#37

The only way to know if high SHBG is a problem is to also measure “free Testosterone” levels. SHBG levels regulate the level of “free Testosterone” by binding a large fraction of the total Testosterone. If “free Testosterone” levels are low, but total Testosterone is normal or high, then the problem is likely excessive levels of SHBG.

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#38

Yes. That’s similar to what the endocrinologist said. She said total testosterone was the thing to pay attention to and that the assay for free testosterone is unreliable and that my range was not problematic. She said only to worry about SHBG if you were taking specific medications that might have a side effect of raising it.

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#39

The normal test for “free Testosterone” is not very accurate, but there is a more expensive LC/MS based test available. Marek sells a more accurate Labcorp test for total and free Testosterone for $90 : Total Testosterone (LC/MS) Free Testosterone (Equilibrium Dialysis) – Marek Diagnostics

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#40

Nope. Normal non-diabetic a1c is below 5.7 per CDC and American Diabetes Association.

#41

That just means the cutoff for being classified as pre-Diabetic is 5.7 or more and anyone with A1C 5.6 or less (while not taking diabetes medications) is considered non-Diabetic. It does NOT mean that a non-diabetic with an A1C of 5.0 to 5.6 is normal or healthy.

It looks like the 5.7 cutoff is based on the 97.5 percentile of A1C for those not previously diagnosed as diabetic AND having fasting BG < 127 and 2-hour post meal BG < 140.

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#42

I’m doing an experiment to budge mine down a bit per

But that is mostly to see if I feel different / if has an effect on my strength training. From a pure longevity perspective it may not be bad and even good

In human and rodent CR individuals SHBG is higher

Perhaps higher SHBG is actually consistent with multiple longevity dimensions…. see eg below.

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#43

I have a hypothesis that megadosing melatonin drives up SHBG. I am not particularly stressed about it though.

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#44

It does NOT mean that a non-diabetic with an A1C of 5.0 to 5.6 is normal or healthy.

That is what the CDC website explicitly says - “A normal A1C level is below 5.7%”

Never seen anywhere that says, “All non-diabetics are supposed to have A1C 4.9 or less.”

#45

That’s what I found interesting about the video that an HbA1c above 5 is possibly better than say 4 (from the perspective of ACM.). However, lower HbA1cs are probably linked to alcohol consumption to some extent.

In early 2022 I was binge drinking intermittently, but also had peaks of over 10 mmol/L in serum glucose. According to the CGM my peaks are now (then because it was some months ago) under 8 mmol/L, but I am still intermittently binge drinking.

What I should probably do is review the week before my measurement of 4.18% and see if there is an obvious cause.

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#46

Higher alcohol intake was associated with lower HbA1c levels

Wow, if that explains it in the population, then maybe lower levels, like 4.8 (or even ~4.5) are ideal, not 5.

4.8 still does not mean hypoglycemia.

I almost never drink alcohol and my levels have consistently been 4.8-4.9 irrespective of diet (even though my glucose spikes heavily in response to carbs (and are thick), esp fruit, so mine could be lower)

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Saúde Cardiovascular
#47

You may be right, but it is difficult to isolate the effect of alcohol.

#48

what if your level is real low because you are non prediabetic and taking life extension drugs like sglt2 and acarbose?

#49

How low is real low? Are you suffering the effects of hypoglycemia?

#50

Neither acarbose or SGLT2i have much potential for hypoglycemia.
Acarbose just slows the absorption of glucose, thus no postprandial spike and SLGT2 inhibitors start working at around 140 mg/dl and just flattens the spike above that level.

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#51

no, just potentially (haven’t measured) lower than what would be optimal for some on all cause mortality

#52

Good to hear. I want to ramp up on the acarbose too for possible life extension. It would seem a little precarious for a non prediabetic taking a high or solid dosage of both jardiance and acarbose. On the initial glucose readings though I didn’t notice any hypoglycemia taking jardiance 25 and acarbose 50 once a day (didn’t see hba1c yet)

#53

If your blood sugar is too low, your body will tell you by giving you side effects such as nausea, dizziness, etc… This is typically a sign of hypoglycemia. So, if these side effects manifest, then your blood sugar is too low.

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#54

I’m trying to find studies how much oral melatonin affects CSF concentrations? I couldn’t find any.

#55

Thank you for this information. I had not heard this at all. Are you saying the SGLT2 does nothing until blood sugar gets up to 140? So a guy on keto using it overnight and it does nothing? I really have trouble believing this. I thought it was draining 500 grams of glucose per day. Where did you get this ?

#56

That is not quite correct : SGLT2i will lower fasting BG, well below 140 mg/dl, though its effect is stronger when BG is above 140mg/dl. It is indeed unlikely to cause hypoglycemia unless you are also taking insulin (in which case you will need need to lower your basal insulin dosage to keep your fasting BG at your target level).

In fact, SGLT2i’s are probably the only safe medication to lower fasting BG (the other medication, basal insulin, is more effective but comes with a serious risk of hypoglycemia due to accidentally injecting into a small vein, which happens about 1-2 times per year by accident). Bill Faloon, the president of Life Extension Foundation is a great advocate for non-diabetics using SGLT2i’s to lower their fasting BG to youthful levels of 70-75 (along with lowering sodium levels to reduce hypertension). Association studies, similar to the one that started this thread, seem to show a J shaped curve with minimum ACM at fasting BG of 85 for those over age 60 : This could be misleading and caused by reverse causation so optimal levels of fasting BG may indeed be closer to youthful levels of 70-75 as suggested by Bill Faloon, or alternately, it is possible that aging brains need more BG for optimal functioning (for example, to avoid the risk of death from slip & fall due to slower reaction times).

More generally, targeting optimal fasting BG makes more sense than targeting optimal A1C : The risk of hypoglycemia and possible suboptimal brain function depends mainly on fasting BG (the lowest level of BG you are likely to encounter if NOT taking Insulin), and since A1C levels are directly proportional to the level of AGE formation, the lower the better, for a given value of fasting BG.

With fasting BG=70, the lowest achievable A1C = 4.1 (if you avoid all refined carbs and sugar, or load up on Acarbose and avoid all sugar), so your BG is 70 at all times. With fasting BG=85, the lowest achievable A1C = 4.6.

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