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[becca]

Hi folks,
Just wondering if anyone knows anything about what consistently high levels of Sex Hormone Binding Globulin (SHBG) mean??  I've been having this tested alongside testosterone to measure free androgen index (which is fine apparently). 
But when I asked at meno clinic if I should be worried that SHBG is consistently outside of the normal range (>200) they said I'd have to ask my GP.  Asked my GP who said I don't know, I thought the clinic would be dealing with that for you.  So they are now writing to the meno clinic to ask what it means.
The GP helpfully looked back through my records and my SHBH was always within normal range before I started on HRT so am wondering if it is connected? 

[Conolly]

Hello Woodpecker,

It seems that any hormonal disruptions like early, surgical or chemical menopause can result in high SHBG levels.

https://www.nursingcenter.com/journalarticle?Article_ID=643341&Journal_ID=54012&Issue_ID=643325

Most women undergoing estradiol ‘absorption' issues have no absorption problem at all.

It has been shown that SHBG levels decrease after a diet high in fats https://academic.oup.com/jcem/article-abstract/64/5/1083/2653957

Are you taking any medication besides HRT?

Conolly X

[Hurdity]

There is a thread on SHBG here: https://www.menopausematters.co.uk/forum/index.php/topic,42225.0.html

and also here https://www.menopausematters.co.uk/forum/index.php/topic,41130.msg648779.html#msg648779 OK I've just noticed that it was you that started the other thread (got confused with the name change!) so you probably have all the info already from these threads maybe? Anyway I've linked to them in case you haven't!

YOu will see from the thread that racjen was also concerned about this but the research as I understand it shows that only oral oestrogen (as part of HRT) increases SHBG. However maybe very high doses also do this?

I'm not sure if there is any medical cause for concenr and your clinic should know this - woiuld be interesting to hear! It just means that you need more added testosterone in order for this to be available biologically - and if you FAI is OK then hopefully all is well.

Do report back on what they say as we would be interested to know.

Conolly - interesting but this the small study you refer to was carried out in men so may well not apply to women and may also vary with menopausal status?

Hurdity x

[becca]

Thank you Connolly and Hurdity - yes I had to change all my usernames and passwords on all my accounts because of a data breach where all my personal info was hacked. 

Thanks for reposting the links to the other threads, I'd somehow missed the one earlier this year and it didn't come up under a search for SHBG. 
At the time of my earlier post I was worried about free androgen index, which as you explained was fine. Now just concerned about the ongoing higher level of SHBG as I read a study (not sure if it has been peer reviewed) that linked high SHBG to increased risk of gastric cancer which is a concern for me as there is a genetic predisposition in my family.

I have also read that SHBG can be affected by alcohol intake so I might try a three month break from all booze (yikes) and see if that makes a difference at my next bloods. 

I guess I just want to know what is changing and why as a result of being on HRT.  If I get any further info or clarity on this I will post on the forum.
 Thank you once again ladies xxxx

[racjen]

Yes, I questioned my high level of SHBG with various medical people and got a similar response ie they haven't got a clue. But interesting that any kind of induced menopause can cause high levels, so  maybe it's the chemo in my case. Can't help feeling it may be part of my problem, but how to find anyone who can shed light on this in terms of actual treatment?

[Conolly]

Hello Hurdity,

I have quoted that article because there are no studies carried out with women (pre or post menopause). Most SHBG studies are related to testosterone, because of its higher binding affinity for testosterone and DHT compared to oestrogens. So they are basically carried out with men, apart from women with androgen issues (PCOS and genetic conditions). You have  said on another thread that women after menopause who are not on HRT looked like men? So maybe studies like this can apply to some extent to postmenopausal women?

Woodpecker,

Alcohol can impair liver function, particularly if there are other underlying conditions, such as liver fat or hepatitis. Liver fat is associated with low SHBG levels and hepatitis (and cirrhosis) with high SHBG levels. Alcohol intake has been seen to increase SHBG levels (in men), even without any liver damage. https://academic.oup.com/alcalc/article/34/6/903/192713 so a break from booze may help 

Oral HRT also increases SHBG levels, have you ever taken oral tablets?

Interestingly, certain progestins like levonorgestrel and norethisterone, have high affinity for SHBG and can bind to it and displace endogenous steroids from it, thereby increasing free concentrations of these endogenous steroids, so maybe you could benefit from them? http://hormonebalance.org/images/documents/Kuhl%2005%20%20Pharm%20Estro%20Progest%20Climacteric_1313155660.pdf

Racjen,

I've been reading your previous posts and I know you have tried levonorgestrel (Mirena) and it didn't suit you. I was wondering how did you manage while you were pregnant? Did you have any issues?

Conolly X

[Hurdity]

Hello Hurdity,

I have quoted that article because there are no studies carried out with women (pre or post menopause). Most SHBG studies are related to testosterone, because of its higher binding affinity for testosterone and DHT compared to oestrogens. So they are basically carried out with men, apart from women with androgen issues (PCOS and genetic conditions). You have  said on another thread that women after menopause who are not on HRT looked like men? So maybe studies like this can apply to some extent to postmenopausal women?

