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  • Test Details
  • Lab Values
  • Clinical Significance
  • Treatment Options

Explore this test

Test Code 1130

Test Details

Sex Hormone Binding Globulin (SHBG)

SHBG is a glycoprotein that binds to sex hormones, specifically testosterone and estradiol.


Immunoassay – Sandwich principle

Patient Preparation


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)


Refrigerated: 7 days

Lab Values

Lab Values

Sex Hormone Binding Globulin (SHBG)


Age Optimal
<21 yrs Not Established
21 – 49 yrs 20.2 – 100 nmol/L
≥50 yrs 14.2 – 102.5 nmol/L



Age Optimal
<20 yrs Not Established
20 – 49 yrs 13.5 – 45.8 nmol/L
≥50 yrs 15.8 – 62.6 nmol/L


Test Details
Clinical Significance

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
  • 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.


  1. 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.
  2. 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.
  3. 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.
  4. 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.
Lab Values
Treatment Options

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
Clinical Significance