Here's a quick skinny on SHBG for those of you who might not know what it is.
https://www.womensinternational.com/new ... rmone.htmlHormone levels in the blood must be just right. Steroid hormones include testosterone, estrogens, DHEA, and progesterone, among others. Steroid hormones are fat soluble, but our blood is mostly water. Therefore, hormones and the blood do not mix very well. The body's solution to this problem is sex hormone binding globulin (SHBG), a protein created by the liver which connects with the fat-loving hormones. The resulting complex becomes water soluble and can move freely in the blood stream.
SHBG carries these hormones throughout the body. SHBG also acts as a reservoir for the hormones it carries and protects the hormones from hyperactive liver metabolism and kidney excretion.
SHBG combines with hormones to different degrees of affinity or attraction. The most strongly bound hormone is dihydrotestosterone (DHT), the active form of testosterone, followed by testosterone itself. SHBG also shows affinity, although considerably less, for estrogens, DHEA and even progesterone.
Estrogens increase SHBG production in the liver if the liver is functioning correctly. Adiponectin, a hormone released by the fat cells is also involved.
If SHBG levels are too high, both testosterone and estrogens are bound. High levels of SHBG increase one's risk for osteoporosis because the testosterone and estrogens needed to assist with bone formation are not available for use. Birth control pills can increase SHBG greatly and high SHBG can be predictive of blood clot formation while on these drugs. High SHBG can also be predictive for cardiovascular disease.
I don't care to see CVD and blood clots mentioned but this might also help to explain my wrestling with osteopenia.
Here's the last two hormone panels.
Estradiol
Dec = <10 pg/mL
July = 33
Reference = menopause <10, but Bredesen wants it closer to 80
DHEA
Dec = 115 mcg/dL
July = 102
Refenence = 23-266
Testosterone (free)
Dec = <0.30 ng/dL
July = 0.14
Reference = <0.30-0.83 (the results from 2 different labs, so lost December detail)
Testosterone (total)
Dec = 32 ng/dL
July = 39
Reference = 2-45
Progesterone
Dec = 0.86 ng/mL
July = 2.5
Reference = menopause <0.15-0.80
Upped Biest to 3mg in October in compounded cream. I thought maybe I wasn't absorbing it well (and was ready to go to a patch), but while SHBG went down some, the estradiol went way down suggesting estradiol is still being bound up.
Thyroids are all normal. My doc wants to test cortisol (24 hour) - a risk factor for high SHBG, and good place to start since the HPA axis can be out of whack with RA. Other possible factors are undernourishment (protein and fiber are two mentioned), so he suggests I try some betaine Hcl in case my stomach acid is not up to digestion par. But, my GI seems to be the best it's been in quite a while, and I've managed to get my BMI to 19 (increased calories and more weight lifting) in the past 2 months.
Anyone had to wrestle with SHBG and if so, what worked?