you fight diseases. Chronic inflammation, on the other hand, can lead to life-threatening issues and raise your SHBG levels.

How Do You Know if Your SHBG Levels Are High?​


A simple blood test provides the best opportunity to test your testosterone levels accurately. Medical technology got very advanced, and it's possible to find out exactly how much testosterone is flowing through your blood quickly and safely.

However, remember that most tests will communicate your total testosterone levels. You should dig a little bit deeper and find out the exact SHBG and free testosterone levels. These are the ones that interest you the most in this case. If the percent of total testosterone that is free testosterone is below 2 percent, then you may have high SHBG.

For example, the optimal SHBG levels in adult males are between 10 and 60 nmol/L. If you have more than that, chances are that your free testosterone levels are also smaller than normal. Ask your doctor for assistance if you cannot figure out the SHBG levels independently. Discounted Labs sells several tests, including the SHBG test as part of lab test panels.



[IMG alt="Factors that increase and decrease SHBG"]https://www.discountedlabs.com/media/wysiwyg/SHBG_level.jpg[/IMG]

How to Lower SHBG and Automatically Increase Free Testosterone Levels?​


Now that you have learned more about SHBG and how it can influence your body, the next obvious question is to find out a way to decrease SHBG levels. You cannot stop the aging process, but you can do something about the other factors that influence SHBG.

Raise Your Total Testosterone Level​


This is the simplest and often the best method to reduce SHBG and increase free testosterone. If your testosterone levels are low, do something to increase them. For example, you can lose weight, start exercising more often and clean your diet of junk food and processed meals.

This will automatically increase your total testosterone level. A fraction of this level is free testosterone, but it's a fraction of something larger than before, so you'll definitely experience its positive effects.

Lower Your Estradiol Levels​


Another way you can reduce your SHBG levels is by lowering the number of estrogens in your body. Estrogens are the maprimaryemale sex hormones but are also needed by the male body. One of the most important estrogens is estradiol. Men have small amounts of estradiol too, but too much can lead to high SHBG levels and even gynecomastia if low testosterone is present.

Lowering estrogen levels is possible for men of all ages. For example, you should avoid soy-based products as these have the tendency to increase your blood estrogen levels. At the same time, try to minimize alcohol consumption, exercise more, lose weight if you are overweight, and get plenty of sleep.

DHEA Supplements Might Help​


DHEA or dehydroepiandrosterone, is one of the most abundant steroids in the human body. It's a weak estrogen and androgen hormone. It serves many purposes in the body and it can be sold as a supplement.

Some studies show that small doses of DHEA administered to men might decrease SHBG levels. However, more research is needed as increasing the levels of DHEA in the body can have serious side effects in the long run.

For example, high levels of DHEA are commonly associated with Parkinson's Disease. This complex neurodegenerative disease can lead to memory loss and poor brain function. If you decide to take DHEA supplements, make sure that you speak with your doctor first.

Remember that these solutions might work for people with SHBG levels higher than normal. If your SHBG level is low, you should not worry about lowering it further.

What if My SHBG Levels Are Already Low?​


In this case, your free testosterone levels are optimal and you don't have to do anything to increase them. However, more SHBG is needed too. This could signify an underlying health condition that must be explored further.

For example, if you have low SHBG in your bloodstream, you might have a fatty liver or metabolic syndrome. This condition can be caused by excessive alcohol consumption or other factors. A liver problem is usually associated with insulin resistance too.

Generally speaking, low SHBG levels are good predictors of diabetes in people of all ages. You must do a blood glucose and a A1c test to see how glucose is processed in your body. If you're pre-diabetic, you can still do something to increase insulin sensitivity and avoid this chronic condition.

Now You Know More About SHBG and the Role It Plays in Your Body!​


Although deciphering the mysteries of testosterone and SHBG is not easy, major medical advancements are made each day. As you can see, too little SHBG is bad, but too much of it is not good either. Patients must aim for an optimal level of SHBG and monitor it closely using a SHBG blood test.

Continue reading...
 
