Skip to content
Intel Lab Diagnostics Dubai
Single Biomarker

Sex Hormone Binding Globulin (SHBG)

Hormone Transport Protein

SHBG is a protein that binds and carries sex hormones in the blood. Low SHBG increases free testosterone and is associated with PCOS, insulin resistance, and metabolic syndrome.

BLOOD24 HOURSNO FASTING
AEDAED319
  • Free home collection
  • Physician-reviewed report

24 Hours

Turnaround

Blood

Sample

About This Test

What the Sex Hormone Binding Globulin (SHBG) test tells you

Sex hormone binding globulin, usually shortened to SHBG, is a carrier protein made by the liver. Most of the testosterone and oestradiol circulating in the blood is not floating free: it is held by SHBG, which binds it tightly, and by albumin, which holds it loosely. Only the small unbound portion, together with the part loosely attached to albumin, can readily leave the bloodstream and act on tissues. SHBG therefore does not produce any hormone of its own; what it does is decide how much of the hormone already present is actually available to be used.

That role is why SHBG is measured. Two people can have an identical total testosterone and yet be in quite different situations, because one has a high SHBG holding most of it out of circulation and the other has a low SHBG leaving more of it active. This is the single most common reason a total testosterone result and a person's symptoms fail to agree, and it is why SHBG is requested alongside testosterone rather than on its own. From the two together, a free testosterone can be calculated and the picture usually resolves.

SHBG also carries information in its own right, because the things that move it are informative. It falls with excess body weight, insulin resistance, an underactive thyroid, and exposure to androgens or anabolic steroids, so a low SHBG often appears in metabolic syndrome and in polycystic ovary syndrome, where the low level raises the active fraction of testosterone and contributes to the symptoms. It rises with an overactive thyroid, with oral oestrogen including some contraceptives, in pregnancy, with liver disease and with age. Read this way it becomes a useful cross-check on whether a hormone result makes sense in the context of the rest of the person.

Sample type
Blood
Measured in
nmol/L
Turnaround
24 Hours
Fasting
Not required
Best for
Adults planning a family
Why Get Tested?

Essential for interpreting testosterone results, evaluating PCOS in women, assessing hypogonadism in men, and understanding metabolic syndrome risk.

  • Making sense of testosterone

    SHBG is the reason a total testosterone can look normal while symptoms persist, so measuring the two together often explains an apparent contradiction.

  • Calculating free testosterone

    The unbound, active fraction is usually derived from total testosterone together with SHBG and albumin rather than measured directly.

  • Assessing androgen excess in women

    A low SHBG raises the proportion of testosterone that is active, which is a common contributor to symptoms in polycystic ovary syndrome.

  • A window on metabolic health

    SHBG falls with insulin resistance and excess weight, so a low result can prompt a wider look at metabolic risk.

When This Test Is Ordered

Reasons your doctor may request the Sex Hormone Binding Globulin (SHBG) test

Your doctor may order this test for any of the reasons below. Some are routine checks, others follow specific symptoms or an earlier result.

  • Low testosterone, excess hair & acne

    • Investigating symptoms of low testosterone in a man, particularly where the total result is borderline.
    • Assessment of polycystic ovary syndrome, excess hair growth or acne in a woman.

  • When hormone results do not fit

    • Any situation where SHBG is expected to be unusual: obesity, thyroid disease, liver disease or oestrogen therapy.
    • Investigating persistent symptoms when previous hormone results have not fitted the clinical picture.

  • Free testosterone & replacement therapy

    • Calculating free testosterone as part of a fuller androgen assessment.
    • Monitoring during testosterone replacement, where SHBG shapes how much of the dose is active.
Preparation
The short version
No prep needed.
  • Blood
  • Free home collection
  • No fasting
  • Results in 24 Hours
  1. 1
    Book any time

    No fasting window: pick any slot that suits you, online or on WhatsApp.

  2. 2
    We come to you

    A DHA-licensed nurse collects your sample at home or in the office: free home collection.

  3. 3
    Results in 24 Hours

    A physician-reviewed, easy-to-read report lands securely by WhatsApp and email.

Prep note
Physician reviewed

Fasting is not required for SHBG itself, but this test is almost always requested together with testosterone, which is conventionally sampled in the morning, so plan for a morning appointment and follow whatever fasting instruction applies to the other tests booked at the same time.

Tell the team about anything that shifts SHBG substantially: oral oestrogen and combined contraceptives, menopausal hormone therapy, testosterone or anabolic steroid use, thyroid medication, steroid tablets and anticonvulsants. Mention pregnancy and any known thyroid or liver condition, since both change the result in a predictable direction.

