Hormone Binding Globulin (SHBG) Biomarker Test

Hormone Binding Globulin (SHBG) Biomarker Test Guide

The Sex Hormone Binding Globulin (SHBG) biomarker test measures the amount of SHBG protein in the blood. SHBG binds to sex hormones—such as testosterone, estrogen, and dihydrotestosterone (DHT)—and regulates their availability in the body. This test provides valuable insights into hormonal imbalances that can affect various aspects of health, including reproductive function, metabolism, and sexual development.

What Is the Hormone Binding Globulin (SHBG) Biomarker Test?

The SHBG biomarker test is a blood test that measures the levels of Sex Hormone Binding Globulin in the bloodstream. SHBG is a protein that binds to sex hormones and controls how much of these hormones are available to the body’s tissues. The test is primarily used to assess hormone balance and the availability of free (unbound) hormones, particularly testosterone and estrogen. This test is often performed alongside other hormone tests, such as free testosterone or estradiol.

Why Get an SHBG Test?

An SHBG test is typically performed to:

Evaluate hormone-related conditions: It helps assess whether there is an imbalance in sex hormones (testosterone or estrogen) that could be causing symptoms like fatigue, sexual dysfunction, or abnormal menstrual cycles.
Diagnose hormonal disorders: SHBG levels can help diagnose conditions like polycystic ovary syndrome (PCOS), hypogonadism, or thyroid disorders.
Evaluate fertility issues: Hormonal imbalances can play a significant role in fertility, and SHBG levels provide insight into hormone regulation.
Assess androgen-related disorders: High or low SHBG levels can help diagnose androgen-related conditions, such as hirsutism (excessive hair growth) or androgenic alopecia (hair loss).
Monitor metabolic conditions: Low SHBG levels are often associated with insulin resistance, type 2 diabetes, and metabolic syndrome.

Any Related Health Symptoms and Reasons to Take the Test

Symptoms or health conditions that may prompt a healthcare provider to recommend an SHBG test include:

Unexplained fatigue or low energy
Abnormal menstrual cycles or signs of menopause
Sexual dysfunction (low libido, erectile dysfunction)
Infertility
Excessive hair growth or hair loss (in women, this can indicate androgen excess)
Acne or oily skin, often associated with elevated androgens
Weight gain or difficulty losing weight
Signs of hormone imbalance: such as gynecomastia (breast development in men) or hot flashes in women

What Are the Normal Ranges for SHBG?

SHBG levels can vary based on gender, age, and other factors like pregnancy or hormonal medications. Generally, the normal ranges are:

Men: 10 to 57 nmol/L
Women (premenopausal): 18 to 144 nmol/L
Women (postmenopausal): 14 to 76 nmol/L
Pregnancy: SHBG levels increase significantly during pregnancy due to elevated estrogen.

SHBG levels should always be interpreted in the context of other hormone tests, as they reflect the availability of free and active sex hormones.

What Type of Health Professionals Can Use the Results?

SHBG test results are used by various healthcare providers:

Endocrinologists: Specialists in hormone-related disorders use SHBG results to diagnose and manage conditions like hypogonadism, PCOS, or thyroid disorders.
Gynecologists: May use SHBG levels to assess hormone balance in women with irregular menstrual cycles, menopause symptoms, or fertility issues.
Reproductive endocrinologists: Utilize SHBG results in fertility assessments to evaluate the hormonal environment and its impact on conception.
Primary care physicians: Can order this test to investigate symptoms of hormone imbalance or metabolic conditions like diabetes and obesity.
Urologists: May use SHBG levels when assessing testosterone availability and diagnosing low testosterone or sexual dysfunction in men.

How to Prepare for the Test

Preparing for the SHBG test is simple:

No fasting required: You don’t need to fast before the test.
Inform your doctor of medications: Some medications, such as hormonal birth control or thyroid medications, may affect SHBG levels. Your healthcare provider may advise adjusting these before testing.
Timing of the test: While SHBG levels don’t fluctuate much throughout the day, your doctor may recommend testing at a specific time based on your hormonal cycle, especially for women.
Hydration: Drink water before the test to stay hydrated.

How Often Should the Test Be Taken?

The frequency of SHBG testing depends on the clinical context:

One-time test: For initial diagnosis of hormonal imbalances or metabolic disorders.
Regular monitoring: Patients undergoing hormone replacement therapy (HRT), treatment for PCOS, or those with ongoing hormonal issues may need regular SHBG testing to track changes in hormone levels.
Follow-up testing: After treatment or lifestyle modifications, follow-up SHBG tests may be needed to evaluate the effectiveness of interventions.

What’s the Next Step After Testing?

After receiving SHBG test results, the next steps depend on the findings:

Normal levels: If SHBG levels are within the normal range, your healthcare provider will interpret them in combination with other hormone levels (such as testosterone or estrogen) to determine whether hormone balance is adequate.
High SHBG levels: High SHBG can lower free testosterone levels, causing symptoms of low testosterone in men (e.g., fatigue, decreased libido, erectile dysfunction). Women with high SHBG may experience symptoms of estrogen dominance or androgen deficiency. Further hormone testing and treatment options may be recommended.
Low SHBG levels: Low SHBG is associated with higher levels of free testosterone, which can cause conditions like PCOS in women or androgen excess in both men and women. It is also linked to insulin resistance and metabolic syndrome, so your doctor may recommend further testing for these conditions.

Questions Related to Hormone Binding Globulin (SHBG) Tests and Results

What does it mean if my SHBG levels are high?
- High SHBG levels can decrease the availability of free testosterone, leading to symptoms of low testosterone in men or hormonal imbalances in women. It may also be caused by liver disease, hyperthyroidism, or certain medications.
What does it mean if my SHBG levels are low?
- Low SHBG levels can increase free testosterone, which may result in androgen excess conditions like PCOS, acne, or hirsutism in women, or may be associated with insulin resistance and metabolic syndrome.
How does SHBG affect my testosterone levels?
- SHBG binds to testosterone, and only a small portion of testosterone is free and active in the body. Changes in SHBG levels can affect how much free testosterone is available, influencing hormonal balance and symptoms.
Can lifestyle changes affect SHBG levels?
- Yes, lifestyle factors such as weight loss, diet, and exercise can influence SHBG levels. Obesity tends to lower SHBG levels, while weight loss and regular exercise can help raise SHBG levels.
Does SHBG testing help diagnose PCOS?
- Yes, SHBG testing can be part of diagnosing polycystic ovary syndrome (PCOS). Women with PCOS often have low SHBG levels, leading to elevated free testosterone, which contributes to symptoms like irregular periods, acne, and excess hair growth.
What can I do if my SHBG levels are abnormal?
- Treatment options depend on whether SHBG is too high or too low. Your healthcare provider may recommend lifestyle changes, medications, or hormone therapy to balance SHBG levels and address the underlying hormonal imbalances.

The SHBG biomarker test is a crucial diagnostic tool for assessing hormonal balance, particularly in relation to testosterone and estrogen. This test is important for diagnosing and managing a wide range of conditions, including PCOS, hypogonadism, and metabolic disorders like insulin resistance. It is easy to prepare for and provides valuable insights when combined with other hormone tests. Healthcare providers such as endocrinologists, gynecologists, and primary care physicians use SHBG test results to guide diagnosis and treatment plans. Following your results, your doctor will discuss the next steps, whether it’s lifestyle changes, hormone therapy, or further diagnostic testing.

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Disclaimer: The information provided in these articles is for informational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult with a qualified healthcare professional before making any decisions about your health or starting any treatments.

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Hormone Binding Globulin (SHBG) Biomarker Test