From the Guidelines
High SHBG levels should be addressed through lifestyle modifications and nutritional approaches, as they can reduce the bioavailability of sex hormones and potentially cause symptoms. To manage high SHBG, it is essential to focus on lifestyle changes, including maintaining a healthy weight, reducing alcohol consumption, and managing stress, as these factors can contribute to elevated SHBG levels 1. Nutritional approaches can also play a crucial role in lowering SHBG, such as:
- Ensuring adequate protein intake (1-1.5g per kg of body weight daily)
- Consuming healthy fats
- Avoiding extreme low-calorie diets Some supplements that may help lower SHBG include:
- Boron (3-10mg daily)
- Magnesium (300-400mg daily)
- Zinc (15-30mg daily)
- Vitamin D (2000-5000 IU daily if deficient) It is also important to note that high SHBG can occur due to various factors, including elevated estrogen, hyperthyroidism, aging, or certain medications, and can reduce hormone availability to tissues, potentially causing symptoms despite normal total hormone levels 1. For those with significantly elevated SHBG causing symptoms like fatigue, decreased libido, or muscle loss, consulting a healthcare provider is recommended, as they may consider medications such as danazol or certain testosterone replacement therapies 1. Regular monitoring of testosterone, free testosterone, and SHBG levels is also essential, particularly in male patients with symptoms of hypogonadism 1.
From the Research
High SHBG Levels
- High SHBG levels have been associated with various clinical disorders, including obesity, metabolic syndrome, polycystic ovary syndrome, osteoporosis, breast and prostate cancer 2
- SHBG levels are also influenced by nutritional factors, with lower SHBG concentrations found in individuals with higher body mass index (BMI) and central adiposity 3
- In men, higher SHBG levels have been linked to an increased risk of cardiovascular disease (CVD) and CVD-related mortality 4
Regulation of SHBG
- SHBG binds to receptor sites on plasma membranes, regulating the free concentration of steroid hormones in plasma 5
- The binding of SHBG to its receptor is inhibited by the presence of steroids, which can affect the regulation of cell function 5
- SHBG has been shown to play a role in the regulation of cell function, with potential implications for the development of various diseases 2, 5
Clinical Implications
- Low SHBG levels have been inversely linked to obesity, diabetes mellitus, and other cardiometabolic disorders, and may be predictive of stroke risk in women 6
- SHBG levels may be used as a risk stratification tool for predicting ischemic stroke in women 6
- The relationship between SHBG and disease risk is complex, and further research is needed to fully understand the role of SHBG in human health and disease 2, 3, 4, 5, 6