Sanesco Blog

Sex Hormone Balance & Your Thyroid


The thyroid gland is, without a doubt, one of the most highly influential glands in the human body. As our Chief Medical Officer, Dr. R.W. “Chip” Watkins, MD, MPH, FAAFP, likes to say: nothing moves in the body without the thyroid.

Thyroid Hormones and SHBG

Thyroid hormones are important for the catabolism and anabolism of many molecules. Thyroid hormones seem to dictate the production of an important glycoprotein called Sex Hormone Binding Globulin, or SHBG. There is positive correlation between thyroid hormone levels and SHBG levels.

SHBG and Hypothyroidism

One study found that those with hypothyroidism had lower levels of SHBG than subjects with healthy thyroid glands. After the researchers of this study administered thyroid medication to the hypothyroid subjects, they found that their SHBG levels increased in a dose-dependent manner (1).

SHBG and Hyperthyroidism

Another study found high SHBG levels to be associated with hyperthyroidism. This study saw a decrease in SHBG levels after normalizing thyroid hormone levels in hyperthyroid subjects (2).

SHBG’s production occurs in the liver and is regulated by hepatocyte nuclear factor-4-alpha or HNF4A. Thyroid hormones’ ability to raise SHBG levels is proposed to be through increasing HNF4A gene expression, thus indirectly upregulating SHBG levels (3).

High SHBG levels can have some negative implications.

One major negative implication of high SHBG could be a decrease in the level of free, unbound sex hormones circulating in the bloodstream. One study found that male subjects with normal total testosterone levels and low calculated free testosterone had high levels of SHBG (4). Thus, one could possibly draw the connection between high SHBG levels and symptoms of hypogonadism in males, such as low libido and fatigue.

Hypogonadism symptoms and low free estradiol may be present in females with high SHBG, as estradiol also binds to SHBG.

Testing Thyroid Function and SHBG Levels

It is important to assess thyroid hormone and SHBG levels to determine if there is an imbalance. If your SHBG level is elevated, boron supplementation may be helpful in reducing it (5).

In addition to assessing thyroid and sex hormone status, your neurotransmitter and adrenal hormone levels may need to be measured. Thyroid hormones, sex hormones, neurotransmitters, and adrenal hormones all function together to create optimal health and balance throughout the body.

Talk to your health care practitioner today about Sanesco’s testing to gain further insight into your specific biochemistry and hormonal balance.



  1. Cavaliere, H., Abelin, N., & Medeiros-Neto, G. (1988). Serum Levels of Total Testosterone and Sex Hormone Binding Globulin in Hypothyroid Patients and Normal Subjects Treated with Incremental Doses of L-T 4 or L-T 3. Journal of Andrology, 9(3), 215-219. doi:10.1002/j.1939-4640.1988.tb01038.x
  2. Ford, H. C., Cooke, R. R., Kelghtley, E. A., & Feek, C. M. (1992). Serum levels of free and bound testosterone in hyperthyroidism. Clin Endocrinol Clinical Endocrinology, 36(2), 187-192. doi:10.1111/j.1365-2265.1992.tb00956.xsex ho
  3. Selva, D. M., & Hammond, G. L. (2009). Thyroid hormones act indirectly to increase sex hormone-binding globulin production by liver via hepatocyte nuclear factor-4-alpha. Journal of Molecular Endocrinology, 43(1), 19-27. doi:10.1677/jme-09-0025
  4. Antonio, L., Wu, F. C., O’neill, T. W., Pye, S. R., Ahern, T. B., Laurent, M. R., . . . Vanderschueren, D. (2016). Low Free Testosterone Is Associated with Hypogonadal Signs and Symptoms in Men with Normal Total Testosterone. The Journal of Clinical Endocrinology & Metabolism, 101(7), 2647-2657. doi:10.1210/jc.2015-4106
  5. Naghii, M. R., Mofid, M., Asgari, A. R., Hedayati, M., & Daneshpour, M. (2011). Comparative effects of daily and weekly boron supplementation on plasma steroid hormones and proinflammatory cytokines. Journal of Trace Elements in Medicine and Biology, 25(1), 54-58. doi:10.1016/j.jtemb.2010.10.001

Clinical Contributor

Nathan Bridges

Clinical Support Manager at Sanesco International, Inc.

Nathan Bridges is the Clinical Support Manager at Sanesco. He holds a Bachelors of Science in Health and Wellness Promotion with a minor in Psychology. He keeps a healthy mind and body by trail running, playing chess, and regularly reviewing recent research.

Connie Shoemaker, ND

Connie Shoemaker, ND

“Educating Sanesco’s clients is the culmination of a life’s work.” Beginning when she left the hospital environment to manage a functional laboratory, Genova Diagnostics (formerly Great Smokies Laboratories) in 1987, Dr. Connie Shoemaker has continued to increase her knowledge of herbs and biochemistry as a journey of love. With her bachelor’s in science from Western Carolina University, she had worked in hospital laboratories for the first twelve years of her career. Then, personal health challenges led her to discover a new approach to her health and a determination to share it with others. In 1991, she began teaching and educating innovative practitioners in the U.S. and internationally as a manager of marketing, sales, and customer service.

The addition of her Doctor of Naturopathy degree to her existing knowledge base expanded her knowledge and her respect for a more natural approach to healing through balance. At Sanesco, she initially served to oversee technical development of products and services.

Now, she educates Sanesco’s clients on application of the CSM™ model for their specific patients and how to integrate the CSM™ model with other modalities they offer in their practice. In her personal life, Connie educates private clients on various health topics.

Disclaimer: The information provided is only intended to be general educational information to the public. It does not constitute medical advice. If you have specific questions about any medical matter or if you are suffering from any medical condition, you should consult your doctor or other professional healthcare provider.

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