# How do I fix low SHBG?



## lifeinoso (Nov 21, 2022)

I have very low SHBG? how do I increase it? 

I'm on 175mg Test C per week and .25 mg arimidex every 3 days:

Total T = 843 (reference range 250-1100), 
Free T = 297 (reference range 35-155) 
Estrodiol = 20 (reference range 0-39)
SHBG = 4 (reference range 15-95)
Albumin = 5.2 (reference range 3.2-4.8)


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## almostgone (Nov 21, 2022)

Why do you prefer it to be higher?


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## lifeinoso (Nov 21, 2022)

So that it regulates my free T?
Is there no issue with having low SHBG? I appreciate any education. I’m trying to find answers. 
If I can’t raise SHBG, should I lower my testosterone dose so I have normal free T levels?


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## almostgone (Nov 21, 2022)

If your normal SHBG levels are low, your free T will be lower than if SHBG was in range.
I would adjust you dosage downward if you're trying to get your free I in range.

Usually guys are trying to lower SHBG instead of raising it and they don't have many outward symptoms.


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## almostgone (Nov 21, 2022)

How do you feel with your estradiol at that dosage of a'dex? Typically, you see guys that feel better in the upper end of the range.
Like you, my SHBG level is very low and my E2 runs low with no ai usage, but I feel fine...no achy joints, etc.


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## lifeinoso (Nov 21, 2022)

almostgone said:


> If your normal SHBG levels are low, your free T will be lower than if SHBG was in range.
> I would adjust you dosage downward if you're trying to get your free I in range.
> 
> Usually guys are trying to lower SHBG instead of raising it and they don't have many outward symptoms.





almostgone said:


> How do you feel with your estradiol at that dosage of a'dex? Typically, you see guys that feel better in the upper end of the range.
> Like you, my SHBG level is very low and my E2 runs low with no ai usage, but I feel fine...no achy joints, etc.


Generally  feel fine with these estrogen levels. Definitely have to warm up well before doing something like heavy squats though or I feel uncomfortable pressure in my knees. Before I added in adex my blood pressure would get a bit too high at times. I retain less fluid with with the added AI and helps my blood pressure stay in range.

My understanding is that free T is most important to optimize rather that total T. I’ll probably lower my dose a bit to get in range for free T since I’m not aware of how to change my SHBG and I don’t see it rising on its own even after being on T for 4 months.


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## lifeinoso (Nov 21, 2022)

almostgone said:


> If your normal SHBG levels are low, your free T will be lower than if SHBG was in range.
> I would adjust you dosage downward if you're trying to get your free I in range.
> 
> Usually guys are trying to lower SHBG instead of raising it and they don't have many outward symptoms.


Would you say it doesn’t  really matter what total T level is as long as free T is optimal?

I’m also just curious why my SHBG isn’t kicking in to lower my free T.


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## almostgone (Nov 22, 2022)

Free T  is the amount of testosterone that isn't bound by proteins/glycoprotein or converted by aromatization and is available for your body to use.


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## lifeinoso (Nov 22, 2022)

almostgone said:


> Free T  is the amount of testosterone that isn't bound by proteins/glycoprotein or converted by aromatization and is available for your body to use.


Yes I understand that. I’m just a bit confused why my body is allowing high levels of free T and not ramping up SHBG to bind it up.


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## almostgone (Nov 22, 2022)

lifeinoso said:


> Yes I understand that. I’m just a bit confused why my body is allowing high levels of free T and not ramping up SHBG to bind it up.


About all I can offer you is that low SHBG hasn't caused me any problems and I'm at 58 and been on Dr. ordered T  for ~20 years ( I believe that's right.

SHBG is regulated by several factors including androgens as to a lesser degree estrogens. Also, your own metabolism and possibly insulin levels are though to to have an effect.

I would consider lowering your dosage to around .3 cc/~67 mg twice per week. You should be able to lower your a'dex somewhat to. Try that for 4-6 weeks and pull the panel you to compare at least free T and SHBG.


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## almostgone (Nov 22, 2022)

I'm kind of wondering if they flubbed the free T panel.


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## lifeinoso (Nov 22, 2022)

almostgone said:


> About all I can offer you is that low SHBG hasn't caused me any problems and I'm at 58 and been on Dr. ordered T  for ~20 years ( I believe that's right.
> 
> SHBG is regulated by several factors including androgens as to a lesser degree estrogens. Also, your own metabolism and possibly insulin levels are though to to have an effect.
> 
> I would consider lowering your dosage to around .3 cc/~67 mg twice per week. You should be able to lower your a'dex somewhat to. Try that for 4-6 weeks and pull the panel you to compare at least free T and SHBG.


Appreciate the input. Thanks man.


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## TiredandHot (Nov 22, 2022)

Is this the same result you got on previous bloodwork or the first time seeing this? You might just have naturally low shbg and higher free t. I could be wrong but I don't see lowering your test dose to have a significant impact on raising shbg.  I guess it's worth a try.


