This is the version of the explanation I wish somebody had given me, written down before I forget what confused me. It is about the hormone panel, and it is deliberately narrow — everything I am not confident about is marked as such.
What is actually established
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.
The condition it depends on
This is a case where measuring the free fraction rather than the total matters, because SHBG is moving at the same time.
What I am not sure about
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. Practical detail welcome, however dull — the duller the better.
DadBodDave 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: 15 ng/mL → 12 ng/mL (improved)
- Noon: 8 ng/mL → 5 ng/mL
- Evening: 4 ng/mL → 2 ng/mL
- Night: 2 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.
DadBodDave said:Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect.
Sex hormone labs after weight loss on the hormone panel — for the men in this thread:
Testosterone: 357 → 597 ng/dL (dramatic improvement!)
Free T: 7.2 → 13.7 ng/dL
Estradiol: 44 → 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.
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Shop Reference StandardsTrialNerd_Beth said:Sex hormone labs after weight loss on the hormone panel — for the men in this thread: Testosterone: 357 → 597 ng/dL (dramatic improvement!) Free T:…
Hormone panel changes on the hormone panel — relevant for anyone curious about endocrine effects:
- Testosterone: increased 28% (weight loss reduces aromatase in adipose tissue)
- Estradiol: normalized from elevated baseline
- SHBG: increased appropriately
- Free testosterone: increased 31%
- 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.
anders_CPH said:HPA axis assessment on the hormone panel: rarely ordered but informative for understanding the stress-metabolism connection: 4-point salivary…
This matches mine closely enough to be worth saying so out loud. The detail I would add is minor and it is already implied above.