need a lesson on SHBG

[qwestar]

SHBG, well I don't know too much about it. I know that sex hormones are bound to it, but,
What is the best level of SHBG?

How should a low SHBG and high estrogen level be percieved? I have a pretty extensive history of higher estrogen levels, and my Dr. says high E2 and low SHBG is indicative of a very high level of free estrogens in my body. Why exactly is that?

this was bloodwork while on HRT cyp 200 mgs/wk

E2 ultrasensitive 43 (10-50)
Total Test 794 (250-1000)
SHBG 11 (7-49)

free test% 2.4 (1.0-2.7)
Free Test 190.2 (50.0-210.0)

Thanks

 

[JanSz]

SHBG, well I don't know too much about it. I know that sex hormones are bound to it, but,
What is the best level of SHBG?

How should a low SHBG and high estrogen level be percieved? I have a pretty extensive history of higher estrogen levels, and my Dr. says high E2 and low SHBG is indicative of a very high level of free estrogens in my body. Why exactly is that?

this was bloodwork while on HRT cyp 200 mgs/wk

E2 ultrasensitive 43 (10-50)
Total Test 794 (250-1000)
SHBG 11 (7-49)

free test% 2.4 (1.0-2.7)
Free Test 190.2 (50.0-210.0)

Thanks

Your doc knows something.

Look only at

FreeT or better BAT
and
FreeE2

To be able to follow that thought you have to test at Quest Diagnostics and do thise tests:

Estradiol, Free, LC/MS/MS (36169X) http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=41772N&SITE=4&SearchString=ESTR&tmradio=title

Testosterone, Free, Bio/Total (LC/MS/MS) http://cas2.questdiagnostics.com/scripts/webdos.wls?MGWLPN=QDCIAP20&wlapp=DOS&OrderCode=14966X&SITE=4&SearchString=BIOAVAIL&tmradio=title

 

[qwestar]

Dr. John knows what's up. I was on 200 mg/wk, going to bring it down to 160 mg/wk to see how it affects the levels, and will do this for 1 month followd by more testing. So I'll wait and see.

Yeah, I do all my testing at quest.

Do you know the specific difference between BAT and Free T?

Is there a distinct difference between the Total T assay Quest offers with the range 260-1100, and 241-827?

I had always been told low SHBG was good, it meant you had more free test. What's the story here?

What are the correlations between high E2 and low SHBG?

 

[JanSz]

Dr. John knows what's up. I was on 200 mg/wk, going to bring it down to 160 mg/wk to see how it affects the levels, and will do this for 1 month followd by more testing. So I'll wait and see.

Yeah, I do all my testing at quest.

Do you know the specific difference between BAT and Free T?

Is there a distinct difference between the Total T assay Quest offers with the range 260-1100, and 241-827?

I had always been told low SHBG was good, it meant you had more free test. What's the story here?

What are the correlations between high E2 and low SHBG?

I prefer doing my tests at Quest.
But even Quest have a multitude of tests for the same analytes that we usually worry about.
So, I studied their menu and picked those that seems to be using the lattest technology.
Mostly that ment looking at tests that are done at Nichols Institute first.
You can learn some by watching how they change menus and ranges as time passes. Hopefully the change is for the better.
------------------------------------------------
BAT vs Free, I am sure you will get many opinions on that one.
Doing tests at Quest one have available both numbers.

I give more weight to BAT.

Important note, in that particular test the FreeT and BAT are calculated (not assayed).
-------------------------------------------------
(260-1100) vs (241-827)
another numbers game.
I do not pay attention to those numbers.
I think the whole TotalTestosterone discussion should be avoided, cause for avoidable stress.

What counts is BAT (or FreeT)

and usually for most people who need T supplementataion that mean being over top range on TotalT.

And that is where unnecessary strees and running in circles is taking place.
-------------------------------------------------------

 

[qwestar]

thanks a lot JanSz.

 

[qwestar]

Your doc knows something.

What is it that he knows? I would love to understand the correlations between normal T levels (with TRT) high E levels and low SHBG?

