Sex Hormone Binding Globulin (SHBG)
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- Also Known As:
- SHBG
- Testosterone-estrogen Binding Globulin
- TeBG

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At a Glance
Why Get Tested?
Most commonly measured in the evaluation of low testosterone (possible androgen deficiency) in men; also commonly used in the evaluation of women with signs and symptoms suggestive of excess male hormones (androgens)
When To Get Tested?
When you have signs and symptoms of increased or decreased testosterone and the total testosterone measurement is inconsistent with your symptoms
Sample Required?
A blood sample drawn from a vein in your arm
Test Preparation Needed?
None; however, testosterone is best measured in the morning because in men, testosterone levels demonstrate diurnal variation with higher levels in the morning.
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The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.
If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.
Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called “normal” values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.
While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are “within normal limits.”
For more information, please read the article Reference Ranges and What They Mean.
What is being tested?
Sex hormone binding globulin (SHBG) is a protein produced by the liver that transports the hormones testosterone (an androgen), dihydrotestosterone (DHT) (an androgen), and estradiol (an estrogen) in the blood as biologically inactive forms. Changes in SHBG levels can affect the amount of hormone that is available to be used by the body’s tissues. This test measures the level of SHBG in the blood and is most often used to help evaluate patients for testosterone deficiency or excess.
In men, about 45% to 65% of testosterone in blood is normally bound to SHBG, with the remainder weakly and reversibly bound to albumin (the main protein in the blood). Only about 2% to 3% of testosterone is immediately available to the tissues as free testosterone, but testosterone that is weakly bound to albumin is also bioavailable and can be readily taken up by the body’s tissues.
Slightly more testosterone is bound to SHBG in the blood (66% to 78%) in women than in men. In women, SHBG plays an integral role in regulating the levels of bioavailable male sex hormones (androgens) and estrogens circulating throughout the body. SHBG has a higher affinity for the androgens testosterone and DHT and so in the setting of low SHBG, women may have signs and symptoms related to androgen excess.
A total testosterone test does not distinguish between bound and unbound testosterone but determines the overall level of testosterone in the plasma. In many cases, this test is sufficient to evaluate patients for excess or deficient testosterone production. However, if your SHBG level is not normal, then the total testosterone may not be an accurate representation of the amount of testosterone that is available to your tissues. An SHBG test may be performed when your signs and symptoms do not correlate with the results of a total testosterone test.
Common Questions
View Sources
Sources Used for Current Review
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(July 2017) ARUP Consult. Male Hypogonadism. Available online at https://arupconsult.com/content/hypogonadism-male. Accessed July 2019.
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Reviewer May 2015: Nicole V. Tolan, PhD, DABCC, Associate Director of Chemistry and POCT, BIDMC and Harvard Medical School.
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