Low SHBG and Estradiol by Dr. Marianco.
- 09-12-2006, 09:15 AM
Low SHBG and Estradiol by Dr. Marianco.
The most common cause of low SHBG is excessive insulin - i.e. insulin resistance. Insulin resistance in turn leads to a cascade of events which results other hormone imbalances such as low testosterone production, suboptimal thyroid hormone activity, adrenal fatigue, etc.
Factors which together in a balance determine SHBG are:
1. Anabolic hormones generally reduce SHBG. These include testosterone, DHEA, insulin, DHT, and growth hormone.
2. Thyroid hormone, Estrogens, and Progesterone (by increasing estrogen receptors/sensitivity), increase SHBG.
In the absence of insulin resistance, the most common other cause of low SHBG is a very high level of other anabolic hormones - most frequency high testosterone from TRT. Those who use anabolic steroids at high doses often drive their SHBG to near zero.
When total testosterone is between 650 to 1000 ng/dl, and a person still has zero sex drive, I would look for other causes for sexual dysfunction - e.g. other hormone, neurotransmitter, or immune system problems.
Raising SHBG does not necessarily increase the risk for Alzheimer's disease. It is important to keep in mind the factors which lead to the risk of Alzheimer's disease.
Insulin resistance (i.e. excessive insulin levels) causes low SHBG. It also greatly increases the risk of Alzheimer's disease because it results in a higher level of inflammatory cytokine production (Cytokines are the chemical messengers of the immune system). It is the inflammation which is one of the underlying factors which leads to Alzheimer's disease.
SHBG level is most often a signal of the overall status of multiple hormone levels. The balance may give an indication of whether one is in an pro-inflammatory state or anti-inflammatory state - with inflammation leading to disease such as Alzheimer's disease, heart disease, strokes, cancer, etc. Some hormones such as some estrogens and insulin can lead to inflammation leading to illness. And other hormones such as the androgens (except DHT), growth hormone, and thyroid hormone, can lead to an antiinflammatory state, reducing the risk for illness. The balance determines the person's risk for illness.
What estradiol level is best for any individual often needs to be determined by trial and error. It is unique for each individual. Most do best around 30 pg/ml. But some do best at lower and higher levels. For example, I have a 65 y.o. patient with a total testosterone of 840 ng/dl and an estradiol of 47 pg/ml. He's having the time of his life - able to make love numerous times each night - after more than a decade of having no sex. The estradiol level works for him without side effects. Some may do better with much loser levels of estradiol - the response is highly individualistic.
Even with low SHBG - which is difficult to correct since it depends on the balance of so many hormones - when the other hormones and neurotransmitters are optimized, sex drive and the ability to have an erection can often return.
When total testosterone is supraphysiologic - i.e. over 1000 ng/dl - problems with libido and erections may occur. Testosterone increases dopamine in the brain in order to increase sex drive, reduce depression, give pleasure to activities. The problem is that dopamine is a very fragile neurotransmitter/hormone in its effects. Too high a dopamine level can cause tolerance to dopamine. This is similar to how one can develop tolerance to drugs such as cocaine and amphetamines which increase dopamine levels in the brain to cause their high. This can lead to the loss of libido when high testosterone levels are maintained for long periods of time.
Conversely, when one is deprived of testosterone (and hence dopamine) for long periods of time due to hypogonadism, one can get a high during the first few weeks of testosterone treatment since the brain becomes supersensitive to dopamine when it has been deprived of it (e.g. making more dopamine receptors to pick up the weaker dopamine signals). Unfortunately, as the brain then gets use to the higher dopamine levels, it will develop some tolerance, and libido will drop off - though we often wish that hopefully a good amount remains.
Any statement I make on this site is for educational purposes only and is subject to change. It does not constitute medical advice, does not substitute for proper medical evaluation from physician, does not create a doctor/patient relationship or liability. If you would like medical advice, you will have to make an appointment. Thank you.
- 09-12-2006, 01:56 PM
I seem to be subject to frequent bouts of hypoglycemia (diziness, weak, and sweating), which I try to control by snacking frequently, would this be caused by excessive insulin?
09-12-2006, 02:20 PM
Potentially, or it may be because your insulin sensitivity is really high.
What does your diet look like?
The topic of SHGB is a good one and I'd like to keep it going in leiu of the newer supplements that drive SHGB levels down.
What are the effects of long term suppression of SHGB?
09-12-2006, 02:37 PM
09-12-2006, 03:58 PM
My diet has not been too good, too much coffee, processed bread, and I do like my sweets for desert.
I also experience fatigue and insomnia.
I plan on improving my diet, I have been considering HRT, but based on this thread, maybe its not such a good idea?
09-12-2006, 04:05 PM
Based on that, you should possibly be somewhat insulin resistant due to high spikes/amounts of insulin from high-glycemic foods. This all depends on how much and how often you eat these foods. Processed foods are the worst, as they generally have a high GI, and lack the nutrition to make you feel full, so you end up eating too much. Also, many people aren't aware that caffeine spikes insulin.Originally Posted by bobi
09-12-2006, 09:53 PM
It would be interesting to examine whether those supps that merely bind to SHBG are BETTER than those that reduce SHBG.
If SHBG levels are left alone it seems the body will not alter other hormonal levels...I wonder if the body would count bound SHBG the same as unbound SHBG.
09-13-2006, 01:58 AM
I've also been wondering that IF you can lower or bind SHBG and achieve elevated levels of free testosterone for extended periods of time;
1. what impact would this have on lipid values if any?
2. if it were proven safe, would this be a viable alternative to exogenous test use?
3. What's the overall impact of lowering or binding SHGB for extended periods of time on the function of the HPTA as well as all the other endocrinological parameters?
09-13-2006, 05:25 PM
Originally Posted by bioman1
From bloodwork the use of Nettle Root for 2 months had no impact on my lipids while Free Test was up some.
Granted this is NOT an extended time period AND the binding to SHBG was not nearly as extensive as using something like Activate...and of course this is just one man's bloodwork. It would be interesting to see other Activate or Nettle Root user's lipid panel results. I know DS had some users of Activate get some bloodwork to measure free test...maybe they also have the lipid data we seek.
My guess and this is purely a guess is that raising free test for some period of time will help build muscle mass and would be an alternative to administering testosterone. But the body always seems to want to achieve homeostasis...so I would imagine that older guys with lower natural free test to begin with might get a bigger bang than younger guys who are already near the natural upper range of free test.
You really zero'd in on the key question, assuming there is a benefit "what would be the impact on HPTA and other endocrinological parameters from long term SHBG manipulation?" Maybe some of the doctors involved in HRT might be able to provide us with some data to help us explore this answer.
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