SHBG is reduced by: high insulin (insulin resistance/diabetes), low thyroid, high testosterone, high DHEA, high growth hormone, low estrogens, low progesterone, high dihydrotestosterone
SHBG is increased by: low insulin, high thyroid, high estrogens, high progesterone, low testosterone, low DHEA, low growth hormone, low Dihydrotestosterone.
Low SHBG increases Free Testosterone.
High SHBG reduces Fress Testosterone
The hormone with the strongest effect on SHBG is insulin.
Low SHBG is most often strongly correlated with diabetes or insulin resistance.
High androgen levels such as the use of supraphysiologic doses of testosterone can also drive SHBG down.
Most cases of insulin resistance/type II diabetes start with hypothyrodism (low thyroid hormone levels). Treating thyroid hormone deficiency can prevent the development of insulin resistance and diabetes. Once the horse is out of the barn - and diabetes type II is present, increasing thyroid hormone alone may not always reverse insulin resistance since other hormone imbalances may occur to perpetuate insulin resistance (e.g. testosterone deficiency or adrenal fatigue - which in turn worsens conversion of T4 to T3, etc.) or end-organ damage may occur which may be irreversible. Insulin resistance itself can worsen thyroid function - thus causing a positive feedback loop or death spiral - by causing loss of zinc and iodine and by causing nervous system damage. This is where the relationships between hormone systems and nutrition become highly intricate and undoing problems can become complex.