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.
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.
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.
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.
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View ResultsLibrarianMeg 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.
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.