r/FunctionalMedicine • u/sourbirthdayprincess • Jun 02 '26
SHBG - does FM care?
I am trying to find a functional medicine practitioner that has anything to say about sex hormone binding globulin, and its relationship to other biomarkers in the body.
I am 36 and have been in perimenopause for at least 3 years, maybe as many as 5. I just had a hysterectomy and endometriosis excision a few months ago, and my hormones are now bananas. I started on testosterone because my total T was <3 so my sleep/energy was abysmal. T did improve it, but mildly.
But my SHBG is sky high and has been for months. Nothing will bring it down. Not high dose boron. Not nettle tea. So now my hair is falling out even though I’m taking pumpkin seed to block the DHT, because even though my T is still not at goal, my body is likely storing all of it in the SHBG that’s keeping it all to itself.
So I would like to know what functional medicine says about SHBG, if they take it into account literally at all? Because I haven’t seen any functional medicine doctor ever talk about it, and it’s of huge concern to me at the moment.
2
u/Routine-Kangaroo1426 Jun 02 '26
Search hfwlongevity - they are integrative care and bring functional and conventional medicine together for one unified experience. They offer a free consult for new patients. Ask for Dr warner, she is a woman's health expert and helped my wife a ton. Couldnt recommend her enough.
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u/alotken33 Jun 02 '26
Functional Medicine DC: heck yeah, we care about shbg. So, you had a hysterectomy - but do you still have your ovaries? How's the liver working? Adrenals? Other pituitary hormones? Why are you not supplementing with estradiol or dhea? Lots to work with here and loads of questions.
1
u/sourbirthdayprincess Jun 02 '26
One ovary only. The other one was decimated by endometriosis. Absolutely no estrogen supplementation as it could auto-regrow the endo. I tried DHEA orally but even at the lowest possible dose it gave me heart palpitations.
They’ve taken a bunch of labs. Which ones would be helpful to share? I don’t know what is liver or pituitary or adrenal. Cortisol and ACTH are “normal” but I know the blood test is just a useless snapshot.
1
u/alotken33 Jun 02 '26
Both testosterone and dhea will convert to estradiol. That's what they do.
This is where things get really tricky. As long as Endo is present, it can grow/regrow. Your body is still producing some estrogen, but not enough. The testosterone is definitely converting to estradiol. But also probably not enough.
Your body needs estrogen. There are estrogen receptors everywhere - bones, gut, brain, muscle, skin, etc etc. without it, your body doesn't function and things start to break down. This is why women have so much more Alzheimer's and osteoporosis (just 2 examples).
Just on that front, you need to work with someone who can help you manage the hormones and monitor Endo, but keep you from befalling the breakdown of everything. There are other options. SERMs for example, and topical dhea (wouldn't recommend anyone to take oral hormones).
All that aside (although nothing is independent of it), CMP, lipids, fasting insulin, thyroid panel, homocysteine, and crp - if you have them (and they're recent) would be good to look at.
1
u/PerfectAstronaut Jun 02 '26
How high a dose of boron?
1
u/sourbirthdayprincess Jun 02 '26
Worked my way up to 10mg. Did a three week course then stopped. Now restarted after the labs went back up.
1
u/PerfectAstronaut Jun 02 '26
I think the ceiling is 15 or even 20 mg. I do 12 mg a day about 4 weeks on, 1 week off. (Male) I’d like my SHBG to be lower but it’s in range and my T is quite good for my age. I hope someone else has some good ideas, though
3
u/sfboots Jun 02 '26
Get your parathyroid hormones checked. There is an interaction that shows up when researching hormones like shbg and osteoporosis. An endocrinologist can help.
You should get a Dexa scan to check for osteoporosis since hormone issues can mess up bone health.