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SHBG Blood Test

What is an SHBG blood test?

This test measures the levels of SHBG in your blood. SHBG stands for sex hormone binding globulin. It's a protein made by the liver and attaches itself to sex hormones found in both men and women. These hormones are:

  • Testosterone, the main sex hormone in men
  • Dihydrotestosterone (DHT), another male sex hormone
  • Estradiol, a form of estrogen, the main sex hormone in women

SHBG controls how much of these hormones are delivered to the body's tissues. Although SHBG attaches to all three of these hormones, an SHBG test is mostly used to look at testosterone. SHBG levels can show if there is too much or too little testosterone being used by the body.

Other names: testosterone-estrogen binding globulin, TeBG

What is it used for?

An SHBG test is most often used to find out how much testosterone is going to the body's tissues. Testosterone levels can be measured in a separate test called total testosterone. This test shows how much testosterone is in the body, but not how much is being used by the body.

Sometimes a total testosterone test is enough to make a diagnosis. But some people have symptoms of too much or too little of the hormone that the total testosterone test results can't explain. In these cases, an SHBG test may be ordered to provide more information about how much testosterone is available to the body.

Why do I need an SHBG blood test?

You may need this test if you have symptoms of abnormal testosterone levels, especially if a total testosterone test can't explain your symptoms. For men, it's mostly ordered if there are symptoms of low testosterone levels. For women, it's mostly ordered if there are symptoms of high testosterone levels.

Symptoms of low testosterone levels in men include:

Symptoms of high testosterone levels in women include:

What happens during an SHBG blood test?

A health care professional will take a blood sample from a vein in your arm, using a small needle. After the needle is inserted, a small amount of blood will be collected into a test tube or vial. You may feel a little sting when the needle goes in or out. This usually takes less than five minutes.

Will I need to do anything to prepare for the test?

You don't need any special preparations for an SHBG test.

Are there any risks to the test?

There is very little risk to having a blood test. You may have slight pain or bruising at the spot where the needle was put in, but most symptoms go away quickly.

What do the results mean?

If your results show your SHBG levels are too low, it may mean the protein is not attaching itself to enough testosterone. This allows more unattached testosterone to be available in your system. It may cause too much testosterone to go to your body's tissues.

If your SHBG levels are too high, it may mean the protein is attaching itself to too much testosterone. So less of the hormone is available, and your tissues may be not be getting enough testosterone.

If your SHBG levels are too low, it can be a sign of:

If your SHBG levels are too high, it can be a sign of:

  • Liver disease
  • Hyperthyroidism, a condition in which your body makes too much thyroid hormone
  • Eating disorders
  • For men, it can mean a problem with the testicles or pituitary gland. The pituitary gland is located beneath the brain and controls many body functions.
  • For women, it can mean problem with the pituitary gland, or Addison disease. Addison disease is a disorder in which the adrenal glands are not able to make enough of certain hormones.

Your health care provider may order additional tests such as total testosterone or estrogen tests to help make a diagnosis. If you have questions about your results, talk to your provider.

Is there anything else I need to know about an SHBG blood test?

SHBG levels are normally high in children of both sexes, so the test is almost always used for adults.

References

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  7. National Cancer Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; NCI Dictionary of Cancer Terms: DHT [cited 2018 Aug 4]; [about 3 screens]. Available from: https://www.cancer.gov/publications/dictionaries/cancer-terms/def/dht
  8. National Heart, Lung, and Blood Institute [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Blood Tests [cited 2018 Aug 4]; [about 3 screens]. Available from: https://www.nhlbi.nih.gov/health-topics/blood-tests
  9. National Institute of Diabetes and Digestive and Kidney Diseases [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Graves' Disease; 2017 Sep [cited 2018 Aug 4]; [about 3 screens]. Available from: https://www.niddk.nih.gov/health-information/endocrine-diseases/graves-disease
  10. National Institute of Diabetes and Digestive and Kidney Diseases [Internet]. Bethesda (MD): U.S. Department of Health and Human Services; Hashimoto's Disease; 2017 Sep [cited 2018 Aug 4]; [about 3 screens]. Available from: https://www.niddk.nih.gov/health-information/endocrine-diseases/hashimotos-disease
  11. Quest Diagnostics [Internet]. Quest Diagnostics; c2000–2017. Test Center: Sex Hormone Binding Globulin (SHBG) [cited 2018 Aug 4]; [about 3 screens]. Available from: https://www.questdiagnostics.com/testcenter/TestDetail.action?ntc=30740
  12. University of Rochester Medical Center [Internet]. Rochester (NY): University of Rochester Medical Center; c2018. Health Encyclopedia: Sex Hormone Binding Globulin (Blood) [cited 2018 Aug 4]; [about 2 screens]. Available from: https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=shbg_blood
  13. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Testosterone: Results [updated 2017 May 3; cited 2018 Aug 4]; [about 8 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/testosterone/hw27307.html#hw27335
  14. UW Health [Internet]. Madison (WI): University of Wisconsin Hospitals and Clinics Authority; c2018. Testosterone: Test Overview [updated 2017 May 3; cited 2018 Aug 4]; [about 2 screens]. Available from: https://www.uwhealth.org/health/topic/medicaltest/testosterone/hw27307.html

The medical information provided is for informational purposes only, and is not to be used as a substitute for professional medical advice, diagnosis or treatment. Please contact your health care provider with questions you may have regarding medical conditions or the interpretation of test results.

In the event of a medical emergency, call 911 immediately.