Sex Hormone-Binding Globulin Test (SHBG Blood Test): How Testosterone Works In Your Body

In this article

SHBG stands for Sex Hormone-Binding Globulin which is a protein made in your liver and attaches to the sex hormones in your blood. The sex hormones that our bodies contain are estrogen, dihydrotestosterone (DHT), and testosterone which are present in both males and females. The hormone that is most important in the SHBG Blood test is testosterone, if this hormone is present too much in women and too less in men can cause problems. This test may be ordered in conjunction with other tests to evaluate the status of your sex hormones.

SHBG and testosterone levels may be ordered for an adult male to help determine the cause of infertility, a decreased sex drive, or erectile dysfunction. Testosterone production also happens in women and even a slight increase in testosterone in them can lead to several symptoms such as irregular or missed periods, acne, infertility, and excess facial or body hair.

SHBG helps control the amount of sex hormones that are actively working in your body. Your tissues can only use sex hormones that are not attached to proteins such as SHBG.

SHBG Blood Test Overview:

The SHBG test is a blood test used to measure the levels of a protein called sex hormone-binding globulin(SHBG) present in our blood. This protein binds to certain hormones such as testosterone, DHT, and estradiol which is a type of estrogen. When these hormones are bound to SHBG they are not available for our body to use. This helps regulate the amount of free hormones that can act in your body.

Purpose: You will need to get this test done if you have symptoms that might be caused due to too much or too little testosterone in your body.

This test helps doctors understand how much free testosterone is available in your body.

If you have abnormal levels of testosterone you might need to do this test to get clear answers from a professional.

If you are a man, low testosterone levels may look like this:

Low sex drive
Fertility problem
Difficulty getting an erection
Low levels of androgen can cause weakness and sexual problems in men. Hypogonadism is a condition that involves low testosterone and low sperm production and can also be diagnosed by this test.

If you are a woman with high testosterone you may look like the:

Weight gain
Acne
Deepening of the voice
Excessive hair growth on the face and body
Irregular or absent periods

How is the SHBG blood test done?

In most cases, you don’t have to do anything special before the test unless your doctor gives you any specific directions. To ensure a smooth test, your doctor will advise you on diet and medication.

Taking the blood sample:

Your blood will be drawn usually from your arm, the test does not hurt a lot it might just feel like a pinch or an ant bite.
A bruise might appear at the place the blood is drawn from which will disappear in a few days.
The entire process usually takes less than five minutes.
Factors like sex, age, obesity, liver disease, and hyperthyroidism can affect SHBG levels.
The SHBG test cannot be done at home and the cost of the test varies according to your healthcare system.

What do SHBG Blood Test Results Mean?

Your SHBG test result will be compared with your total testosterone levels.

Normal SHBG levels:

Males: 10 to 57 nmol/L

Females: 18 to 144nmol/L

Note:

In men, the SHBG levels decrease as they grow old.
If a woman is pregnant their SHBG levels rise.

Low SHBG Levels:

Conditions Related to Low SHBG Levels:

Hypothyroidism
Type 2 diabetes
Obesity
Cushing’s syndrome
PCOS In females

High SHBG level:

Conditions related to high SHBG
Liver disease
Eating disorder
Reduced androgen production in males
Hyperthyroidism

How to Increase SHBG Levels

Excercising regularly has been shown to increase SHBG levels in both men and women.
Consuming coffee has also been linked to increased SHBG levels.
Eating more fiber and less sugary food may help raise SHBG levels.

Key Takeaways:

SHBG (sex hormone-binding globulin) is a liver-produced protein that attaches to sex hormones like testosterone, DHT, and estrogen, controlling their availability in the body.

SHBG tests help diagnose hormone imbalances. Low SHBG in men may indicate issues like infertility or erectile dysfunction, while high testosterone in women can lead to symptoms such as weight gain and irregular periods

If you have symptoms of hormone imbalance or if your initial hormone tests are unclear, an SHBG test can provide more insights.

Causes of Abnormal Levels:

Low SHBG: Hypothyroidism, Type 2 diabetes, obesity, Cushing’s syndrome, PCOS.
High SHBG: Liver disease, eating disorders, reduced androgen production, hyperthyroidism.