Sex hormone-binding globulin and risk of hyperglycemia in patients with androgenetic alopecia.

J Am Acad Dermatol. 2011 Apr 19. [Epub ahead of print]
Sex hormone-binding globulin and risk of hyperglycemia in patients with androgenetic alopecia.
Arias-Santiago S, Gutiérrez-Salmerón MT, Buendía-Eisman A, Girón-Prieto MS, Naranjo-Sintes R.
Source
Dermatology Unit, San Cecilio University Hospital, Granada, Spain.

BACKGROUND:
Low circulating levels of sex hormone-binding globulin (SHBG) are a strong predictor of the risk of type 2 diabetes. Androgenetic alopecia (AGA) has been related to an increase in cardiovascular risk, but the mechanism of this association has not been elucidated. AGA can be associated with low levels of SHBG and insulin resistance, which could be related to hyperglycemia and type 2 diabetes.

OBJECTIVE:
The objective of this study was to evaluate SHBG and blood glucose levels in men and women with early-onset AGA and control subjects to determine whether low levels of SHBG are associated with hyperglycemia.

METHODS:
This case-control study included 240 patients consecutively admitted to the outpatient clinic (Dermatology Department of San Cecilio University Hospital, Granada, Spain), 120 with early-onset AGA (60 men and 60 women) and 120 control subjects (60 men and 60 women) with skin diseases other than alopecia.

RESULTS:
Of patients with AGA, 39.1% presented with hyperglycemia (>110 mg/dL) versus 12.5% of controls (P < 0.0001). AGA patients with hyperglycemia or diabetes presented lower significant levels of SHBG than alopecic patients without hyperglycemia or type 2 diabetes, respectively. Patients with AGA and hyperglycemia presented significantly lower levels of SHBG than controls with hyperglycemia (22.3 vs 39.4 nmol/L for AGA patients and controls, respectively, P = .004). No significant differences in SHBG levels were noticed between patients and controls without hyperglycemia. Binary logistic regression showed a strong association between lower SHBG levels and glucose levels greater than 110 mg/dL in patients with AGA even after additional adjustment for sex, abdominal obesity, and free testosterone (odds ratio = 3.35; 95% confidence interval = 1.9-5.7; P < .001).

LIMITATIONS:
The study of a wider sample of AGA patients would confirm these findings and would permit analysis of the pathogenic mechanisms underlying the increase in cardiovascular risk in patients with AGA.

CONCLUSION:
An association between early-onset AGA, hyperglycemia/diabetes, and low levels of SHBG was observed in the current study. Low levels of SHBG could be a marker of insulin resistance and hyperglycemia/diabetes in patients with AGA.

So we should try to increase SHBG? Would raising free T help with this?

CS are you aware of any studies correlating heavy metal levels with MPB?

theseeker wrote:So we should try to increase SHBG? Would raising free T help with this?

In order to raise free T, you would need to lower SHBG. At least that is the only way I'm aware of. I'm talking about the ratio. You could raise total free T if you raise T and/or block E.

crincrin wrote:CS are you aware of any studies correlating heavy metal levels with MPB?

I've looked on many occasions but have not found any.

What I can say is that there is anecdotal evidence--I've heard of patients mentioning that they heard of people experiencing hair growth following courses of ETDA-chelation (it primarily removes Lead).

Regarding SHBG. Low SHBG is only a concern in young people when testosterone is at an all time high. To normalize SHBG requires improve blood sugar stabilization--there's really nothing new with this study because similar ones have been published in the past few years.

Antioxidants, such as the ones from plants will help normalize SHBG and of course, avoidance of refined grains and sugars.

Paradox wrote:

theseeker wrote:So we should try to increase SHBG? Would raising free T help with this?

In order to raise free T, you would need to lower SHBG. At least that is the only way I'm aware of. I'm talking about the ratio. You could raise total free T if you raise T and/or block E.

You can also lower aromatase... There are plenty of other factors involved with free T... Yes SHBG is common and especially in the case of this study because IGF-1 has a negative correlation with SHBG... Most people who have low SHBG have caused such implications by a diet high in carbohydrates

Glucose and fructose are metabolized in the liver. When there’s too much sugar in the diet, the liver converts it to lipid. Using a mouse model and human liver cell cultures, the scientists discovered that the increased production of lipid shut down a gene called SHBG (sex hormone binding globulin), reducing the amount of SHBG protein in the blood. SHBG protein plays a key role in controlling the amount of testosterone and estrogen that’s available throughout the body.

Link to article: http://www.sciencedaily.com/releases/2007/11/071109171610.htm

CS are you aware of any studies correlating heavy metal levels with MPB?

I found this study about how mercury exacerbates autoimmune disorders:
www.melisa.org/pdf/Mercury-and-autoimmunity.pdf

itzmecorey wrote:

Paradox wrote:

theseeker wrote:So we should try to increase SHBG? Would raising free T help with this?

In order to raise free T, you would need to lower SHBG. At least that is the only way I'm aware of. I'm talking about the ratio. You could raise total free T if you raise T and/or block E.

You can also lower aromatase... There are plenty of other factors involved with free T... Yes SHBG is common and especially in the case of this study because IGF-1 has a negative correlation with SHBG... Most people who have low SHBG have caused such implications by a diet high in carbohydrates

That's what i meant by blocking the conversion to E- lowering aromatase.

I disagree that increasing SHBG is only necessary in "young" people with high androgens.

I'm one of the "lucky ones" with low SHBG, so I can speak to it very directly.

At age 19, I was diagnosed with clinically low testosterone (clinical hypogonadism) with a testosterone level of 185 ng/dl. Naturally, I also had low SHBG. Increasing testosterone with testosterone injections and medications has not helped. The SHBG stays low. In fact, it goes even lower (from 13 down to about 9 nmol/dL.)

You'd think that would be the perfect situation for someone concerned with hair loss. Low T = low DHT = delayed hair loss, right? The problem, however, was that even with low total testosterone and low free testosterone, I started going bald at 17! If that doesn't speak to the havok that low SHBG can wreak, I don't know what will.

I didn't start testosterone supplementation until age 22, and I began taking Propecia once I became aware of the potential increase in DHT from my topical androgen medication.

I am currently trying desperately to raise SHBG. Per CS recommendations, I'm going to try beta-sisterol. Can I also use soy isoflavones?