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Sex Hormone-Binding Globulin (SHBG)

SHBG is the liver-made protein that binds most of your circulating testosterone. It controls how much is bioavailable. High SHBG masks low free T; low SHBG is one of the earliest signals of insulin resistance.

Category
Hormones
Units
nmol/L
Reference range
20-50 nmol/L (men)

What does a high Sex Hormone-Binding Globulin result mean?

Hyperthyroidism, chronic alcohol, oestrogen excess, hepatitis, ageing, calorie restriction. Drags down free testosterone.

What does a low Sex Hormone-Binding Globulin result mean?

Insulin resistance, NAFLD, hypothyroidism, obesity, anabolic steroid use. Often appears before HbA1c moves.

Why does Sex Hormone-Binding Globulin matter?

SHBG is a signal, not a target. Treat the upstream cause (metabolic, thyroid, liver) and SHBG follows.

FAQs

Can you lower SHBG naturally?
Yes — resolving hyperthyroidism, reducing alcohol, gaining lean mass, and addressing high oestradiol all lower SHBG over weeks to months.
Is low SHBG dangerous?
Not directly, but it's a strong early signal of insulin resistance. Treat the metabolic cause, not the number.

References

  1. [1]Sex Hormone-Binding Globulin and Risk of Type 2 Diabetes in Women and MenNEJM (2009)

Want Sex Hormone-Binding Globulin interpreted in the context of your full panel? Every FORM bloodwork tier covers it, with an MD walking you through the result.

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