SHBG: Normal Range, Symptoms, Impact, And More

Medically reviewed by Maria Sarino, MD FACT CHECKED

The human body is fascinating. No amount of knowledge accounts for enough. You may always find something new to know and explore. Everything is so magically correlated, isn’t it? 

One such term you might have come across and may want to know about is SHBG. You might mainly encounter this term during a medical checkup.

A medical professional may recommend an SHBG test if you have unreasonably low testosterone or too high.

But the question is what is this SHBG? Are you trying to seek answers to your questions? If yes, continue reading until the end. 

SHBG is an acronym for Sex hormone-binding globulin. It is a protein synthesized mainly in the liver. It tends to bind with certain hormones i.e. 

  • Testosterone,  
  • Dihydrotestosterone
  • Estradiol 

SHBG is the hormone carrier that transports them throughout the bloodstream. Our body has a different mechanism for regulating hormonal levels. When hormones are in a bound form, the cell could not use them. 

When your SHBG levels are low, your body has more availability of sex hormones as they are unbound and free for use.

However, if your SHBG levels are high, your body has limited unbound sex hormones available to be put to use.

Now, SHBG depends on numerous factors. Age, gender, and health conditions impact its levels. 

Usually, adults have lower SHBG levels in comparison to females. Children have high SHBG levels and are suspected to have lots of changes. So the SHBG test is not for children and is only conducted for adults. 

With increasing age, the SHBG levels increase. This impact is more prominent in males. Females are subjected to high SHBG levels when pregnant. Once the postpartum period begins, the level starts decreasing.

Normal Range Of SHBG

The normal range is mainly gender oriented. So males have an optimal range of 10-57 nmol/liter. On the other hand, females have a slightly higher range of around 18-144 nmol/liter. 

Low SHBG Symptoms

If you have low SHBG, you will likely have a surplus of free sex hormones like testosterone and estrogen.

  • Fluid Retention

    In this type of condition, Your legs, feet, face, or hands may swell due to excessive retained water. 

    Along with this, it may also affect your walking and several cognitive behavior throughout the day. 
  • Acne

    One of the leading causes of acne is hormone fluctuations. An increased testosterone level may cause the emergence of whiteheads, blackheads, or cyst-filled pimples. 

  • Weight Gain

    Weight fluctuations are also common with hormonal imbalances. Testosterone is a great bulk factor but may also turn worse if it exceeds normal levels. It may lead to increased appetite and you may put on some unwanted weight.

  • Increased Muscle Mass

    Testosterone may play a key role in building muscles and strength. Although, this increased muscle mass is not always pleasing and may be unwanted. 
  • Mood Swings

    Busting the myth that mood swings are feminine, hormone fluctuations could instigate mood swings.

    It may affect everyone equally. Since low SHBG shoots up t-levels, men are likely to experience emotional instability. 

    Although estrogen is the female sex hormone, a little concentration is present in the male body.

  • Breast Tenderness

    Swollen breasts especially from the front area may arise due to high estrogen concentration. It may make the breasts tender. 

  • Emotional Instability

    If you feel tons of emotions and keep swinging between them all often, these mood swings might be an alarm of excessive testosterone. 

High SHBG Symptoms

  • Sexual Disorders

    These may include arrested sexual development (in teens), infertility, decreased sperm concentration and motility, reduced sex drive, and impotence.
  • Reduced Testicle Size

    High SHBG means a lack of free male sex hormones. Thus, the size of the genital area, especially the testicles, reduces in size.

  • Affected Sexual Health

    In females, high levels of SHBG may experience loss of libido, vaginal dryness, and difficulty in arousal. 
  • Reduced Muscle Mass

    The high SHBG levels may lead to loss of bone mineral density, weak bones, and reduced muscle mass. It also increases the risk of osteoporosis. 

  • Affected Mental Health

    SHBG also affects brain causing a loss of memory, depression, and anxiety. The lack of availability of sex hormone induce tiredness and reduce well-being. 

