Sex Hormone Binding Globulin (SHBG)
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Glycoprotein produced mainly by the liver that binds to sex hormones
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🧪 What is Sex Hormone Binding Globulin (SHBG)?
SHBG is a glycoprotein produced mainly by the liver that binds to sex hormones — primarily testosterone and estradiol — regulating their bioavailability and activity in the body. Only the free (unbound) hormones are biologically active.
❓ Why is the Test Done?
To:
- Evaluate sex hormone status and androgen or estrogen activity
- Investigate causes of abnormal androgen levels, such as hirsutism, infertility, or sexual dysfunction
- Assess polycystic ovary syndrome (PCOS)
- Evaluate thyroid disorders, liver disease, and obesity affecting hormone binding
- Help interpret total testosterone levels by calculating free testosterone
📊 Normal Range
Sex | SHBG Range (nmol/L) |
|---|---|
Adult males | 10 – 57 |
Adult females | 18 – 144 |
Values may vary by lab and assay.
📈 Interpretation of Results
SHBG Level | Clinical Implications |
|---|---|
High SHBG | Liver disease, hyperthyroidism, estrogen therapy, pregnancy, anorexia nervosa |
Low SHBG | Obesity, hypothyroidism, insulin resistance, PCOS, androgen excess |
🧠 Associated Conditions
Condition | Details |
|---|---|
PCOS | Often associated with low SHBG and high free testosterone |
Liver disease | Impaired SHBG production or altered levels |
Thyroid disorders | Hyperthyroidism increases SHBG; hypothyroidism decreases it |
Obesity and insulin resistance | Reduce SHBG levels, increasing free androgens |
Hormone therapy | Estrogen increases SHBG; androgens decrease SHBG |
🔄 Related / Follow-Up Tests
- Total and free testosterone
- Estradiol
- Thyroid function tests
- Insulin and glucose tests
- Liver function tests
✅ Fasting Required?
Test | Fasting Required |
|---|---|
SHBG | ❌ No |
📝 Summary Table
Parameter | Details |
|---|---|
What | Glycoprotein that binds sex hormones affecting their activity |
Why | Assess hormone balance, androgen status, PCOS, liver/thyroid effects |
Normal Range | Men: 10–57 nmol/L; Women: 18–144 nmol/L |
High Levels | Liver disease, hyperthyroidism, estrogen therapy |
Low Levels | Obesity, PCOS, hypothyroidism, insulin resistance |
Associated Conditions | PCOS, thyroid disorders, liver disease, obesity |
Follow-up Tests | Testosterone, estradiol, thyroid and metabolic tests |
Fasting Required | ❌ No |
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