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ForumsLab Results & BiomarkersSHBG changes during weight loss on GLP-1 — hormonal implications

SHBG changes during weight loss on GLP-1 — hormonal implications

Dr.ReproEndo Fri, May 29, 2026 at 2:44 AM 17 replies 420 viewsPage 1 of 4
Dr.ReproEndo
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May 29, 2026 at 2:44 AM#1

Putting this up for argument rather than for agreement. I have read it twice and I am still not certain what it supports.

Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect. Less adipose tissue means less aromatase activity, so in men testosterone commonly rises and estradiol falls, and SHBG rises as insulin resistance improves — which means total testosterone can rise while free testosterone moves less than expected. In PCOS, improved insulin sensitivity frequently restores ovulation, which is a fertility change people are not always expecting.

Where I think it is weakest: the follow-up is short relative to how long people actually take these drugs, so durability is an assumption here rather than a finding.

So the question, as narrowly as I can put it: why total and free can move differently here, and which of the two is worth tracking. I have searched first, so if this is covered somewhere point me at it and I will read it.

Note on sourcing:
Figures above are from the primary publication rather than the press summary. If a number here disagrees with one you have, post yours and we will work out which of us is reading a secondary source.
13 16mona_PHX, andrew_nyc, Dr.EndoEP and 10 others
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BenResearch_OR
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May 29, 2026 at 3:05 AM#2
Dr.ReproEndo said:
Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect.

HPA axis assessment on the hormone panel: rarely ordered but informative for understanding the stress-metabolism connection:

4-point salivary cortisol:

  • Morning: 16 ng/mL → 13 ng/mL (improved)
  • Noon: 9 ng/mL → 6 ng/mL
  • Evening: 5 ng/mL → 2 ng/mL
  • Night: 3 ng/mL → 1 ng/mL

The cortisol curve is normalizing — less flat, better diurnal variation. Reduced visceral fat = reduced cortisol overproduction. The metabolic benefits cascade into stress hormone regulation.

14 17PharmD_Rodriguez, julia.endo, JessicaM_2024 and 11 others
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LibrarianMeg
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May 29, 2026 at 3:26 AM#3
Dr.ReproEndo said:
Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect.

Hormone panel changes on the hormone panel — relevant for anyone curious about endocrine effects:

  • Testosterone: increased 42% (weight loss reduces aromatase in adipose tissue)
  • Estradiol: normalized from elevated baseline
  • SHBG: increased appropriately
  • Free testosterone: increased 18%
  • Cortisol AM: within normal limits, no significant change

My reproductive endocrinologist says the testosterone improvement alone could explain the energy and mood benefits I've experienced.

15 18julia.endo, JessicaM_2024, TomFromTexas and 12 others
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Dr.PathRoch
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May 29, 2026 at 3:47 AM#4
LibrarianMeg said:
Hormone panel changes on the hormone panel — relevant for anyone curious about endocrine effects: Testosterone: increased 42% (weight loss reduces…

Sex hormone labs after weight loss on the hormone panel — for the men in this thread:

Testosterone: 341 → 621 ng/dL (dramatic improvement!)
Free T: 5.6 → 13.1 ng/dL
Estradiol: 53 → 27 pg/mL
SHBG: 23 → 43 nmol/L

Visceral fat contains aromatase which converts testosterone to estrogen. As you lose visceral fat, this conversion decreases and testosterone naturally rises. I feel 10 years younger.

16 19SaraMom3, Dr.MetabolicMD, RetaRick_CA and 13 others
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chris_chi24
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May 29, 2026 at 5:38 AM#5
BenResearch_OR said:
HPA axis assessment on the hormone panel: rarely ordered but informative for understanding the stress-metabolism connection: 4-point salivary…

Same experience, arrived at from the opposite direction. I had assumed I was the exception until I read this.

17 20SleepFixSam, PurityPaulOR, MaxMetOK and 14 others
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