High SHBG Levels

  • High Estrogen Levels

    Excessive estrogen in the blood also shoots up SHBG levels. The main reasons for high estrogen were found to be birth control pills and synthetic female hormones.

    Hormone replacement therapy also plays a part in inducing high SHBG due to estrogen. 

  • Pregnancy

    When a female conceives, the SHBG levels shoot up and come back to normal levels after delivery. 

  • Affects Liver Health

    Since the liver produces SHBG, several conditions or damage to the liver may cause abnormally high production of SHBG. 

  • Stress

    Stress may mess up almost everything, especially hormones. Along with SHBG, it increases estrogen levels, blood pressure, testosterone, and heart rate. 

Impact Of Abnormal SHBG Levels

High SHBG Levels

  • Prostate Cancer

    This cancer builds in the prostate gland(of males) that produces seminal fluid for sperm transportation.

    High SHBG may also be a cause of prostate cancer as it results in a lack of free testosterone. 

  • Alzheimer’s Disease

    It is a slow neurological disorder that reduces the ability to think, and memory and eventually affects daily day tasks.

    Thus, it depicts the possibility of an effect of sex hormones in blood plasma on Alzheimer’s disease, dementia, and other brain issues. 

  • Bone Loss

    Several studies confirm that SHBG may lead to osteoporotic fractures like vertebral fractures and the genesis of bone loss. 

  • Eating Disorder

    Abnormal eating behavior like binge eating or avoiding meals, reluctance to eat in public, and constant thinking about weight and food are all types of eating disorders.

    High levels of SHBG are often found in people with the eating disorder anorexia nervosa. 

    Abnormal eating behavior like binge eating or avoiding meals, reluctance to eat in public, and constant thinking about weight and food are all types of eating disorders.

    High levels of SHBG are often found in people with the eating disorder anorexia nervosa. 

  • Addison’s Disease

    The condition in which adrenal glands fail to produce enough hormones is termed Addison’s disease. It is more commonly caused due to high SHBG in women than men. 

Low SHBG Levels

  • Hypogonadism

    Hypogonadism is the inability of gonads to normally produce sex hormones. Since SHBG levels and sex hormones are interconnected

  • Infertility

    Low SHBG levels may decrease sperm mass and count which leads to infertility in men. Likewise, women with low SHBG levels have a problem with ovulation and normal menstrual cycle. 

  • Low Sex Drive

    Since SHBG levels regulate sex hormones, any abnormality in its levels affects sexual functions. One of them is loss of libido.

    Moreover, fatigue and body ache caused by low SHBG may also cause low sex drive. 

  • PCOS

    Polycystic Ovarian Syndrome is the condition of elongated ovaries with cyst formation.

    It is linked to low SHBG levels. These are considered biomarkers of metabolism abnormalities in females. 

  • Prostate Cancer

    Just like high SHBG affects prostate glands and may increase the risk of prostate cancer, so does low SHBG levels. 

  • Pituitary Problems

    The pituitary gland beneath the brain produces the pituitary hormone. Lack or excess of the hormone due to low SHBG causes problems in reproduction, growth, and blood pressure.

What Is SHBG Test?

SHBG test is conducted to check abnormal SHBG levels. This test may be recommended by the doctor if they suspect that any of the above-stated problems is due to high or low SHBG.

It could also be conducted if the total testosterone test fails to explain your symptoms. To conduct this test, a blood sample is taken from a needle with the help of a syringe. It is tested in the lab and the results come within 2-3 days.

Conclusion

Sex hormone-binding globulin is a protein that regulates sex hormones and transports them through the bloodstream.

Abnormal levels of SHBG are both a sign and cause of several health problems. Some natural factors like gender, age, and pregnancy affect SHBG levels.

Some factors like alcohol, smoking, and stress also play a role. A test, medications, and lifestyle changes may help bring the levels back to normal.

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