SHBG

Sex Hormone-Binding Globulin (SHBG) Testing

The SHBG test assesses the levels of sex hormone-binding globulin (SHBG) in the blood. Sex hormone-binding globulin is a protein majorly produced in your liver that binds to sex hormones, such as oestrogen and testosterone, in your bloodstream. This protein regulates how much of these hormones are available to the body. When SHBG binds to sex hormones, they become inactive, leaving only the "free" hormones for tissue use.

Your medical practitioner might request this test if you display symptoms linked to an imbalance of testosterone levels, whether too high or too low. Testosterone, often referred to as the male sex hormone, is also present in women in smaller quantities and plays an essential role in both genders.

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What Is the purpose of an SHBG test?

The SHBG test helps assess how testosterone functions in the body.

  • In men: It is often recommended if there are signs of low testosterone, such as difficulty maintaining an erection or reduced fertility.
  • In women: It may be requested if symptoms suggest excessive testosterone levels, such as acne, deepening of the voice, or irregular menstrual cycles.

Usually, a total testosterone test is performed first. This measures all testosterone in the blood, including the amount bound to proteins and the free testosterone. However, a normal total testosterone result doesn't always explain certain symptoms, as free testosterone levels may still be abnormal. If this occurs, an SHBG test may be ordered to provide more clarity.

In some cases, total testosterone tests and SHBG are conducted simultaneously to offer a fuller picture.

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Why should SHBG levels be checked?

Testing SHBG levels may be recommended if you are experiencing signs of unusual levels of testosterone, especially when a total testosterone test result does not fully explain your symptoms.

Symptoms in Men

An SHBG test may help investigate symptoms of low testosterone, including:

  • Low libido
  • Fertility issues
  • Erectile difficulties

Symptoms in Women

This test may be ordered to explore symptoms of high testosterone, such as:

  • Issues with fertility
  • Excess body or facial hair
  • Persistent acne
  • Unexplained weight gain
  • Deepening of the voice
  • Irregular or absent menstrual periods

Test procedure

Test Preparation

No specific preparation is required for this test. Ensure you are well hydrated before the test to make the blood collection procedure easier.

During the test

A healthcare professional will take a blood sample by inserting a small needle into your arm's vein. The blood is collected in a test tube. You might feel a slight sting as the needle is inserted and removed, but the procedure typically takes less than five minutes.

Results collection

Results are made available a few days after the test has been performed. Your healthcare practitioner will interpret your SHBG test results alongside your total testosterone levels to estimate the amount of free testosterone available in your body.

Are There Any Risks Associated with the Test?

The risks are minimal. You may experience slight bruising or discomfort at the needle's insertion site, but these symptoms usually resolve quickly.

Low levels of SHBG

If your SHBG levels are low, more testosterone is available for use by the body. Causes of low SHBG levels include:

  • SHBG levels also naturally decline with age as sex hormone production decreases.
  • Cushing's syndrome
  • Polycystic ovary syndrome (PCOS) in women
  • Obesity or being overweight
  • Hypothyroidism
  • Overuse of anabolic steroids or steroid medications
  • Type 2 diabetes

High levels of SHBG

high SHBG levels can mean that less testosterone is available for use, which may result in symptoms of testosterone deficiency. Causes of high SHBG levels include:

  • Hormone replacement therapy or contraceptive pills (in women)
  • Reduced testosterone production (in men)
  • Liver disease
  • Eating disorders
  • Hyperthyroidism

Additional Uses of the SHBG Test

In some cases, SHBG testing may help detect early puberty in children. SHBG levels are typically high in children to prevent sex hormones from affecting body tissues. Low SHBG levels in children may indicate early puberty.

Schedule an appointment

If you are in London and your doctor recommends getting an SHBG test, kindly contact us. We will ensure your test is carried out and provide you with the needed care throughout this process.

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