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[pepperminty]

Hi ladies ,

 if you have  very high SHBG of 200 which makes calculating free testosterone N/A apparently - and also  a within normal range of testosterone (1.31) would it be advisable to take testosterone?

Thanks PMXX

[Alicess]

I have the same question. I also have a SHBG of ≥200 and my testosterone is 1,2..  I found this:

Under physiological conditions, approximately 70% of testosterone  is bound to SHBG with high affinity, about 20–30% is weakly bound to albumin, and the remaining 1-2% is free

Testosterone lowers SHBG so lower SHBG will also free more estradiol.

You could  try  a very low dose of T and see how you go?

Alicess x

[pepperminty]

Hi Alicess,

it is a minefield isn't it? There seems to be no information or studies on this at all. I wonder if  high SHBG has any bearing on whether testosterone should be given ? I know oral HRT can raise SHBG . I wonder if SHBG is above 200 can  free testoserone still be calculated?

PMX

[Alicess]

Hi Pepperminty,

Yes, it is a minefield indeed. I 've had a bloodtest a few years back which included free testosterone. My testosterone was lower at that time though.

Testosterone.  0.8  nmol/l.                  0.10  - 1.42 nmol/l 

SHBG.             ≥ 200                              27.1  -  128

Free testosterone                                 not calculable

 So I think not much testosterone is left with high SHBG, even for women. Both testosterone and levonorgestrel lower SHBG and if I remember correctly so does Tibolone/ Livial.  I believe there"s not enough attention for SHBG in women; aprox. 40 % of estradiol is also bound to SHBG while estrone  only binds for 16 % to SHBG. Very difficult to maintain a balance with both high and low SHBG.

[pepperminty]

Hi Alicess,

I did not know taht testosterone lowers SHBG. Do you have a link to any research?

  I wonder then if when I was on prempac c that the conjugated estrogen had less effect on SHBG perhaps. That type of estrogen was a god send for me at the time. ( I did not know where it came from). Just the progeterone part that drove me insane.
The book estrogen matters recomends conjugated estrogen .

PMXx

[Alicess]

I've lost most of my bookmarks so it's a bit difficult to find the right research re testosterone decreasing SHBG but I found some studies: To be honest when I researched testosterone and SHBG a few years back I found a lot of research re T and SHBG now it's difficult to find much at all. So I start to doubt my statement that T decreases SHBG! I want to research more.

https://pubmed.ncbi.nlm.nih.gov/2860769/

https://www.sciencedirect.com/topics/pharmacology-toxicology-and-pharmaceutical-science/testosterone ( chapter Testosterone deficiency)

Androgens ( like testosterone)  decrease SHBG. But testosterone can convert to estradiol through aromatase, at least in men on TRT, and estradiol increases SHBG. Endogenous testosterone can also convert to estradiol in both men and female.

To my knowledge conjugated estrogens (CEE) like Premarin and in Prempak increase SHBG. Premarin doesn't contain a progestin like Prempak

According to Wiki  (https://en.m.wikipedia.org/wiki/Conjugated_estrogens )

A dosage of 0.625 mg/day oral CEEs has been found to increase SHBG levels by 100%.[40][41] For comparison, 1 mg/day oral estradiol increased SHBG levels by 45%, while 50 µg/day transdermal estradiol increased SHBG levels by 12%.[40][41] Ethinylestradiol is more potent in its effects on liver protein synthesis than either CEEs or estradiol, with 10 µg/day oral ethinylestradiol having been found to be approximately equivalent to 1.25 mg/day CEEs.

It's confusing and almost impossible to figure out . And I feel research or studies aren't always reliable as they rely on bloodtests but don't test and include the important parameters.

Alicess x