Sex Hormone-Binding Globulin (SHBG)

A protein that carries sex hormones in your blood and helps explain free versus total levels.

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Test Summary

Sample Type 
Blood
Required Blood
1 mL
Analysis Type
Serum
Collection method
In person at the lab; at-home where available

Why test

Sex Hormone-Binding Globulin (SHBG)

?

Clinicians order SHBG when symptoms and total hormone levels do not match, such as possible low testosterone, polycystic ovary syndrome (PCOS) features, or fertility concerns. It helps estimate free (bioactive) testosterone or estradiol and shows thyroid, liver, or metabolic effects on hormones. Results can guide follow-up testing and next steps. You can test this marker with Aniva across Germany and Finland.

What is

Sex Hormone-Binding Globulin (SHBG)

?

Clinicians order SHBG when symptoms and total hormone levels do not match, such as possible low testosterone, polycystic ovary syndrome (PCOS) features, or fertility concerns. It helps estimate free (bioactive) testosterone or estradiol and shows thyroid, liver, or metabolic effects on hormones. Results can guide follow-up testing and next steps. You can test this marker with Aniva across Germany and Finland.

What insights will i get from

Sex Hormone-Binding Globulin (SHBG)

?

High: May occur with estrogen therapy, pregnancy, hyperthyroidism, or some liver conditions. It can lower free testosterone or estradiol, sometimes explaining symptoms despite normal totals.
Low: Often seen with obesity, insulin resistance, hypothyroidism, androgen use, or nephrotic syndrome. It can raise free hormone and is common in PCOS. Review medicines and supplements, and consider pairing SHBG with total testosterone, estradiol, and thyroid tests to clarify the picture.

Sample type & collection

  • Sample: Blood
  • Fasting: No
  • Best timing: Any time; collect at a consistent time if monitoring
  • Collection: In person at the lab; at-home where available
  • Typical volume: 1 mL
  • Analysis: Serum
  • Prep tips: Avoid high-dose biotin for 24–48 hours; list all hormones
  • Turnaround: 1–3 business days

Sex Hormone-Binding Globulin (SHBG)

is best interpreted with:

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Sex Hormone-Binding Globulin (SHBG)

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Sex Hormone-Binding Globulin (SHBG)
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Limits & interferences with

Sex Hormone-Binding Globulin (SHBG)

:

Common factors that can skew results include estrogen-containing birth control or HRT (raise SHBG), anabolic steroids or androgens (lower), thyroid medicines, significant liver disease, pregnancy, and acute illness. High-dose biotin supplements can interfere with some immunoassays; avoid for 24–48 hours before testing if safe. Weight changes, insulin resistance, and age can also shift SHBG.

Special situations include pregnancy, known thyroid or liver disease, and high-dose biotin use—confirm or adjust interpretation with your clinician.

Questions about

Sex Hormone-Binding Globulin (SHBG)

:

What do high or low SHBG results mean? High SHBG can reduce free hormones; low SHBG can increase them. Context with other tests helps explain symptoms.

Do I need to fast for an SHBG test? No. Fasting is not required unless your clinician bundles it with tests that need fasting.

What can affect SHBG levels? Estrogen or androgen medicines, thyroid status, liver disease, pregnancy, weight, insulin resistance, and high-dose biotin can all affect results.

How often should I test SHBG? Test when symptoms change or when starting, stopping, or adjusting hormone or thyroid treatment. Your clinician will guide timing.

How long do results take? Most labs report SHBG within 1–3 business days.

What should I discuss with my clinician? Share symptoms, all medicines, contraception, and supplements (especially biotin). Ask whether to calculate free testosterone or estradiol and check thyroid or liver markers.

Sources:

  • MedlinePlus — SHBG Blood Test. (2024). https://medlineplus.gov/lab-tests/shbg-blood-test/
  • Endocrine Society — Testosterone Therapy in Men with Hypogonadism: Guideline. (2018). https://academic.oup.com/jcem/article/103/5/1715/4939465
  • Mayo Clinic Laboratories — Sex Hormone-Binding Globulin (SHBG), Serum. (2024). https://www.mayocliniclabs.com/test-catalog/overview/100052
  • FDA — Biotin Interference with Lab Tests: Safety Communication. (2019). https://www.fda.gov/medical-devices/safety-communications/biotin-interference-lab-tests-fda-safety-communication
  • NIDDK — Polycystic Ovary Syndrome (PCOS). (2023). https://www.niddk.nih.gov/health-information/endocrine-diseases/polycystic-ovary-syndrome
Medical disclaimer: This content is for informational purposes only and is not medical advice. Always discuss results with a qualified healthcare professional.

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