The SHBG test, also known as the Sex hormone binding globulin (SHBG) test, aims to determine the level of active (free) sex hormones in the body. SHBG plays a central role in regulating the action of sex hormones, and any imbalance in its level may lead to noticeable symptoms even when other hormone levels appear normal.
For this reason, SHBG is considered one of the most important hormone tests, especially for men and women who suffer from hormonal disorders, infertility, or unexplained symptoms despite normal basic hormone test results.
What Is the Sex hormone binding globulin (SHBG) Test?
The SHBG test is a blood test used to measure the level of a protein called Sex Hormone Binding Globulin (SHBG). This protein is produced in the liver and binds to sex hormones such as testosterone and estrogen, regulating the amount of free (biologically active) hormone in the body.
The SHBG test is commonly requested when a patient’s symptoms do not match standard hormone test results, such as having symptoms of low testosterone despite a normal total testosterone level.
Read more: Hormonal Health Test Package for Men
Why Is the SHBG Test Performed?
The most common reasons for performing an SHBG test include:
- Accurate evaluation of free testosterone levels
- Diagnosis of sex hormone disorders
- Fertility assessment in men and women
- Supporting the diagnosis of polycystic ovary syndrome (PCOS)
- Explaining low libido or menstrual irregularities
How Is the Test Performed?
- A routine blood sample is taken
- Fasting is not required in most cases
- Preferably performed in the morning along with other hormone tests
📌 Important Note:
The Sex hormone binding globulin (SHBG) test should not be interpreted alone. It must be evaluated together with total and free testosterone tests to reach an accurate diagnosis.
Book Your SHBG Test Now
The SHBG test is now available at Al Safa Lab, providing more accurate diagnosis of hormonal disorders and infertility.
It is a simple test that can clearly explain your symptoms and give you a complete picture through reliable hormonal assessment, supported by a specialized medical team and an accredited laboratory equipped with the latest medical testing technologies.
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- WhatsApp: +20 103 090 3637
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- Visit Us: End of Mostafa El-Nahas Street, above Carrefour Market, 6 Mehdi Arafa Street, Nasr City, Cairo Governorate
Why Is Sex hormone binding globulin (SHBG) Important?
The importance of SHBG (Sex Hormone Binding Globulin) lies in its ability to:
- Determine the level of biologically active free testosterone
- Explain symptoms of hormone deficiency or excess despite normal lab results
- Help diagnose fertility disorders
- Be linked to metabolic and cardiovascular health
Therefore, measuring total testosterone alone is not sufficient without assessing SHBG.
Normal SHBG Levels
Normal SHBG levels vary by age and sex, but common reference ranges include:
🔹 Normal Range for Men:
10 – 57 nmol/L
🔹 Normal Range for Women (Non-pregnant):
18 – 144 nmol/L
Women generally have higher SHBG levels due to the effect of estrogen. Results should always be interpreted alongside other hormone tests, not in isolation.
SHBG Test for Men
The SHBG test is particularly important for men because it:
- Determines the actual free testosterone level
- Explains symptoms of low testosterone despite normal total testosterone
High SHBG in men may cause:
- Decreased libido
- General fatigue
- Loss of muscle mass
- Erectile dysfunction
- Mood changes
Causes of High SHBG
High SHBG means that a large portion of sex hormones is inactive. Common causes include:
- Hyperthyroidism
- Aging
- Severe weight loss
- Use of oral contraceptives
- Estrogen therapy
- Malnutrition
- Liver disease
Symptoms of High SHBG
Symptoms vary by sex but are usually related to reduced free hormone levels.
Symptoms in Men:
- Low sexual desire
- Erectile dysfunction
- Low energy
- Muscle weakness
Symptoms in Women:
- Menstrual irregularities
- Symptoms of estrogen deficiency
- Dry skin
You may also be interested in: Hormonal Health Test Package for Women
Treatment of High SHBG
Treatment focuses on addressing the underlying cause, and may include:
- Treating thyroid disorders
- Improving liver health
- Correcting nutritional deficiencies
- Adjusting or discontinuing hormone therapy (under medical supervision)
- Weight management
After performing an SHBG test, the use of medications or supplements without medical consultation is not recommended.
Can SHBG Be Reduced Naturally?
In some cases, yes—especially when lifestyle or nutrition is the main cause. Helpful measures include:
- Improving dietary habits
- Increasing healthy protein intake
- Treating vitamin deficiencies
- Reducing stress
- Engaging in moderate physical activity
However, medical treatment remains the cornerstone and should be guided by SHBG test results.
Difference Between SHBG and Testosterone
| Hormone | Function |
| SHBG | Regulates the amount of active hormone |
| Testosterone | Primary male sex hormone |
High SHBG can cause symptoms of testosterone deficiency even when total testosterone levels are normal.
Frequently Asked Questions
Is SHBG the same as testosterone?
No. SHBG is a carrier protein that binds testosterone and estrogen in the blood and regulates the amount of free active hormone. Testosterone is the primary male sex hormone responsible for sexual characteristics and vital functions.
What is the normal testosterone level in children?
It varies by age and sex:
- Before puberty: Very low, often below 30 ng/dL
- During puberty: Levels gradually increase
Values should always be assessed according to age and developmental stage under medical supervision.
What is SHBG protein?
SHBG (Sex Hormone Binding Globulin) is a liver-produced protein that binds sex hormones and regulates their free concentration in the bloodstream, directly affecting hormonal activity.
How can SHBG levels be increased?
SHBG levels can be increased by treating the underlying cause, such as:
- Improving insulin resistance
- Losing excess weight
- Regulating thyroid function
- Improving diet quality
- Reducing sugar and unhealthy fat intake
Medications or supplements should not be used without consulting a physician.
Is high SHBG a disease?
No, it is an indicator of a hormonal or metabolic imbalance that requires medical evaluation.
Is low SHBG dangerous?
Low SHBG may be associated with insulin resistance and metabolic disorders.
Does SHBG affect fertility?
Yes, SHBG affects fertility in both men and women.
Can a single test be relied upon?
No, SHBG must be interpreted together with total and free testosterone tests.
