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Evidence-based GLP-1 & peptide discussion since 2023
ForumsLab Results & BiomarkersHas anyone dealt with shbg changes during weight loss on glp-1?

Has anyone dealt with shbg changes during weight loss on glp-1?

DadBodDave Thu, Jan 9, 2025 at 6:10 PM 6 replies 1,624 viewsPage 1 of 2
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DadBodDave
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Jan 9, 2025 at 6:10 PM#1

This is the version of the explanation I wish somebody had given me, written down before I forget what confused me. It is about the hormone panel, and it is deliberately narrow — everything I am not confident about is marked as such.

What is actually established

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.

The condition it depends on

This is a case where measuring the free fraction rather than the total matters, because SHBG is moving at the same time.

What I am not sure about

So the question, as narrowly as I can put it: why total and free can move differently here, and which of the two is worth tracking. Practical detail welcome, however dull — the duller the better.

— DadBodDave · corrections welcome and will be edited into this post with credit
41 11laura_annarbor, JenMemphis, pat_auckland and 38 others
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anders_CPH
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Jan 9, 2025 at 7:03 PM#2
DadBodDave 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: 15 ng/mL → 12 ng/mL (improved)
  • Noon: 8 ng/mL → 5 ng/mL
  • Evening: 4 ng/mL → 2 ng/mL
  • Night: 2 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.

40 10MariaRD, AussieAnna, BethLabQueen and 37 others
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TrialNerd_Beth
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Jan 9, 2025 at 7:56 PM#3
DadBodDave said:
Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect.

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

Testosterone: 357 → 597 ng/dL (dramatic improvement!)
Free T: 7.2 → 13.7 ng/dL
Estradiol: 44 → 27 pg/mL
SHBG: 23 → 43 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.

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Dr.BariatricHTX
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Jan 9, 2025 at 8:49 PM#4
TrialNerd_Beth said:
Sex hormone labs after weight loss on the hormone panel — for the men in this thread: Testosterone: 357 → 597 ng/dL (dramatic improvement!) Free T:…

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

  • Testosterone: increased 28% (weight loss reduces aromatase in adipose tissue)
  • Estradiol: normalized from elevated baseline
  • SHBG: increased appropriately
  • Free testosterone: increased 31%
  • 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.

38 8stefan_berlin, Dr.EM_Chicago, pete_RVA and 35 others
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marcus_mpls
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Jan 10, 2025 at 1:49 AM#5
anders_CPH 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. The detail I would add is minor and it is already implied above.

37 7mona_PHX, andrew_nyc, Dr.EndoEP and 34 others
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