What medications can lower the levels of Sex Hormone-Binding Globulin (SHBG)?

From the Guidelines

Testosterone replacement therapy is the most effective medication to lower sex hormone binding globulin (SHBG) levels, as it can indirectly reduce SHBG levels by increasing free testosterone availability. According to the most recent study 1, certain medications can indirectly reduce SHBG, including oral anabolic steroids, glucocorticoids, growth hormone, and insulin-sensitizing drugs like metformin (500-2000 mg daily). Metformin is often used in conditions like polycystic ovary syndrome (PCOS) where high SHBG may be problematic.

Some key points to consider when attempting to lower SHBG levels include:

• Dietary and lifestyle modifications, such as maintaining a moderate protein intake, reducing fiber consumption, and ensuring adequate caloric intake, can help lower SHBG levels.
• Weight loss in overweight individuals and resistance training can decrease SHBG levels as well.
• The reason for targeting SHBG reduction is that this protein binds to sex hormones like testosterone and estrogen, making them unavailable for use by the body.
• When SHBG levels are high, less free hormone is available for biological activity, which can contribute to symptoms of hormone deficiency despite normal total hormone levels.

It's essential to consult with a healthcare provider to determine if this approach is appropriate for your specific condition and to monitor hormone levels during treatment. Additionally, a study on lipid metabolism 1 found that certain medications, such as anabolic steroids, can reduce plasma lipoprotein(a) levels, but this effect is not directly related to SHBG levels.

In terms of specific medications, the study 1 suggests that metformin may be a useful option for reducing SHBG levels in conditions like PCOS. However, testosterone replacement therapy is the most effective medication to lower SHBG levels, and its use should be carefully considered and monitored by a healthcare provider.

From the Research

Medication to Lower Sex Hormone Binding Globulin Levels

There are no direct studies on medication to lower sex hormone binding globulin (SHBG) levels. However, some studies suggest that certain therapeutic interventions can improve SHBG levels in patients with polycystic ovary syndrome (PCOS) and other metabolic disorders.

• The study 2 found that therapeutic interventions improved SHBG levels in PCOS women, which further reduced PCOS-associated complications.
• The study 3 suggested that low hepatic SHBG production may be a key step in the pathogenesis of PCOS, and that serum SHBG levels may be useful as a diagnostic biomarker and therapeutic target for managing women with PCOS.
• The study 4 discussed the regulation of SHBG by nutritional factors and its clinical implications, but did not provide information on medication to lower SHBG levels.

Factors Affecting SHBG Levels

Several factors can affect SHBG levels, including:

• Body mass index (BMI) 5
• Diabetes 5
• Ethnicity 5
• Chronic obstructive pulmonary disease (COPD) 5
• Coronary heart disease 5
• Smoking 5
• Nutritional factors 4
• Genetic polymorphisms, such as the SHBG rs1799941 polymorphism 6

SHBG and Metabolic Disorders

SHBG has been associated with various metabolic disorders, including:

• Polycystic ovary syndrome (PCOS) 2, 3
• Obesity 5, 4
• Insulin resistance 2, 3
• Metabolic syndrome 2
• Diabetes type II 2
• Non-alcoholic fatty liver disease (NAFLD) 3