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## lifeinoso (Nov 22, 2022)

Since free T is calculated based off total T and SHBG, perhaps my free T isn’t as high as the panel is showing if you take into account  my high albumin. 
What do you think of that hypothesis?


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## lifeinoso (Nov 22, 2022)

TiredandHot said:


> Is this the same result you got on previous bloodwork or the first time seeing this? You might just have naturally low shbg and higher free t. I could be wrong but I don't see lowering your test dose to have a significant impact on raising shbg.  I guess it's worth a try.


Yes I’ve had low SHBG before getting on T as well as after. Same results in 3 different tests over the last year.


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## almostgone (Nov 22, 2022)

lifeinoso said:


> Since free T is calculated based off total T and SHBG, perhaps my free T isn’t as high as the panel is showing if you take into account  my high albumin.
> What do you think of that hypothesis?


I'm not sure about that because albumin has a nonspecific limited affinity for androgens.
I would bring it up with your PCP/TRT provider


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## almostgone (Nov 22, 2022)

About the only thing I can think of Prl is rhat ( prolactin) can effect SHBG. Insulin resistance and metabolic syndrome can blunt SHBG levels as well.


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## GreenAmine (Nov 22, 2022)

lifeinoso said:


> why my SHBG isn’t kicking in to lower my free T.


Literature is scant on this subject, but if testosterone acts like any other biomolecule in this regard, then your body lowered SHBG (which "protects" T) so that more testosterone will be converted to estrogen/DHT/etc. or tagged for excretion since plasma concentrations are higher than what the body wants. The lowering of SHBG is part of a feedback mechanism that helps maintain homeostasis.

T that is bound to SHBG and serum albumin is not useless. Cells have SHBG receptors, which are activated when an SHBG-hormone complex attaches to its binding site.

If you feel fine, then don't worry about it. Lowering your dose might help, but I personally wouldn't mess with it if it's working.


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## lifeinoso (Nov 22, 2022)

almostgone said:


> About the only thing I can think of Prl is rhat ( prolactin) can effect SHBG. Insulin resistance and metabolic syndrome can blunt SHBG levels as well.


My prolactin currently is right in mid range, used to be high, but lowered it with P5P. SHBG didn’t change though.


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## lifeinoso (Nov 22, 2022)

GreenAmine said:


> Literature is scant on this subject, but if testosterone acts like any other biomolecule in this regard, then your body lowered SHBG (which "protects" T) so that more testosterone will be converted to estrogen/DHT/etc. or tagged for excretion since plasma concentrations are higher than what the body wants. The lowering of SHBG is part of a feedback mechanism that helps maintain homeostasis.
> 
> T that is bound to SHBG and serum albumin is not useless. Cells have SHBG receptors, which are activated when an SHBG-hormone complex attaches to its binding site.
> 
> If you feel fine, then don't worry about it. Lowering your dose might help, but I personally wouldn't mess with it if it's working.


Thanks for the input


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## lifeinoso (Nov 22, 2022)

almostgone said:


> I'm not sure about that because albumin has a nonspecific limited affinity for androgens.
> I would bring it up with your PCP/TRT provider


I’m my own TRT provider


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## BigBaldBeardGuy (Nov 22, 2022)

lifeinoso said:


> I have very low SHBG? how do I increase it?
> 
> I'm on 175mg Test C per week and .25 mg arimidex every 3 days:
> 
> ...



Take Metformin. 

SHBG is lowered by insulin resistance. Metformin is used to treat Type 2 diabetes because it works against insulin resistance.


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## lifeinoso (Nov 22, 2022)

BigBaldBeardGuy said:


> Take Metformin.
> 
> SHBG is lowered by insulin resistance. Metformin is used to treat Type 2 diabetes because it works against insulin resistance.


Great idea I’ll look into it


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## lifeinoso (Nov 22, 2022)

lifeinoso said:


> … Thing is, I’m already using Semaglutide (GLP-1) so not sure if taking Metformin would be redundant.


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## lifeinoso (Nov 22, 2022)

BigBaldBeardGuy said:


> Take Metformin.
> 
> SHBG is lowered by insulin resistance. Metformin is used to treat Type 2 diabetes because it works against insulin resistance.


Doesn’t a GLP-1 like semaglutide have similar effects on insulin sensitivity?  Because I’m already using that.


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## lifeinoso (Nov 22, 2022)

lifeinoso said:


> Doesn’t a GLP-1 like semaglutide have similar effects on insulin sensitivity?  Because I’m already using that.


I should probably test my A1C anyways.


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## lifeinoso (Nov 25, 2022)

BigBaldBeardGuy said:


> Take Metformin.
> 
> SHBG is lowered by insulin resistance. Metformin is used to treat Type 2 diabetes because it works against insulin resistance.


Actually I’m going to try Berberine first.


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