Test Code 1130
Test Details
Sex Hormone Binding Globulin (SHBG)
SHBG is a glycoprotein that binds to sex hormones, specifically testosterone and estradiol.
Methodology
Immunoassay – Sandwich principle
Patient Preparation
None
Preferred Specimen
1.0 mL serum (0.5 mL minimum) collected in serum separator tube (SST / Tiger Top)
Alternate Specimen
Dried Blood collected on an AdvanceDx 100 card
Transport Temperature
Refrigerated (ship on frozen cold packs)
Stability
Refrigerated: 7 days
Lab Values
Sex Hormone Binding Globulin (SHBG)
Female
Age | Optimal |
<21 yrs | Not Established |
21 – 49 yrs | 20.2 – 100 nmol/L |
≥50 yrs | 14.2 – 102.5 nmol/L |
Male
Age | Optimal |
<20 yrs | Not Established |
20 – 49 yrs | 13.5 – 45.8 nmol/L |
≥50 yrs | 15.8 – 62.6 nmol/L |
Clinical Significance
Sex Hormone Binding Globulin (SHBG)
- Elevated SHBG levels can be seen:1-4
- In elderly men
- In patients with hyperthyroidism and cirrhosis of the liver
- When oral contraceptives or antiepileptic drugs are taken
- Markedly higher SHBG levels are seen in pregnant women due to their increased estrogen
production1-4 - Decreased SHBG concentrations are often seen with:1-4
- Hypothyroidism
- Polycystic ovarian syndrome (PCOS)
- Obesity
- Elevated androgen levels
- High doses of biotin (> 5 mg/day) may interfere with assay results. Patient assumed to be refraining from biotin supplementation for at least 3 days prior to blood draw.
References:
- Bhasin S, Cunningham GR, Hayes FJ, et al. Testosterone therapy in men with androgen deficiency syndromes: Endocrine Society clinical practice guidelines. J Clin Endorcinol Metab. 2010;95(6):2536-2559.
- Santen RJ, Allred DC, Ardoin SP, et al. Postmenopausal hormone therapy: an Endocrine Society scientific statement. J Clin Endocrinol Metab. 2010;95(7 Suppl 1):s1-s66.
- Kopper NW, Gudeman J, Thompson DJ. Transdermal hormone therapy in postmenopausal women: a review of the metabolic eff ects and drug delivery technologies. Drug Des Devel Ther. 2008;2:193-202.
- Goodman N, Cobin RH. Reproductive disorders. In: Camacho PM, Gharib H, Sizemore GW, eds. Evidence-Based Endocrinology. 3rd ed. Philadelphia, PA: Lippincott Williams & Wilkins. 2012:190-228.
Treatment Options
Sex Hormone Binding Globulin (SHBG)
- Identify etiology of elevated or decreased LH levels with physical assessment and additional diagnostic tests as indicated
- Treatment is based on etiology of abnormal hormone level