A very recent paper by Ito et al (Ito M, Miyauchi A, Fujiwara M et al, TITLE: Biochemical markers reflectng thyroid function in athyreotic patients on levothyroxine monotherapy: Source Thyroid 2017. discusses this very topic and uses SHBG as a marker for adequate treatment. The paper is held in TUK by Louise Roberts for members to read.
SHBG is a marker (like cholesterol - invesely) for thyroid hormone activity, it is not conclusive but one more piece in the jigsaw. If your SHBG is really low it is unlikely to be due to hypothyroidism, more likely some other cause which should be checked out. Hypothyroidism could still be contributing to some degree.
The National Acadamy of Hypothyroidism stated this
' A symptomatic patient with an average T3 level and a below average free T3 (a general guidline being a free T3/reverse T3 ratio less than 2) should be considered as a candidate for thyroid supplementation. A relatively low SHBG can be useful marker for low tissue thyroid levels and can aid in the diagnosis of tissue hypothyroidism' ???
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