Back to all Questions

question from a user

Some questions about how SHBG works: A lot of guys here and elsewhere talk about taking either supplements or medication specifically to lower SHBG, to "increase free T" As I understand, SHBG can neither create nor destroy testosterone, only store or transport it. I would think that this means altering SHBG levels is a relatively futile endeavor, as it will only change total T levels without changing free T levels. My understanding is that free T levels are most important when it comes to the positive and negative effects of TRT, and total T becomes important as a buffer to maintain T levels My own example of this: my provider prescribed low dose anavar specifically to lower SHBG, with the hope of increasing free t while total T stays the same (roughly). What actually happened was my free T stayed the same while total T lowered. I liken it to a water storage tank: we dump water in at the top, either in infrequent great big bucketfuls (injections, the size of the "bucket" can vary quite a abit based on protocol) or smaller more frequent cupfuls (natural production throughout the day). There is a drain valve at the bottom of the tank. Closing the valve is like raising SHBG. The water level increases (higher total T if you will) until the higher pressure at the bottom causes outflow to again equal inflow and the waterline stays at a new higher level. Opening the valve causes the opposite effects (like lowering SHBG) I would argue that the "effective" supplements or meds are actually doing the following: lowering SHBG while simultaneously increasing testosterone production rate. This would be like dumping more water into the tank above while opening the drain valve at the same time. Balance the adjustments of the two variables and you can get the level to remain the same as before. In theory. Applying the above to lab test results, we'd see total T change little, while free T increases noticably. So is the above analogy and my "theory" totally bunk? Does the free T increase come about from another mechanism I don't understand, instead of directly from the lowering of SHBG while production rate stays the same? What am I missing, and is there a better, simpler way to understand what's going on here? How could the testosterone ester be explained, as I don't think my above analogy properly accounts for it (maybe it's more like two tanks, we dump into one, then it overflows into another?) If you got through the above text wall and have some thoughts to share, thank you!

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.


Ready to get answers?
Ask your own question today.

Get $30 off your first month’s order

Enter your email address now to receive $30 off your first month’s cost, other discounts, and additional information about TRT.

Legal Disclaimer

This website is a repository of publicly available information and is not intended to form a physician-patient relationship with any individual. The content of this website is for informational purposes only. The information presented on this website is not intended to take the place of your personal physician's advice and is not intended to diagnose, treat, cure, or prevent any disease. Discuss this information with your own physician or healthcare provider to determine what is right for you. All information is intended for your general knowledge only and is not a substitute for medical advice or treatment for specific medical conditions. The information contained herein is presented in summary form only and intended to provide broad consumer understanding and knowledge. The information should not be considered complete and should not be used in place of a visit, phone or telemedicine call, consultation or advice of your physician or other healthcare provider. Only a qualified physician in your state can determine if you qualify for and should undertake treatment.