Defy Medical TRT clinic doctor

How SHBG Influences Free Testosterone​


It's a well-known fact that the levels of albumin in your blood are generally stable. This protein doesn't have massive spikes in quantity for a male adult. On the other hand, SHBG levels can increase and decrease based on various factors.

Most importantly, the levels of SHBG influence how much free testosterone you have in your blood. High levels of SHBG are usually associated with low levels of free testosterone. Less testosterone is available for muscles, the brain, and organs.

The vice-versa is also true. Lower levels of SHBG are associated with higher levels of free testosterone. This can positively influence your mood and libido.








 
Last edited by a moderator:
And now we're saying the same thing. If you accept my premise that the exogenous testosterone dose sets free testosterone, then you can use any free T calculator to see that a lower SHBG requires lower total testosterone to maintain a particular free testosterone level.

It's also plausible that low SHBG has a separate effect on underlying metabolism, in the fluid analogy effectively enlarging the hole in the lower tank more than predicted. This effect is not present in my data in the graph above, even with SHBG values ranging from mid-20s nMol/L to mid-40s. But if present maybe it's only significant at even lower levels?
 




The formulas are not producing false results. The confusion arises because they are given in the form

FT = f(TT, SHBG, ALB)

This makes sense when you want to estimate free testosterone and the three function parameters are relatively easy to measure. However, this form creates the perception that total testosterone drives free testosterone, and also encourages the misperception that total testosterone can be treated as constant and directly under our control in the case of TRT. Instead, consider rearranging the formula to

TT = f1(FT, SHBG, ALB)

I've been arguing that this form is more natural with respect to physiology. Free testosterone is driven proportionally by the production rate of testosterone, or by the testosterone dose rate in those on TRT. The relative constancy of free testosterone allows for your observation above that "[Free testosterone] controls TTotal, so that TTotal increases or decreases porporcionalmente at the level of SHBG." If you invert the Vermeulen calculation and ignore albumin then the equation looks something like this:

TT = (a + b * FT + SHBG) * FT / (c * FT + d)

This does imply that total testosterone increases monotonically with SHBG when free testosterone is fixed.
 
1676649189013.png
 
I have seen no further discussion here. No wonder many stay perpetually confused.

Anyone have anything to refute or debate above arguments by @Cataceous ?

Myth: "lowering SHBG *frees up* more T"

No it only improves the ratio of FT to TT (%FT). Lowering SHBG does not increase your absolute FT level. Big difference.

Discuss.
 
Last edited by a moderator:
...
Myth: "lowering SHBG *frees up* more T"
...
I can reiterate a thought experiment to help people with visualization. Suppose in a short period of time we remove a significant fraction of a guy's SHBG along with whatever is bound to it. Suppose further that we alter the regulation of SHBG production such that the lower level of SHBG is maintained. This procedure has no immediate effect on the level of free testosterone. Total testosterone has been reduced by the amount that was attached to the removed SHBG.

Question: What, if anything, has changed that would put downward pressure on free testosterone?

The argument is that there is no pressure on free testosterone precisely because the level hasn't changed. That is, in a functional HPTA there is regulation for the desired level of free testosterone, and this is not changed by the removal of some SHBG. The situation is similar for guys on TRT, except in this case testosterone regulation is via the dose rate of testosterone rather than the HPTA. The dose rate doesn't change in this experiment, so why should free testosterone drop?

To illustrate with the Vermeulen calculator, removing half of a guy's SHBG, albumin = 4.3 g/dL:

Before SHBG removal:
SHBG: 50 nMol/L
TT: 800 ng/dL
FT: 14.1 ng/dL
BioT: 331
SHBG-bound T: 800 - 331 = 469 ng/dL

After SHBG removal:
SHBG: 25 nMol/L
TT: 566 ng/dL
FT: 14.1 ng/dL
BioT: 331
SHBG-bound T: 566 - 331 = 235 ng/dL

Total testosterone after the SHBG removal is about equal to the original total testosterone less the amount of testosterone that was bound to the removed SHBG.
 
