MAY 7, 2011 SEX HORMONE BINDING GLOBULIN ( SHBG)

"The purpose of our lives is to be happy." Dalai Lama

If you do not want happiness in your life, then something is wrong. Everyone deserves happiness, including you. I used to think I could never be happy. I had a good childhood. There was no addictions growing up except the family drama. Every Italian family I know has drama. We were no exception. I am sure my brother and I created drama for our mother. My brother was born 50 years ago today on Mother's Day. I was born the year before on Father's Day. My mother dressed us like Irish twins when we were young. Always in matching outfits, some which she and my Nanny made. Looking back at those photos today does put a smile on my face. We were close when we were young, but as we got older we had some differences. Today I look at those differences as the men who we became- different occupations, different lives, and different opinions. Despite these differences, we are brothers. If you have a sibling(s) it doesn't matter what differences you have or have had--you will always have a brother or sister. There is comfort in knowing that, especially when your parents are no longer here. So with warmest love and affection I say Happy 50th dear brother, Paul.

There is a marker of hormonal balance called Sex Hormone Binding Globulin (SHBG). It is a very important marker and its imbalances are associated with many diseases and the aging process. I ordered it recently on a male patient to see why his testosterone level was low despite replacement. It is useful information, but the insurance company refused to pay for the blood test. Why didn't the insurance company pay for the lab test? I do not know, but I do know the insurance companies often dictate how we practice medicine today.

SHBG is produced in the liver (just as cholesterol). It is a transport carrier for estrogens and testosterone. It is the master regular of the sex hormones. SHBG levels rise as we get older, as the sex hormones continue to decline. Testosterone (in males and females) declines as aromatase enzyme levels increase, moving testosterone to more estrogen and progesterone. What doctors don't usually know is that circulating testosterone in your blood is either bound to the protein albumin or SHBG. So it is important to measure and insurance companies should pay the bill.

For me the SHBG level is linked to a cardiovascular marker called HS (or high sensitive or cardiac) C- reactive protein (HS-CRP). Low SHBG globulin is linked to elevated triglycerides (TG) and LDL (low density lipoproteins). When you have a high TG you will have a low HDL(good cholesterol) There is an inverse relationship between TG and HDL.

Low SHBG is associated with high levels of CRP is women. This is the inflammatory and infection marker for the coronary arteries. For men, a low SHBG indicates a higher incidence of death from cardiovascular disease.

Another fact is that the steady rise in SHBG with aging is directly correlated to bone loss and osteoporosis in women and men. So I ask again, why aren't insurance companies paying for this blood test?

SHBG can be a preventative marker for many diseases. We need to practice Preventative Medicine . Studies indicate that SHBG abnormalities is associated with many diseases.

Ask your doctor to order a serum SHBG level and fight your insurance company to PAY for it.

Until tomorrow...