question from a user
AlphaMD's Answer
Overall, your analogy is correct. SHBG is like a buffer for "overflow". It is there to keep levels of the sex hormones from going too high or too low. Sex hormone binding globulin, like the name suggests, attaches to all sex hormones.
We tend to focus on SHBG and its effect on testosterone, but most also forget it attaches to DHT, estradiol, androstendiol, and esterone as well. It also weakly binds to DHEA and progesterone. It also binds to some anabolic steroids, such as Anavar.
Because it attaches to 6 other hormones besides testosterone, it is not possible to "dial-in" SHBG levels by solely focusing on SHBG and testosterone levels. If any of the hormones go outside of normal, the liver will start to produce more SHBG in an effort to keep it in check, with a prevalence of maintaining DHT levels (meaning the body more aggressively produces SHBG if DHT gets too high in comparison any of the other sex hormones).
There are plenty of ways to manipulate SHBG levels, though in the end, so long as free testosterone level is therapeutic and symptoms of hypogonadism are resolved, it really doesn't matter what someone's SHBG level is.
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