High SHBG low free testosterone

With aging our SHBG tends to increase resulting in less free T. A common pattern in lab testing is to have a pretty good total T level with a low free T level, thus effectively resulting in low T. By lowering SHBG one can increase the free T level. ...
In the absence of supporting references this is easily dismissed as a correlation that does not establish causality. In other words, it is like saying that dresses cause breast cancer.

A. SHBG tends to increase with age. OK.
B. Free testosterone tends to decrease with age. OK.
Therefore A causes B. Not OK.

In fact, "B causes A" is the more plausible hypothesis because it's known that androgens tend to decrease SHBG.
 
In the absence of supporting references this is easily dismissed as a correlation that does not establish causality. In other words, it is like saying that dresses cause breast cancer.

A. SHBG tends to increase with age. OK.
B. Free testosterone tends to decrease with age. OK.
Therefore A causes B. Not OK.

In fact, "B causes A" is the more plausible hypothesis because it's known that androgens tend to decrease SHBG.
Does testosterone lower SHBG?


SHBG levels are often decreased in men who present for evaluation of AOH [45, 46]. In this study, 13/14 untreated men with a testosterone level of < 300 ng/dL had an SHBG level of < 30 nmol/L, and increased BMI predicted lower SHBG levels in not only untreated but also testosterone-treated men.

 
Does testosterone lower SHBG?
...
Yes, [free] androgens, including testosterone, tend to lower SHBG. In turn, lower SHBG leads to lower total testosterone, without much effect on free levels.

The second reference is just plain wrong.

If our SHBG levels are higher, we’ll have less testosterone or oestrogen available. If our SHBG levels are lower, we’ll have more testosterone and oestrogen available.

This reasoning depends on total testosterone being held constant. As I have explained many times before, this is not physiological. The HPTA does not regulate according to total testosterone; it sets free testosterone. For those on TRT a fixed dose rate leads to constant free testosterone, not constant total testosterone.
 
Yes, [free] androgens, including testosterone, tend to lower SHBG. In turn, lower SHBG leads to lower total testosterone, without much effect on free levels.

The second reference is just plain wrong.

If our SHBG levels are higher, we’ll have less testosterone or oestrogen available. If our SHBG levels are lower, we’ll have more testosterone and oestrogen available.

This reasoning depends on total testosterone being held constant. As I have explained many times before, this is not physiological. The HPTA does not regulate according to total testosterone; it sets free testosterone. For those on TRT a fixed dose rate leads to constant free testosterone, not constant total testosterone.
Cut my SHBG in about half (55 to 30) after over 5 years on TRT and TOT. Of course we could post peer reviewed literature till the cows come home as they say but nobody really wants that, right?

@Vince The above gets into association vs causation, diabetes, AOH, etc which creates a lot of confusion as to what is causing what. Lurking variable/effects, etc.
 
Last edited by a moderator:
...
@Vince The above gets into association vs causation, diabetes, AOH, etc which creates a lot of confusion as to what is causing what. Lurking variable/effects, etc.
Throw fatty liver in there too. We had a pretty detailed discussion of this Winters article starting here:
 
Throw fatty liver in there too. We had a pretty detailed discussion of this Winters article starting here:
Good point. I used etc but should have added obesity, met syndrome, liver,...

Thanks!

Thousands of posts later here we are. Seems like the definition of insanity haha.
 
Throw fatty liver in there too. We had a pretty detailed discussion of this Winters article starting here:
Yes we heard this many times. Repeating the same thing over and over again.

SHBG has been shown to increase in parallel with a decrease in intrahepatic fat mass, assessed using ultrasound, computed tomography, or magnetic resonance imaging.

 

Table of Contents​




When people hear about testosterone, they immediately think about muscles, alpha males, confidence, and probably sports cars. This is the most important male sex hormone and one of the most important hormones in the human body.

However, this hormone has several fractions. It is influenced by your lifestyle and it can influence how you think and how you feel. For example, too much sex hormone-binding globulin (SHBG) can decrease free testosterone which can lead to low libido and other symptoms. That is why some men search for ways to decrease SHBG levels.