The plan right now is a slightly lower T dose, 160 mgs/wk still with 250 IU HCG Day 5 & 6. He will see how this affects the levels in a month.

 

[neoborn]

Sex hormone binding globulin (SHBG) is a glycoprotein possessing high affinity binding for 17 beta-hydroxysteriod hormones such as testosterone and oestradiol. It is probably synthesized in the liver, plasma concentrations being regulated by, amongst other things, androgen/oestrogen balance, thyroid hormones, insulin and dietary factors, it is involved in transport of sex steroids in plasma and its concentration is a major factor regulating their distribution between the protein-bound and free states. Its detailed role in the delivery of hormones to target tissues is not yet clear. Plasma SHBG concentrations are affected by a number of different diseases, high values being found in hyperthyroidism, hypogonadism, androgen insensitivity and hepatic cirrhosis in men. Low concentrations are found in myxoedema, hyperprolactinaemia and syndromes of excessive androgen activity. Concentrations are also affected by drugs such as androgens, oestrogens, thyroid hormones and anti-convulsants. Measurement of SHBG is useful in the evaluation of mild disorders of androgen metabolism and enables identification of those women with hirsutism who are more likely to respond to oestrogen therapy. Testosterone:SHBG ratios correlate well with both measured and calculated values of free testosterone and help to discriminate subjects with excessive androgen activity from normal individuals.

Something I found on basic process.

 

[JanSz]

What is it that he knows? I would love to understand the correlations between normal T levels (with TRT) high E levels and low SHBG?

The plan right now is a slightly lower T dose, 160 mgs/wk still with 250 IU HCG Day 5 & 6. He will see how this affects the levels in a month.

If you have totally unsymetrical schedule, like you have presented here, picking correct day to do blood draw is subject to another error and approximation.

For this and other reasons for my self I am working on E2D schedule, every other day.

Day#1 T shot plus (liquid) anastrozole precisely measured with insuline syringe with cut out needle.

Day#2 380iu HCG

For both shots I use same size syringe,
BD 31ga 5/16" long 3/10cc


To figure out adjustmens to T and Anastrozole I test at Quest, blood drawn at Quest.
I do thise two tests for that purpose:

Estradiol, Free, LC/MS/MS (36169X)
Testosterone, Free, Bio/Total (LC/MS/MS)

Above tests have multitude of information.
I use and aim for:

FreeE2 (0.45 - 0.6)
BAT ~575

Note that I do not use TotalT levels,
and E2 levels
======================================================================
You can see description of above two tests here:

Quest Diagnostics: Test Menu

Quest Diagnostics: Test Menu
==========================================
58 Estradiol, Free, LC/MS/MS (36169X) Quest Diagnostics: Test Menu
59 /------------------------------------ Estradiol, Free (Males (Adult): < or = 0.45 pg/mL )
60 /------------------------------------ Estradiol (Males (Adult): < or = 29 pg/mL)


66 Testosterone, Free, Bio/Total (LC/MS/MS) Quest Diagnostics: Test Menu
67 /------------------------------------ Testosterone Total (included in T panel)
68 /------------------------------------ Testosterone Free(included in T panel)
69 /------------------------------------ Testosterone Bioavailable(included in T panel)
70 /------------------------------------ SHBG(included in T panel)
71 /------------------------------------ Albumin, serum(included in T panel)

 

[qwestar]

thanks guys for the help.

JansZ I have been on schedule with the shots and blood work. I do T shots every sunday, and the blood work is on thursdays.

 

[JanSz]

thanks guys for the help.

JansZ I have been on schedule with the shots and blood work. I do T shots every sunday, and the blood work is on thursdays.

Ok, you are on 7 day schedule.
Day #1 test shot
Days#2 - 4 nothing
Days #5 & 6 HCG shots

please describe probable hourly TotalT levels of somebody on this schedule

and how that is infuenced by condition of testicles.

testicles 100%
75%
50%
25%
0%
-----------------------------------------------------

I cannot describe that either.
All I am saying that more frequent and very symetrical schedule should help in making better guess at this.