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Sex Hormone Binding Globulin (SHBG)

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Sex Hormone-binding Globulin (SHBG) is a protein produced by the liver that binds to sex hormones, primarily testosterone and estrogen. By binding these hormones, SHBG regulates the amount of 'free' or active hormones available to the body's tissues. Levels of SHBG are influenced by estrogens, thyroid hormones, and androgens. This test is crucial for assessing hormone imbalances, as decreased levels are often seen in conditions like hirsutism, virilization, and obesity, while increased levels may indicate hyperthyroidism, male hypogonadism, or pregnancy.

Quick facts

Sample type

Serum

Turnaround

2–4 business days

Fasting

No Fasting Required

Doctor’s order included

Licensed physician review and requisition included with every test.

Sex Hormone Binding Globulin (SHBG)

  • General Health & Wellness
  • Men's Health
  • Women's Health
  • Sexual Health
  • Thyroid Function
    • Cpt Codes
    • 84270

    what is Sex Hormone Binding Globulin (SHBG) and why is it important?

    Sex Hormone-binding Globulin (SHBG) is a protein produced by the liver that binds to sex hormones, primarily testosterone and estrogen. By binding these hormones, SHBG regulates the amount of 'free' or active hormones available to the body's tissues. Levels of SHBG are influenced by estrogens, thyroid hormones, and androgens. This test is crucial for assessing hormone imbalances, as decreased levels are often seen in conditions like hirsutism, virilization, and obesity, while increased levels may indicate hyperthyroidism, male hypogonadism, or pregnancy.

    When to Consider the Sex Hormone Binding Globulin (SHBG) Test

    You may consider an SHBG test if you are experiencing symptoms or have conditions that suggest a hormone imbalance, including:

    • In women: Hirsutism (excess body hair), diffuse hair loss, or other signs of virilization.
    • In men: Symptoms suggestive of low testosterone, such as fatigue, decreased libido, or muscle loss.
    • Symptoms of hyperthyroidism, such as unexplained weight loss, rapid heartbeat, or anxiety.
    • If you are obese or have a history of liver disease (cirrhosis).
    • If you are a woman taking oral contraceptives, as these can affect SHBG levels.

    This test helps evaluate how much of your sex hormones are freely available to your body's tissues.

    Who Benefits from the Sex Hormone Binding Globulin (SHBG) Test?

    The Sex Hormone Binding Globulin (SHBG) test is particularly beneficial for individuals:

    • Experiencing symptoms of hormone imbalance, such as unexplained hair loss or excessive hair growth (hirsutism) in women.
    • With signs of virilization (development of male characteristics in females).
    • Who are obese, especially postmenopausal women.
    • With suspected male hypogonadism (low testosterone).
    • Diagnosed with or suspected of having hyperthyroidism or liver conditions like cirrhosis.
    • Considering or currently using oral contraceptives, as these can influence SHBG levels.

    Understanding your SHBG levels can provide insight into the availability of your sex hormones, offering crucial information for managing various health conditions.

    Commonly Used for Diagnosis and Management Of

    The Sex Hormone Binding Globulin (SHBG) test serves as a critical diagnostic and monitoring tool for a range of conditions related to sex hormone balance. As a physician, I frequently utilize SHBG levels to gain deeper insights into a patient's endocrine health, particularly when symptoms suggest an imbalance in biologically active hormones.

    In Women:

    • Hirsutism and Virilization: Low SHBG levels are often a key indicator in women experiencing excessive hair growth (hirsutism), acne, or other signs of virilization, suggesting higher levels of free androgens. This can be crucial in diagnosing conditions like Polycystic Ovary Syndrome (PCOS).
    • Polycystic Ovary Syndrome (PCOS): SHBG is frequently suppressed in PCOS, reflecting increased free androgen levels and insulin resistance, which are central to the syndrome's pathophysiology.
    • Ovulatory Dysfunction: Abnormal SHBG levels can contribute to or reflect underlying hormonal imbalances affecting menstrual regularity and fertility.

    In Men:

    • Hypogonadism (Low Testosterone): While total testosterone may appear normal, low SHBG can indicate elevated free testosterone, and conversely, high SHBG can lead to symptoms of low testosterone despite adequate total levels, guiding treatment decisions for true androgen deficiency.
    • Andropause Symptoms: For men experiencing symptoms such as fatigue, decreased libido, or muscle loss, SHBG helps differentiate between actual testosterone deficiency and issues related to its bioavailability.

    In Both Genders:

    • Thyroid Disorders: Particularly hyperthyroidism, which often leads to elevated SHBG. Monitoring SHBG can assist in assessing thyroid function impact on sex hormones.
    • Liver Disease (e.g., Cirrhosis): As SHBG is produced by the liver, its levels can be altered in liver dysfunction, serving as a marker for hepatic synthetic capacity and its influence on hormone metabolism.
    • Obesity and Insulin Resistance: Low SHBG levels are commonly observed in individuals with obesity and insulin resistance, reflecting an altered hormonal milieu that can predispose to metabolic syndrome and related complications.
    • Monitoring Hormone Replacement Therapy: SHBG levels can be monitored to assess the effectiveness and impact of sex hormone replacement therapies (e.g., estrogen or testosterone therapy) on the bioavailability of administered hormones.

    By integrating SHBG results with clinical presentation and other hormonal assays, a comprehensive picture of a patient's endocrine status can be formed, leading to precise diagnoses and tailored management strategies.

    Caution

    Important Considerations for Your SHBG Test Results

    It's important to discuss your SHBG test results with a healthcare provider. They can interpret the findings in the context of your overall health, symptoms, and medical history to determine the best course of action for you. This test provides valuable information, but it is just one piece of a comprehensive health assessment.

    As with all tests containing monoclonal mouse antibodies, erroneous findings may be obtained from samples taken from patients who have been treated with monoclonal mouse antibodies or who have received them for diagnostic purposes. In rare cases, interference due to extremely high titers of antibodies to streptavidin and ruthenium can occur.

    Frequently Ordered Together

    How It Works?

    1
    Add Your Test to Cart and Check out

    once Test Order is received, Our physicians will review your request and email you the easy-to-follow requisition form.

    2
    Locate and Visit Your Nearest Laboratory

    Find the closest partner location—most are within 2–3 miles—and drop by for a quick, no‑appointment blood draw.

    3
    Get your Results Online

    Once your sample is processed, we’ll send your report straight to your inbox within 1–3 business days. Just click the link to view your results anytime.

    4
    Book a Optional Consult

    Have Questions about results? Book a phone or video visit with one of our doctors. They’ll walk you through your report, explain any findings, and recommend next steps