Posts Tagged ‘testosterone hormone replacement therapy’

The blood test for Sex Hormone Binding Globulin (SHBG) is usually ordered when total testosterone results are not consistent with a patient’s symptoms: decreased sex drive, infertility, erectile dysfunction for males and abnormal hairiness in females.   Typically, This test is ordered for males because it is suspected that there is a testosterone deficiency and has been validated by a testosterone total serum test or a testosterone total & free blood test.

hormone blood tests

Should I Order a Sex Hormone Binding Globulin Test?

Since the sex hormone binding globulin (SHBG) is commonly used to determine a hormone imbalance – it is commonly ordered with other hormone tests such as testosterone, estradiol, prolactin and lutenizing hormone to evaluate a patient’s hormone balance.  SHBG and testosterone testing may be useful in helping to detect and evaluate excess testosterone production and/or decreased SHBG concentrations so this test is helpful if a hormone imbalance is suspected.

The SHBG results may suggest the following if you have increased levels of the hormone:

  1. liver disease
  2. hyperthyroidism
  3. eating disorders
  4. Hormone Replacement Therapy (HRT) including oral contraceptives
  5. Decreased sex hormone production

The SHBG results may suggest the following if you have decreased levels of the hormone:

  1. Obesity
  2. Polycyctic ovarian syndrome
  3. Hypothyroidism
  4. Hirsutism
  5. Acne
  6. Cushing disease

The Scientific Explanation

Levels of SHBG are under the positive control of estrogens and thyroid hormones, and are suppressed by androgens. These influences dynamically control the liver synthesis of this carrier protein. Decreased levels of SHBG are frequently seen in hirsutism, virilization, obese postmenopausal women, and in women with diffuse hair loss. Increased levels may be present in cases of hyperthyroidism, testicular feminization, cirrhosis, male hypogonadism, pregnancy, women using oral contraceptives, and prepubertal children.

Elevated SHBG levels can be seen in elderly men, and are often found in patients with hyperthyroidism and cirrhosis of the liver. SHBG levels also increase when oral contraceptives or antiepileptic drugs are taken. Pregnant women have markedly higher SHBG serum concentrations due to their increased estrogen production. Decreased SHBG concentrations are often seen with hypothyroidism, polycystic ovarian syndrome (PCOS), obesity, hirsutism, elevated androgen levels, alopecia, and acromegaly.

Take Control of Your Health

Medical Disclaimer: The information included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her health care provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. The writer is not a physician or other health provider.


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The most common reason men seek testosterone therapy is waning sexual desire or performance.  However, when tested, more than 25% of the men had normal testosterone levels.  Additionally, men with subnormal levels did not have libido or performance issues, so physicians are questioning the purpose of testosterone replacement therapy.  Some physicians, will suggest a trial of topical testosterone therapy for up to a year to see if sexual function or other symptoms improve.

Physicians have used synthetic testosterone, for decades, to treat men whose hormone level is unambiguously low. Low testosterone levels or Hypogonadism, can be caused when the testes do not manufacture enough testosterone.  It can also occur when the pituitary gland doesn’t signal the testes to generate the testosterone the body needs.  There is a natural decline in testosterone as men age, so there is an increased usage in taking testosterone to reverse the age-related decline.

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Monitor your Testosterone Levels

The symptoms of testosterone deficiency are very general and can be attributed to several other health issues.  Symptoms include fatigue, depressed mood, diminished muscle mass, etc., so measuring testosterone levels is beneficial.  In men over 65, the goal should be 300–450 ng/dL, the middle of the normal range for that age.

Monitoring for testosterone-dependent diseases is warranted: benign prostate enlargement and prostate cancer are the main concerns, but doctors should also check for worsening of sleep apnea, breast tenderness, and elevated red blood cell counts.

NIH Research

The National Institute of Health is continuously studying the effects of testosterone therapy in men and how it affects their overall health and wellness.  A recent study, which was also published in the New England Journal of Medicine, included a clinical trial of testosterone treatment in older men.  The findings were that the treated men had a higher rate of adverse cardiovascular events, such as heart attacks and elevated blood pressure.  The group of older men receiving testosterone gel compared to those receiving placebo had an increase of adverse events and the trial was stopped.

The researchers published their findings in the New England Journal of Medicine and noted that the high hazardous outcome could have been because the study participants had high rates of high blood pressure, diabetes, obesity and high cholesterol  However, this may be a realistic population for those currently receiving hormone therapy.

Testosterone Therapy – Ask Your Physician

Testosterone replacement therapy has been used for years and is recommended to be done under the direction of a physician. Physicians and patients, especially older men, should consider the adverse effects along with other information on the risks and benefits of testosterone therapy.  Each person is different and responds differently, so it is best to be under the guide of a physician.  Test your testosterone levels to be sure you need the therapy and also to see if the therapy is working.

Blood Tests:

Testosterone, Total $39

Testosterone, Total & Free $59

Men’s Hormone Package : Testosterone, Total & Free, Estradiol, PSA $69

Take Control of Your Health

Medical Disclaimer: The information included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her health care provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. The writer is not a physician or other health provider.


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