Why Is SHBG Low In PCOS? 

Why is SHBG low in PCOS (polycystic ovarian syndrome)? What is the underlying factors that influence sex hormone-binding globulin in females and males? What could be driving this process over the short term and over the long term? If you're curious why SHBG is low in PCOS, and the cause of low shbg, keep watching. OK why is sex hormone binding globulin low in women with PCOS, first of all let's define some terminology here sex all sex hormone binding globulin and PCOS so first PCOS is more of a syndrome than it is like a disease state or concrete diagnosis I say this because it's more of a combination of several different characteristics or patterns rather than a clear-cut physiology that fits that everyone fits into.
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but there are some commonalities and distinct things about PCOS that other people don't have and they're sort of ou know a commonality and some of those things are typically here is weight gain and insulin resistance decrease fertility and hormonal imbalances that make conception a lot harder sometimes here's actual lack of IV population seems to be in more severe cases that will be present there's Andrew androgynous ation so basically females taking on more male characteristics with a corresponding high testosterone or more specifically high free testosterone and there's ovarian cysts and other hormonal imbalances but not all women have all aspects of these but what seems to be most common and all of most of the women that get this diagnosis is there's ovarian cysts and there's some sort of a problem with the insulin resistance and sex hormone binding globulin so so what is sex hormone binding globulin sometimes it's abbreviated as SH B G and basically what sexual non binding globulin does is it carries hormones around in the body so specifically a carries estrogen and carries testosterone and when I say estrogen it's all estrogen so you want to III and for testosterone it carries dihydrotestosterone and other forms of testosterone as well so what happens with PCOS is you have this androgynous ation and part of what's driving that is a decrease in sex hormone binding globulin this happens through to two distinct mechanisms but first a little bit about the sex hormone binding globulin story so so females generally have more sex hormone binding globulin because sex hormone binding globulin is increased in the liver the liver produces this protein and it goes up when you're when there's more estrogen floating around so estrogen as a signal to make more sex from one binding globulin and it actually goes down in the presence of insulin so in PCOS there is increased insulin that drives down the sectional binding globulin so typically females have lots of this excellent binding of it but because of the insulin resistance their sex hormone binding globulin goes down and as a result there's less this floating around and because of that the testosterone levels the free testosterone goes up so a testosterone you have total testosterone and then bioavailable testosterone usually you know a fraction of the total testosterone the bioavailable is basically the unbound so meaning it's not bound to any other proteins specifically sex hormone binding globulin is the one that typically binds up most of the testosterone and the other hormones so it kind of works like a buffer if you will so again why is sex hormone binding globulin low in someone with PCOS so most of the time people women with PCOS are producing more insulin so that's what insulin resistance is in the presence of the same carbohydrate load or same macronutrient load you need more insulin to get that into the tissues and insulin has an opposite reaction to sex hormone binding globulin so when insulin goes up sex hormone binding globulin goes down and then as a result of that testosterone goes up so so that's how that relationship goes no in most of the time that there that's how the issue starts but there's also this issue with estrogen too so some women with PCOS also have an ovulation meaning they don't ovulate anymore which causes low estrogen and as a result of that that estrogen also has an influence on that section on binding globulin which will the low estrogen will keep it low will prevent it from rising up like it normally does so probably and I found some paper and research to support this is over time you get that an opulent beginning stages of PCOS you're likely having the insulin resistance and over time you then you start to have androgynous ation and then over time and ovulation so that's just a theory but there is some supporting research and I'll put a link to that paper a couple papers in the description but we see the effect of high glucose and high insulin on other organs and other tissues and how it damages different organs and different tissues so it's not surprise that this may. functional medicine practitioner