If you are interested in testosterone fractions and how to naturally increase this sex hormone in your body then keep reading. You will find out more about the bioavailability of testosterone and why it plays a vital role in your health. You will also find out how to decrease SHBG levels.

Testosterone Fractions in Men​


If you do a testosterone test, your doctor will mention your average levels. For example, the generally accepted healthy levels of testosterone for men are between 350 ng/dl and 1,100 ng/dl. If you have a total testosterone level under 350 ng/dL, you might be diagnosed with hypogonadism (testosterone deficiency).

However, this is the total testosterone level in your bloodstream. This hormone is made up of several fractions and they are important too. For example, there are bound testosterone (bound) and free testosterone (non-bound) levels that circulate through your blood. Total testosterone is made up of these two types of testosterone.

Free testosterone makes up for about 2% of your total testosterone levels. This is the one that goes to your muscles, brain, and influences other organs and tissues in your body. The bound testosterone usually attaches to two substances - albumin or SHBG.

The amount of testosterone that is bound to albumin is about a third of your total testosterone. The amount of testosterone that is bound to SHBG is approximately two-thirds of your total testosterone. Albumin is a protein and it carries your testosterone through the bloodstream and releases it as it is needed.

You often hear the term "bioavailable testosterone". This refers to the amount of testosterone that can be used by your body. Luckily, testosterone bound to albumin can detach if necessary and get used as free testosterone. The one bound to SHBG cannot do that.

In this case, the bioavailable testosterone in your body is the sum of free testosterone and albumin-bound testosterone.

How SHBG Influences Free Testosterone​


It's a well-known fact that the levels of albumin in your blood are generally stable. This protein doesn't have massive spikes in quantity for a male adult. On the other hand, SHBG levels can increase and decrease based on various factors.

Most importantly, the levels of SHBG influence how much free testosterone you have in your blood. High levels of SHBG are usually associated with low levels of free testosterone. Less testosterone is available for muscles, the brain, and organs.

The vice-versa is also true. Lower levels of SHBG are associated with higher levels of free testosterone. This can positively influence your mood and libido.

What Factors Influence Your SHBG Levels?​


Multiple types of factors influence how much SHBG there is in your bloodstream. Aging is one of the most important factors. As men age, their SHBG levels will naturally go up while the free testosterone levels will go down.

However, you can do something about the other factors. For example, liver problems can increase SHBG levels in men of all ages. If you have a fatty liver due to chronic alcohol consumption or other reasons, chances are that your SHBG levels are also higher than normal. This is true for other liver problems such as cirrhosis or cancer.

Thyroid problems can also increase SHBG levels. If your thyroid gland is less active or hyperactive, you might start to feel the symptoms of this health issue. Too much estradiol in your body is also responsible for increasing SHBG levels.

Obesity and high triglyceride levels are commonly associated with an increase in SHBG levels in the blood. If you are overweight and your lipid profile is not very good, chances are that your overall testosterone levels might drop.

Finally, inflammation is another factor that could increase SHBG levels and decrease free testosterone ones. Acute inflammation is good for the body to help you fight diseases. Chronic inflammation, on the other hand, can lead to life-threatening issues and raise your SHBG levels.

How Do You Know if Your SHBG Levels Are High?​


A simple blood test provides the best opportunity to test your testosterone levels accurately. Medical technology got very advanced, and it's possible to find out exactly how much testosterone is flowing through your blood quickly and safely.

However, remember that most tests will communicate your total testosterone levels. You should dig a little bit deeper and find out the exact SHBG and free testosterone levels. These are the ones that interest you the most in this case. If the percent of total testosterone that is free testosterone is below 2 percent, then you may have high SHBG.

For example, the optimal SHBG levels in adult males are between 10 and 60 nmol/L. If you have more than that, chances are that your free testosterone levels are also smaller than normal. Ask your doctor for assistance if you cannot figure out the SHBG levels independently. Discounted Labs sells several tests, including the SHBG test as part of lab test panels.



