The intentional adjustment of the binding affinity or concentration of circulating proteins responsible for transporting steroid and thyroid hormones, such as Sex Hormone-Binding Globulin (SHBG) or Thyroid-Binding Globulin (TBG). Modulating these carriers directly alters the fraction of biologically active, unbound hormone available to target tissues, even if total hormone levels remain unchanged.
Origin
This area arises from clinical biochemistry, recognizing that total hormone assays do not always reflect physiological availability, necessitating a focus on the dynamic equilibrium between bound and free fractions. It is a critical concept in interpreting sex hormone panels.
Mechanism
Modulation affects the free hormone fraction ($fT_3$, free testosterone) by altering the binding capacity of SHBG or albumin. For example, certain nutritional states or pharmaceutical agents can increase SHBG synthesis in the liver, effectively sequestering more total testosterone and lowering the bioavailable pool perceived by peripheral receptors.
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