Menopause Matters Forum
Menopause Discussion => All things menopause => Topic started by: Flan747 on June 23, 2022, 08:25:03 AM
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Morning ladies, long story short, I am 2 weeks on Testim alongside HRT regime which I’ve been on a long time now, however my SHBG remains high. I did 8 months on Androfem and T levels remained low and sometimes lower. I’m on 100 Everol, symporms have crept back including anxiety and very restless nights. I’m thinking maybe I need more estrogen? Question is will the estrogen do anything if my SHBG is high? Xx
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Yes, it will still do something if you need more estrogen, just means you need more estrogen than if it was lower SHBG potentially. SHBG binds more to testosterone than estrogen I believe. SHBG fluctuates throughout the cycle too.
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Thank you, I know I need more estrogen but have been advised it won’t work until the T starts working when I get my SHBG down. Xx
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No it doesn't mean it won't work just because SHBG is high.Thats what i was told by my specialist anyway.
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That’s great to hear, the k you so much for this, just why’s I needed to hear xx
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Have you had your estrogen levels tested with a blood test? If you're already at 100mcg patch then before going over that, advice is to run bloods to check you are actually absorbing the patch. Some women don't and instead of going ever-higher on the patches might need to switch to gel instead for eg...
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Hi Joziel, on 75 it was between 700 and 800. I was on the gel before but the fluctuations were too much, now in the patches it’s consistent. I have been given the advice to reduce estrogen to get my SHBG down to get my T to work but surely my others symptoms will come back? I just don’t get it, I would usually email my Newson specialist however they are now charging £50 xx
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Depends where you are in meno whether you are peri or not when doing blood test for estradiol because they fluctuate so much so may not tell you how much you absorb. Symptoms really should guide you.
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I’m peri, so yes they may have been fluctuations. Symptoms are all creeping back in and I’m inclined to go with increasing the patch but like I said advice is I need to lower the SHBG! So confused xx
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What if you can't lower it, that surely doesn't mean you won't increase the estrogen that you need to treat the symptoms.My SHBG was not tested until I tried Testosterone, it was never tested when just on Estradiol and Utrogestan, symptoms were key.
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That’s my thinking too? I was going email my specialist but apparently you can’t you have to pay £50 for a nurse / pharmacist phone call, just waiting for an email back as surely this can’t be right xx
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Hi ladies,
My SHBG is monitored due to taking a high level of estrogen. So far, 8 months in, it’s not gone through the roof but I was initially told it was likely.
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Can I ask what your SHBG has been Tora? I’m totally confused by it all xx
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It fluctuates but hasn’t been over 90 or under 47 in the last 8 months. Regrettably it wasn’t taken before I started HRT.
I was told stress can play a large part in readings and to make sure I was eating enough protein.
I’m not a doctor but I was under the impression that androgens can reduce SHBG and Estradiol can increase it, I’ll check with my doc.
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I don't get the SHBG thing ;D Explain that bit to me?
If it's any help, I am on testosterone, Estradot and utrogestan (and desogestrel mini pill). I was given testosterone by the Newson clinic from the start, without a test of existing levels and without trying to get the estrogen anywhere.
On my bloods a few weeks ago, my testosterone was perfect at 3% FAI but my estrogen was still low-ish at 233nmol. (That was on a 50mcg patch. I'm now on 62.5 with a view to increase to 75 v gradually due to estrogen sensitivity.) But no one freaked out about me taking testosterone when my estrogen was still on the low side.
If that helps.
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Sorry Joziel I have no idea about the SHBG, the more I look into it the more confused I get. It does look like I need to lower my dose and increase
My T so that maybe my next move xx
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Hi Joziel,
I’m not the right person to properly explain SHBG so bear with me as I’m going through my notes from first appointment.
It’s a transport protein which delivers T,E & DHT to cells. If SHBG is too high it binds itself to the hormone so that the cell can’t access it.
Too low and the tissues potentially get too much hormone.
I *think* SHBG is usually tested regarding testosterone levels to determine Free Androgen Index either before starting T or around 3 months into treatment.
AFAIK it’s more likely to inhibit T.
Flan747, my doc insists that blood tests are taken first thing in the morning, have your readings fluctuated? I don’t think SHBG levels are affected just by estrogen. I was given quite a list of lifestyle ‘suggestions’ ;)
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Hi Tora yes they fluctuate badly unfortunately, interested about how to lower SHBG my specialist only said about having blood tests done for certain things to rule other problems out which I’ve had and all were clear xx