Blood Testing for Sex Hormone Binding Globulin (SHBG)

The blood test for Sex Hormone Binding Globulin (SHBG) is usually ordered when total testosterone results are not consistent with a patient’s symptoms: decreased sex drive, infertility, erectile dysfunction for males and abnormal hairiness in females. Typically, This test is ordered for males because it is suspected that there is a testosterone deficiency and has been validated by a testosterone total serum test or a testosterone total & free blood test. hormone blood tests

Should I Order a Sex Hormone Binding Globulin Test?

Since the sex hormone binding globulin (SHBG) is commonly used to determine a hormone imbalance – it is commonly ordered with other hormone tests such as testosterone, estradiol, prolactin and lutenizing hormone to evaluate a patient’s hormone balance. SHBG and testosterone testing may be useful in helping to detect and evaluate excess testosterone production and/or decreased SHBG concentrations so this test is helpful if a hormone imbalance is suspected. The SHBG results may suggest the following if you have increased levels of the hormone:
  1. liver disease
  2. hyperthyroidism
  3. eating disorders
  4. Hormone Replacement Therapy (HRT) including oral contraceptives
  5. Decreased sex hormone production
The SHBG results may suggest the following if you have decreased levels of the hormone:
  1. Obesity
  2. Polycyctic ovarian syndrome
  3. Hypothyroidism
  4. Hirsutism
  5. Acne
  6. Cushing disease

The Scientific Explanation

Levels of SHBG are under the positive control of estrogens and thyroid hormones, and are suppressed by androgens. These influences dynamically control the liver synthesis of this carrier protein. Decreased levels of SHBG are frequently seen in hirsutism, virilization, obese postmenopausal women, and in women with diffuse hair loss. Increased levels may be present in cases of hyperthyroidism, testicular feminization, cirrhosis, male hypogonadism, pregnancy, women using oral contraceptives, and prepubertal children. Elevated SHBG levels can be seen in elderly men, and are often found in patients with hyperthyroidism and cirrhosis of the liver. SHBG levels also increase when oral contraceptives or antiepileptic drugs are taken. Pregnant women have markedly higher SHBG serum concentrations due to their increased estrogen production. Decreased SHBG concentrations are often seen with hypothyroidism, polycystic ovarian syndrome (PCOS), obesity, hirsutism, elevated androgen levels, alopecia, and acromegaly.
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Medical Disclaimer: The information included on this site is for informational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her health care provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. The writer is not a physician or other health provider.
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