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ForumsLab Results & BiomarkersSHBG changes during weight loss on GLP-1 — hormonal implications

SHBG changes during weight loss on GLP-1 — hormonal implications

Dr.ReproEndo Fri, May 29, 2026 at 2:44 AM 17 replies 420 viewsPage 1 of 4
Dr.ReproEndo
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May 29, 2026 at 2:44 AM#1

This gets cited here weekly, usually second-hand, so it is worth setting out what it does and does not establish.

Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect. Less adipose tissue means less aromatase activity, so in men testosterone commonly rises and estradiol falls, and SHBG rises as insulin resistance improves — which means total testosterone can rise while free testosterone moves less than expected. In PCOS, improved insulin sensitivity frequently restores ovulation, which is a fertility change people are not always expecting.

Where I think it is weakest: the completion rate deserves as much attention as the headline, because a large effect among those who finished is a different claim from a large effect among those enrolled.

What I am trying to establish is why total and free can move differently here, and which of the two is worth tracking. If the honest answer is that nobody knows, that is a useful answer and I would rather have it.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
13 16mona_PHX, andrew_nyc, Dr.EndoEP and 10 others
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Dr.NutriCornell
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May 29, 2026 at 3:05 AM#2
Dr.ReproEndo said:
Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect.

HPA axis assessment on the hormone panel: rarely ordered but informative for understanding the stress-metabolism connection:

4-point salivary cortisol:

  • Morning: 16 ng/mL → 15 ng/mL (improved)
  • Noon: 9 ng/mL → 6 ng/mL
  • Evening: 5 ng/mL → 2 ng/mL
  • Night: 3 ng/mL → 1 ng/mL

The cortisol curve is normalizing — less flat, better diurnal variation. Reduced visceral fat = reduced cortisol overproduction. The metabolic benefits cascade into stress hormone regulation.

14 17Dr.SleepRoch, laura_annarbor, JenMemphis and 11 others
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DebRD_ATL
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May 29, 2026 at 3:26 AM#3
Dr.ReproEndo said:
Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect.

Hormone panel changes on the hormone panel — relevant for anyone curious about endocrine effects:

  • Testosterone: increased 35% (weight loss reduces aromatase in adipose tissue)
  • Estradiol: normalized from elevated baseline
  • SHBG: increased appropriately
  • Free testosterone: increased 22%
  • Cortisol AM: within normal limits, no significant change

My reproductive endocrinologist says the testosterone improvement alone could explain the energy and mood benefits I've experienced.

Last edited: May 29, 2026 at 7:26 AM
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Dr.PeteFamMed
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May 29, 2026 at 3:47 AM#4
DebRD_ATL said:
Hormone panel changes on the hormone panel — relevant for anyone curious about endocrine effects: Testosterone: increased 35% (weight loss reduces…

Sex hormone labs after weight loss on the hormone panel — for the men in this thread:

Testosterone: 282 → 602 ng/dL (dramatic improvement!)
Free T: 5.7 → 14.2 ng/dL
Estradiol: 49 → 24 pg/mL
SHBG: 20 → 48 nmol/L

Visceral fat contains aromatase which converts testosterone to estrogen. As you lose visceral fat, this conversion decreases and testosterone naturally rises. I feel 10 years younger.

16 19Dr.BariatricHTX, LindaRN_retired, tommy_boulder and 13 others
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wendy_avl
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May 29, 2026 at 5:38 AM#5
Dr.NutriCornell said:
HPA axis assessment on the hormone panel: rarely ordered but informative for understanding the stress-metabolism connection: 4-point salivary…

This matches mine closely enough to be worth saying so out loud.

17 20RickReta_CO, PharmHunterJen, TomTeleRx and 14 others
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