Source: www.goodhormonehealth.com/SHBG and polycystic ovarian syndrome (PCOS).pdf
"SHBG also binds to estradiol and therefore, a high SHBG coupled with a normal estradiol may
mean that the amount of bioavailable estradiol is actually on the low side, and a low SHBG may
mean a higher bioavailable estradiol. Because of the wide range of estradiol, this is often less
important than for testosterone.
Dr. Friedman frequently is trying to figure out whether the patient has hypopituitarism,
polycystic ovarian syndrome, or Cushing's syndrome. All these conditions can lead to acne and hirsutism. However, the testosterone is usually high in polycystic ovarian syndrome, especially
the bioavailable testosterone, while it is usually low in Cushing's syndrome or hypopituitarism.
Dr. Friedman recently published a paper that a testosterone level above 31 ng/dL (done at
Esoterix) is more indicative of polycystic ovarian syndrome, and less than that is more indicative
of Cushing's syndrome. If the testosterone is measured in other labs, different cut-offs will be
needed.
In conclusion, it is very important to measure bioavailable and total testosterone as well as
SHBG in most women being evaluated for hormonal disorders. Dr. Friedman encourages
patients to visit his website at www.goodhormonehealth.com for more information."
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