Sex Hormone Binding Globulin (SHBG) Test

What is Sex Hormone Binding Globulin or SHBG?

Sex Hormone Binding Globulin or SHBG is a protein that is found mainly in the liver. The protein binds itself to three sex hormones that are present both in men and women. The three hormones are:

– Estrogen or the female sex hormone.
– Dihydrotestosterone or DHT, a male sex hormone.
– Testosterone, the primary male sex hormone.

What does an SHBG do?

SHBG regulates the number of sex hormones that are released in the body. Although SHBG binds itself to all the three hormones, it plays a significant role in maintaining the balance of the male hormones namely testosterone and DHT as compared to estrogen. An SHBG test is often used to monitor the functioning of testosterone in the body.

What is an SHBG test?

SHBG test is a blood test that measures the amount of sex hormone-binding globulin in your blood. The test is used to measure any excess or deficit of testosterone in your body.

Does this test have any other name?

The other names of the SHBG test are TeBG and testosterone-estrogen binding globulin.

What is the importance of the Sex Hormone Binding Globulin or SHBG test?

testosterone in women and too little of the hormone in men can cause some serious health problems.

A total testosterone test can be used to measure the levels of testosterone in the blood, but often this test is not enough. In men, the SHBG test is ordered if the testosterone level is too low. In women, the test is ordered if the testosterone levels are too high. High and low SHBG levels can indicate several medical conditions such as:

– Liver disease.
– Type 2 diabetes.
– Gestational diabetes.
– Cardiovascular problems.
– Erectile dysfunction.
– Hirsutism
– PCOS
– Hyperthyroidism
 
An SHBG test can be done to understand the underlying causes of these diseases and also to regulate the hormone imbalance.

When do I need the test?

Your doctor may ask you to do an SHBG test if you are exhibiting certain symptoms of abnormal testosterone levels.

In men, the symptoms of low testosterone level include:

Difficulty in getting erection.
Decreased sex drive.
Weight gain.
Low sperm count.
Enlarged breast tissue.
 
In women, the symptoms of high testosterone level include:

Irregularities in menstruation.
Abnormal facial and body hair growth.
Deepening of the voice.
Excess acne.
A gain in weight.
Breast tenderness.

How do I prepare for the test?

You do not need any specific preparation for the test. However, the test is normally conducted early in the morning because the testosterone levels are high during the early hours of the day. Inform your doctor if you are taking any:

– Medication for the central nervous system, opiates, or any other drugs.
– Dietary supplements.

You must also inform your doctor if you are under any special diet regimen or exercise rigorously as this may affect the test results.

Do I need to fast before the test?

No, you need not fast before the test. You can take your regular meals before the test

How is the test conducted?

The SHBG test is a simple blood test whereby a blood sample is withdrawn from the vein of your arm.

– A health care provider will visit you in the morning to take a blood sample or you can go to your nearest laboratory to take the test.

– You must wear a half-sleeved shirt or top for the convenience of the test.

– A small patch of skin in the upper part of your arm is cleaned with an antiseptic solution.

– The technician will tie a tourniquet or an elastic band around your arm. This will swell up the veins and make it easier for him to draw the blood.

– A needle attached to a syringe or vial is then inserted into the vein and blood is withdrawn.

– The blood is then collected into the vial or test tube.

– The needle is removed after the blood is withdrawn.

– The tourniquet is removed and the puncture site is pressed with a cotton swab to stop bleeding.

– A band-aid is applied to the area of the puncture site.

How do I feel during the test?

You may feel a little stinging sensation while the needle has been inserted into your vein. Some people may also complain of weakness or dizziness during the test. The symptoms are very mild and will go away within a few minutes

How long does it take to have an SHBG test?

The test will take less than five minutes to complete.

Is there any risk to the test?

There are no risks to this test. There may be a slight bruising or pain in the puncture site, but it will go away quickly. Some individuals may experience a hematoma that is blood clot under the skin, redness or even a mild infection. If the symptoms persist, they should consult a doctor immediately.

What is the average cost of the SHBG test in India?

The average cost of the SHBG test varies between Rs 130 to Rs 4000 depending on the city, laboratory, and quality of the test.

SHBG Levels Chart

What do my SHBG test results mean?

Low SHBG test results indicate that the protein is not attaching itself to enough testosterone. As a result of which, too much testosterone is released in the blood and body tissues. A high SHBG test level indicates that it is attaching itself to too much testosterone. This results in less amount of testosterone available in the system and the body tissues are not getting enough testosterone.

A very low SHBG result can indicate the following conditions such as:

– Hypothyroidism or low levels of thyroid hormones.
– Cushing’s syndrome, a condition wherein the body produces an excess amount of the cortisol hormone.
– Type 2 diabetes.
– Cancer of testicles or adrenal glands in men.
– PCOS or polycystic ovary syndrome in women can lead to female infertility.
– Infertility in men.
– Insulin resistance.
– Your SHBG levels can also be low if you are under prolonged use of steroid medications.

If the SHBG levels are too high, they may indicate:

– Hyperthyroidism, a condition when the thyroid levels in the body are too high.
– Liver disease.
– Eating disorder.
– Men can have dysfunction or problems with the pituitary glands or testicles.
– Addison disease or pituitary gland disorder in women.
Some people can have high SHBG levels due to the use of anticonvulsants, a medication used for seizures.

What is the importance of the SHBG test in women?

In women, optimal SHBG levels play an important role in maintaining the overall physical and mental health. The SHBG level may vary according to the age of a woman. Low SHBG levels indicate high testosterone and can cause several medical conditions and symptoms such as:
 
Androgenization or development of male characteristics due to excess testosterone in the system.
Body and facial hair.
Hair loss.
A decrease in breast tissue.
Abnormality in the skin.
Cardiovascular disease.
Type 2 diabetes.
Metabolic syndrome.
Cushing’s syndrome.
 
High risk of diabetes among postmenopausal women.
Compared to men, older women have high SHBG levels. High SHBG levels can be due to several factors like:
 
Use of contraceptive pills.
Anorexia nervosa.
Hormone treatments for thyroid and estrogen.

How is the SHBG test important during pregnancy?

Sex hormone-binding globulin or SHBG test is extremely important during the first and second trimester of pregnancy to diagnose gestational diabetes mellitus (GDM) or glucose intolerance. Early detection of GDM allows control of the disease and also decreases maternal and fetal risks of birth trauma, pre-eclampsia (PE) and fetal growth restriction or RCIU. The SHBG test during early pregnancy is extremely important for the wellbeing of both the mother and the unborn child.

Can children do the SHBG test?

Yes, the SHBG test is an important biomarker to determine several conditions in children such as:

– Childhood obesity.
– Premature coronary artery disease or CAD in obese children.
– Hyperinsulinemia or prepubertal insulin resistance.

How do I improve my SHBG levels?

To improve your SHBG levels, you must consult your doctor who may recommend certain medications or lifestyle changes. Lifestyle changes that will increase your SHBG levels include:

– Physical exercise.
– Weight loss.
– Coffee intake.
– Dietary changes.
– To lower SHBG levels you may follow:
– High protein diet.
– Take supplements.