Test ID SHBG1 Sex Hormone-Binding Globulin, Serum
Specimen Required
Collection Container/Tube:
Preferred: Serum gel
Acceptable: Red top
Submission Container/Tube: Plastic vial
Specimen Volume: 1 mL
Collection Instructions: Centrifuge and aliquot serum into a plastic vial.
Secondary ID
608102Useful For
Diagnosis and follow-up of women with signs or symptoms of androgen excess (eg, polycystic ovarian syndrome and idiopathic hirsutism)
An adjunct in monitoring sex-steroid and antiandrogen therapy
An adjunct in the diagnosis of disorders of puberty
An adjunct in the diagnosis and follow-up of anorexia nervosa
An adjunct in the diagnosis of thyrotoxicosis (tissue marker of thyroid hormone excess)
A possible adjunct in diagnosis and follow-up of insulin resistance and cardiovascular and type 2 diabetes risk assessment, particularly in women
Method Name
Immunoenzymatic Assay
Reporting Name
Sex Hormone-Binding Globulin, SSpecimen Type
SerumSpecimen Minimum Volume
0.5 mL
Specimen Stability Information
Specimen Type | Temperature | Time |
---|---|---|
Serum | Refrigerated (preferred) | 14 days |
Frozen | 90 days | |
Ambient | 7 days |
Clinical Information
Sex hormone-binding globulin (SHBG), a 95 kDa homodimer, is the blood transport protein for testosterone and estradiol. SHBG is mainly produced in the liver and has a half-life of approximately seven days. SHBG binds reversibly to sex steroids. SHBG has a relatively high-binding affinity to dihydrotestosterone (DHT), medium affinity to testosterone and estradiol, and exhibits a low affinity to estrone, dehydroepiandrosterone, androstenedione, and estriol. Albumin, which exists at physiologically higher concentrations than SHBG, also binds to sex steroids, although with a much lower binding affinity (eg, about 100 times lower for testosterone).
Decreased SHBG serum concentrations are associated with conditions in which elevated androgen concentrations are present, or the effect of androgen on its target organs is excessive. Because of the high-binding affinity of SHBG to DHT, as compared to estradiol, SHBG has profound effects on the balance between bioavailable androgens and estrogens. Increased SHBG concentrations may be associated with signs and symptoms of hypogonadism in men, while decreased concentrations can result in androgenization in women. SHBG is regulated by insulin, and a low SHBG concentration often indicates insulin resistance and, consequently, may be a predictor of type 2 diabetes.
Endogenous or exogenous thyroid hormones or estrogens increase SHBG concentrations. In men, there is also an age-related gradual rise, possibly secondary to the mild age-related fall in testosterone production. This process can result in bioavailable testosterone concentrations that are much lower than would be expected based on total testosterone measurements alone.
Reference Values
CHILDREN:
Males
Tanner Stages |
Mean Age |
Reference Interval (nmol/L) |
Stage I |
10.4 |
17-135 |
Stage II |
11.1 |
21-114 |
Stage III |
12.7 |
12-138 |
Stage IV |
14.5 |
7.7-67 |
Stage V |
14.2 |
3.9-40 |
Females
Tanner Stages |
Mean Age |
Reference Interval (nmol/L) |
Stage I |
10.5 |
16-182 |
Stage II |
10.9 |
24-121 |
Stage III |
12.5 |
18-87 |
Stage IV |
14 |
7.7-108 |
Stage V |
14.9 |
10-79 |
ADULTS:
Males
≥18 years: 13.3-89.5 nmol/L
Females
18-46 years: 18.2-135.5 nmol/L
47-91 years: post-menopausal: 16.8-125.2 nmol/L
Cautions
In rare cases, some individuals can develop antibodies to mouse or other animal antibodies (often referred to as human anti-mouse antibodies [HAMA] or heterophile antibodies), which may cause interference in some immunoassays. Caution should be used in interpretation of results, and the laboratory should be alerted if the result does not correlate with the clinical presentation.
For patients presenting with cirrhosis or subclinical thyroid conditions, carefully evaluate results as these conditions can potentially cause erroneous sex hormone-binding globulin (SHBG) results.
SHBG results should be interpreted in light of the total clinical presentation of the patient, including symptoms, clinical history, data from additional tests, and other appropriate information.
Day(s) Performed
Monday through Saturday
Report Available
1 to 3 daysPerforming Laboratory

Test Classification
This test has been cleared, approved, or is exempt by the US Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.CPT Code Information
84270