[IMG alt="Factors that increase and decrease SHBG"]https://www.discountedlabs.com/media/wysiwyg/SHBG_level.jpg[/IMG]

How to Lower SHBG and Automatically Increase Free Testosterone Levels?​


Now that you have learned more about SHBG and how it can influence your body, the next obvious question is to find out a way to decrease SHBG levels. You cannot stop the aging process, but you can do something about the other factors that influence SHBG.

Raise Your Total Testosterone Level​


This is the simplest and often the best method to reduce SHBG and increase free testosterone. If your testosterone levels are low, do something to increase them. For example, you can lose weight, start exercising more often and clean your diet of junk food and processed meals.

This will automatically increase your total testosterone level. A fraction of this level is free testosterone, but it's a fraction of something larger than before, so you'll definitely experience its positive effects.

Lower Your Estradiol Levels​


Another way you can reduce your SHBG levels is by lowering the number of estrogens in your body. Estrogens are the maprimaryemale sex hormones but are also needed by the male body. One of the most important estrogens is estradiol. Men have small amounts of estradiol too, but too much can lead to high SHBG levels and even gynecomastia if low testosterone is present.

Lowering estrogen levels is possible for men of all ages. For example, you should avoid soy-based products as these have the tendency to increase your blood estrogen levels. At the same time, try to minimize alcohol consumption, exercise more, lose weight if you are overweight, and get plenty of sleep.

DHEA Supplements Might Help​


DHEA or dehydroepiandrosterone, is one of the most abundant steroids in the human body. It's a weak estrogen and androgen hormone. It serves many purposes in the body and it can be sold as a supplement.

Some studies show that small doses of DHEA administered to men might decrease SHBG levels. However, more research is needed as increasing the levels of DHEA in the body can have serious side effects in the long run.

For example, high levels of DHEA are commonly associated with Parkinson's Disease. This complex neurodegenerative disease can lead to memory loss and poor brain function. If you decide to take DHEA supplements, make sure that you speak with your doctor first.

Remember that these solutions might work for people with SHBG levels higher than normal. If your SHBG level is low, you should not worry about lowering it further.

What if My SHBG Levels Are Already Low?​


In this case, your free testosterone levels are optimal and you don't have to do anything to increase them. However, more SHBG is needed too. This could signify an underlying health condition that must be explored further.

For example, if you have low SHBG in your bloodstream, you might have a fatty liver or metabolic syndrome. This condition can be caused by excessive alcohol consumption or other factors. A liver problem is usually associated with insulin resistance too.

Generally speaking, low SHBG levels are good predictors of diabetes in people of all ages. You must do a blood glucose and a A1c test to see how glucose is processed in your body. If you're pre-diabetic, you can still do something to increase insulin sensitivity and avoid this chronic condition.

Now You Know More About SHBG and the Role It Plays in Your Body!​


Although deciphering the mysteries of testosterone and SHBG is not easy, major medical advancements are made each day. As you can see, too little SHBG is bad, but too much of it is not good either. Patients must aim for an optimal level of SHBG and monitor it closely using a SHBG blood test.

Continue reading...
good info, has anyone had success with lowering SHBG with Boron, or anything else, If I raise my T it increases DHT and my PSA and hairloss are issues, I am on 7mg a day Boron but its not made much difference
 
good info, has anyone had success with lowering SHBG with Boron, or anything else, If I raise my T it increases DHT and my PSA and hairloss are issues, I am on 7mg a day Boron but its not made much difference
I also supplement with boron, I started using it for bone health. I would combine it with magnesium and zinc.
 
I also supplement with boron, I started using it for bone health. I would combine it with magnesium and zinc.
I take Mag and Zinc, how much boron do you take, I heard (maybe not true) that it can be liver toxic and to take breaks from it, thats maybe not right either
 
Beyond Testosterone Book by Nelson Vergel
I take Mag and Zinc, how much boron do you take, I heard (maybe not true) that it can be liver toxic and to take breaks from it, thats maybe not right either
I'm at work right now. I would have to check but I think I take 10 mg twice a day.
 
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