Naturally Reversing High SHBG with High Total Testosterone and Normal Free Testosterone
Yes, high Sex Hormone-Binding Globulin (SHBG) with high total testosterone and normal free testosterone can be reversed naturally through weight management, regular physical activity, and dietary modifications. 1
Understanding SHBG and Testosterone Relationship
SHBG is a glycoprotein that binds to sex hormones like testosterone, affecting their bioavailability. When SHBG is elevated:
- It binds more testosterone, reducing free testosterone availability
- Total testosterone may appear high while free testosterone remains normal
- This can create a functional hypogonadism despite seemingly normal hormone levels 2
Natural Approaches to Lower SHBG
Weight Management
- Weight loss through regular physical activity and dietary modifications is recommended as a first-line approach to normalize SHBG levels 1
- Obesity is a major confounder in testosterone levels and can increase SHBG 3
Dietary Modifications
- Balanced diet with adequate protein intake
- Moderate carbohydrate consumption (excessive carbohydrates can increase insulin, which may lower SHBG)
- Healthy fats from sources like olive oil, avocados, and nuts
Regular Physical Activity
- Combination of resistance training and aerobic exercise
- Aim for at least 150 minutes of moderate-intensity exercise per week
- Avoid excessive endurance training which may increase SHBG
Optimize Other Hormones
- Address thyroid dysfunction if present, as thyroid hormones affect SHBG levels 1, 4
- Monitor insulin sensitivity, as hyperinsulinemia can affect SHBG 1
Monitoring Progress
When attempting to naturally reverse high SHBG:
- Monitor SHBG and free testosterone levels every 3-6 months 1
- Use calculated free testosterone (cFT) rather than free androgen index (FAI) 1
- Track symptoms improvement with targeted questioning about libido, energy levels, and sexual function
When to Consider Medical Intervention
If natural approaches fail after 3-6 months:
- Consider screening with morning serum testosterone level if symptoms of hypogonadism persist 3
- In men with total testosterone levels close to lower limits, determine free testosterone concentrations using reliable methods 3
- Consider medical consultation for potential hormone optimization if symptoms persist despite lifestyle modifications
Important Considerations
- High SHBG can mask androgen deficiency symptoms even when total testosterone appears normal 2
- SHBG changes can affect both subjective symptoms and objective markers of testosterone activity independently of total testosterone 2
- Addressing modifiable cardiovascular risk factors is essential when managing SHBG levels 1
Remember that SHBG levels are affected by multiple factors including age, liver function, thyroid status, and medications, so a comprehensive approach addressing all modifiable factors will be most effective.