This gets cited here weekly, usually second-hand, so it is worth setting out what it does and does not establish.
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 comparator does most of the work in how this gets reported, and it is not the comparator most people think they are citing.
The question I want answered is why total and free can move differently here, and which of the two is worth tracking. Not looking for reassurance. Looking for the part I have got wrong.
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.
EndoResFellow 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: 18 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.
EndoResFellow 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: 307 → 627 ng/dL (dramatic improvement!)
Free T: 6.2 → 13.7 ng/dL
Estradiol: 44 → 25 pg/mL
SHBG: 21 → 49 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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View ResultsDr.ObesityMed said:Sex hormone labs after weight loss on the hormone panel — for the men in this thread: Testosterone: 307 → 627 ng/dL (dramatic improvement!) Free T:…
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.
LabKate said:HPA axis assessment on the hormone panel: rarely ordered but informative for understanding the stress-metabolism connection: 4-point salivary…
Adding a me-too, because a thread of one person's experience is not much use. The detail I would add is minor and it is already implied above.