Woodpecker,

Alcohol can impair liver function, particularly if there are other underlying conditions, such as liver fat or hepatitis. Liver fat is associated with low SHBG levels and hepatitis (and cirrhosis) with high SHBG levels. Alcohol intake has been seen to increase SHBG levels (in men), even without any liver damage. https://academic.oup.com/alcalc/article/34/6/903/192713 so a break from booze may help 

Oral HRT also increases SHBG levels, have you ever taken oral tablets?

Interestingly, certain progestins like levonorgestrel and norethisterone, have high affinity for SHBG and can bind to it and displace endogenous steroids from it, thereby increasing free concentrations of these endogenous steroids, so maybe you could benefit from them? http://hormonebalance.org/images/documents/Kuhl%2005%20%20Pharm%20Estro%20Progest%20Climacteric_1313155660.pdf

Racjen,

I've been reading your previous posts and I know you have tried levonorgestrel (Mirena) and it didn't suit you. I was wondering how did you manage while you were pregnant? Did you have any issues?

Conolly X

I don't know why you thought it appropriate to misquote something I said probably a couple of years ago? Firstly how would you know I said anything remotely like that as you weren't a member of the forum (or were you? – or perhaps told by a trouble-maker?)? It is usual practice to quote the actual post if someone is quoted, although that point is irrelevant in this instance because it really is not forum protocol (of any forum) to refer to ancient posts and threads – (just as it is not protocol to resurrect ancient threads), particularly ones that caused controversy! Be that as it may....

Some progestogens - notably the testosterone derived ones, also bind to the androgen receptor

From what I have read this whole subject is extremely complex and not completely understood so you may well not get a answer Woodpecker, or racjen.

I doubt whether past use of a progestogen would permanently affect SHBG because all these compounds (hormones, steroids etc) are continually being metabolised, synthesised and replenished and it all exists in a complex dynamic equilibrium. 

Reducing alcohol intake is of course good for our health anyway as it reducing excess unnecessary fat intake to some extent (well -some fats anyway!).

Yes please do let us know Woodpecker if you shed any further light on this issue especially re your situation!

Hurdity x

[Conolly]

Hurdity,

I'm sorry if I have offended you! I have read that thread along with many others. I have Asperger's Syndrome and the thought of misquoting you is such a dreadful thing. Actually I sort of agree that the lack of oestrogen makes us menopausal women look like men in some aspects, although I don't think this is necessarily a bad thing. I'm even excited to have a more ‘masculine' way of living, without periods, pregnancies, big breasts and bums, lol, really enjoying my Guinness belly lol.

I didn't pay attention to the controversy. I'm genuinely interested in the scientific aspect of the matter, opinions and beliefs are irrelevant to me.

I will try to find the thread in order to quote you properly or is it not necessary? I didn't know it's not considered acceptable to quote old threads. I'm a member of other forums where this is common practice. We often enjoy comparing our own opinions from past times, not to mention reading old members experiences. It's truly enlightening. Oh, and CLKD is always reminding us new members to bump old threads instead of creating new ones, lol.

Conolly X

[Droopeydrawers]

Is it acceptable  protocol to call forum members " trouble makers" and do you have a particular list  of "trouble makers" or is that for your eyes only? Would it contain only members who dare to question your theories.ive never came across any trouble makers on this forum only bullies, especially when I dared to read over historical posts and as expected it was the same old posters heavily involved in any debates on bullying of course denying all or any involvement.I can tell you now if I was conolly id be making no apologies to anyone for " misquoting" facts that are plainly there for anyone interested enough to read.Conolly is a valuable contributor to this forum and many of the members value her input because it's presented in a non aggressive and factual way.If she gets it wrong which we all can do occasionally she's the first to say so.This attack on her or anyone else like this are totally unwarranted and damaging to the forum agenda.We do not need disciplining from our peers you are only a member like everyone else here and it borders on bullying. Conolly id withdraw that apology.DD

[Mary G]

Droopydrawers, thanks for highlighting the reason I rarely post on this forum now and dare not go into details of my HRT regime.   As you so rightly say, Conolly is a valued member of this forum and nobody should act like an unofficial moderator.   

I do indeed remember the post that Conolly referred to but it was subsequently deleted.

I have reported this incident to admin.

[Dotty]

Mary G.....good to hear from you  .  All I remember about you is your desire to help others and how helpful and sympathetic you were to me when I was struggling so much.  I often think about the ladies who helped and supported me when I was so ill xx

Droopey drawers   ..... keep posting.    xx

[Conolly]

Hello ladies,

Thank you for the kind words, but I keep my apologies. I haven't even noticed 'trouble maker' because I don't pay attention to emotional bits in posts, unless they are from ladies suffering from terrible symptoms or diseases, which sincerely break my Aspie heart and mind.

Let's move on and try to help ladies who are in real distress. Speaking of which, I've been reading very interesting articles on SHBG and I think many ladies will find them useful (particularly Woodpecker and racjen), I am trying to highlight the important parts into a cohesive and comprehensive text.

Wishing you all well,

Conolly X

[Conolly]

Hello Petrichor,

Sorry, I've missed your post! The article abstract is very interesting, it's a pity most of the good and more recent articles are pay-per-view. I love Creative Common platforms!

I am very interested in surgical and chemical menopause, it's sad that so little is known and so many are suffering to find the right regimen to control symptoms.

Keep learning, that's what keeps me going through the tough times 

Conolly X