If a free testosterone is to be calculated, albumin is usually measured on the same sample, so let the laboratory know if that has not been requested. Take your usual medicines unless your doctor has told you otherwise.

Understanding Your Results

SHBG is a carrier protein, so it decides how much of your sex hormone is free to act rather than how much exists. A result in the Normal band, 18 to 54 nmol/L, needs no action of its own. A Low result, 0 to 17 nmol/L, is most often linked to excess body weight and insulin resistance, and is a frequent finding in diabetes, metabolic syndrome and polycystic ovary syndrome, where it raises the active fraction of testosterone. A High result, 55 to 200 nmol/L, fits an overactive thyroid, oral oestrogen or pregnancy, liver disease, very low body weight, and rising age in men. Because SHBG is usually the explanation when total and free testosterone tell different stories, it is read as part of a hormone assessment rather than alone. Thyroid status, oestrogen therapy and liver disease need to be known first. Your doctor reads it with your testosterone, albumin, symptoms and history.

SmartReport
1754
Healthy zone36nmol/LNormal
Reference ranges · nmol/L
Low
Low: may relate to insulin resistance or androgen excess.
0–17
Normal
Within a typical adult range.
18–54
High
Elevated: interpret with clinical context.
55–200

Ranges are a guide: your physician interprets your result alongside your symptoms and history.

Reading a High or Low Result

  • What a higher result can point to

    • An overactive thyroid, which raises SHBG production by the liver.
    • Oral oestrogen, including some combined contraceptives and menopausal hormone therapy, and the raised oestrogen of pregnancy.
    • Liver disease, particularly cirrhosis, which alters how the liver makes and handles carrier proteins.
    • Very low body weight, disordered eating or prolonged undernutrition.
    • Increasing age in men, which is one reason total testosterone can hold up while the active fraction falls.
    • Some medications, including certain anticonvulsants.

  • What a lower result can point to

    • Excess body weight and insulin resistance, the commonest reasons for a low SHBG.
    • Type 2 diabetes and metabolic syndrome, in which a low SHBG is a frequent accompanying finding.
    • Polycystic ovary syndrome, where the low level increases the active fraction of testosterone.
    • An underactive thyroid, which reduces liver production of the protein.
    • Testosterone therapy, anabolic steroid use or other androgen exposure.
    • Glucocorticoid treatment, and conditions in which protein is lost through the kidneys.

These are possibilities, not diagnoses. A single value outside the reference range is interpreted alongside your symptoms, history and other tests: your doctor decides what it means for you.

Limitations & Safety

What this test cannot tell you

  • SHBG is not a diagnosis on its own; it is interpreted as part of a testosterone or oestrogen assessment and has little meaning in isolation.
  • Calculated free testosterone depends on assumptions built into the formula and on the albumin value used, so results from different calculations are not interchangeable.
  • Oestrogen therapy, thyroid disease and liver disease all move SHBG substantially, and these need to be known before the result can be judged.
  • A single measurement reflects current metabolic and hormonal conditions, which can change as weight, thyroid status or medication changes.

Risks of the blood draw

  • Mild bruising or brief soreness where the needle went in.
  • Occasional lightheadedness, which settles after a few minutes of rest.
  • Bleeding or infection at the site, which is rare with sterile single-use equipment.
Key Points
  • 1SHBG is a carrier protein, not a hormone; it decides how much of your sex hormone is available rather than how much exists.
  • 2It is the usual explanation when total testosterone and free testosterone tell different stories.
  • 3A low SHBG is closely linked to excess weight and insulin resistance; a high one to thyroid overactivity, oestrogen and liver disease.
  • 4Free testosterone is normally calculated from total testosterone, SHBG and albumin together.
  • 5It should be requested alongside a testosterone measurement, not on its own.
Related Tests
View all
Book in 60 seconds

Know your Sex Hormone Binding Globulin (SHBG).
No waiting room required.

A nurse comes to you, results land in 24 Hours, and a physician walks you through exactly what they mean.

AED319
Ask a clinician
FAQ

Frequently Asked Questions

Everything you need to know about the Sex Hormone Binding Globulin (SHBG) test. Can't find what you're looking for?

Talk to our team→

Because the carrier decides how much of the hormone can act. Two people with the same total testosterone can differ considerably in how much is available to their tissues, depending entirely on their SHBG. Measuring it turns an ambiguous total result into an interpretable one.