How to Lower Sex Hormone-Binding Globulin (SHBG) Levels
The most effective strategies to lower SHBG levels include resistance training, maintaining adequate protein intake, addressing insulin resistance, and reducing hepatic lipogenesis through dietary modifications. These approaches target the underlying metabolic pathways that regulate SHBG production in the liver 1, 2.
Understanding SHBG and Its Significance
SHBG is a glycoprotein primarily produced by the liver that binds to sex hormones, particularly testosterone and estradiol, regulating their bioavailability. High SHBG levels can reduce the amount of free (bioavailable) testosterone, which may be particularly problematic in certain clinical conditions 3.
Clinical Conditions Associated with Elevated SHBG:
- Liver disease (SHBG synthesis increases in chronic liver disease) 1
- Hyperthyroidism
- Estrogen excess
- Aging (particularly in men)
- Certain medications (estrogens, thyroid hormones, tamoxifen)
Evidence-Based Strategies to Lower SHBG
1. Address Insulin Resistance and Metabolic Health
Improve insulin sensitivity: Insulin has a suppressive effect on SHBG production 2.
- Moderate carbohydrate intake, particularly refined carbohydrates
- Regular physical activity
- Maintain healthy body weight
Dietary modifications:
- Moderate protein intake (0.8-1.6g/kg body weight)
- Reduce monosaccharides (glucose, fructose) which decrease SHBG by inducing lipogenesis 2
- Consider a diet that reduces hepatic lipogenesis
2. Exercise Interventions
- Resistance training: Prioritize compound movements 2-3 times weekly
- High-intensity interval training: Can improve insulin sensitivity
- Consistent exercise routine: More effective than sporadic intense workouts
3. Nutritional Approaches
- Maintain adequate protein intake: Supports hormone production without excessive SHBG elevation
- Consider vitamin D optimization: Low vitamin D status has been associated with higher SHBG levels
- Moderate alcohol consumption: Excessive alcohol can increase SHBG through liver effects
4. Medication Considerations
- Review current medications: Some medications like thyroid hormones can increase SHBG 2
- Avoid unnecessary estrogen exposure: Environmental or pharmaceutical
Special Clinical Considerations
For Men with Low Testosterone
Men with symptoms of hypogonadism and high SHBG should be evaluated with morning testosterone levels 1. If SHBG is elevated with low free testosterone, addressing the underlying cause of high SHBG may be beneficial before considering testosterone replacement.
For Women with PCOS
Women with polycystic ovary syndrome often have low SHBG levels already, but those with atypical presentations may have elevated SHBG that contributes to symptoms 1. In these cases, the above strategies may be particularly helpful.
Monitoring Progress
When attempting to lower SHBG levels:
- Measure baseline SHBG, total and free testosterone
- Implement targeted interventions for 2-3 months
- Retest to assess progress
- Adjust approach based on results
Important Caveats
Don't focus solely on SHBG: The goal should be optimizing overall hormonal health rather than just lowering SHBG.
Individual variation exists: The relationship between SHBG and free testosterone is complex and doesn't always follow expected patterns 4.
Avoid extreme approaches: Severe caloric restriction or extreme diets may have unpredictable effects on hormonal balance.
Consider underlying conditions: Elevated SHBG may be a symptom of another health issue that requires specific treatment.
By implementing these strategies with consistency and patience, SHBG levels can be modulated to support optimal hormonal balance and health.