Hormone hspg: what is it in women, the norm by age, the causes of deficiency and high rates. Hormone hspg in men: normal values, causes of deviations and their treatment

Hormones are present in the body of each person; they are responsible for the normal functioning of various organs, as well as physiological processes in them. One of these hormones is the hormone SHBG (SHBG) - a globulin that binds sex hormones, it binds free forms of testosterone, which subsequently goes into a bound form. This hormone is transport, it promotes bound forms of sex hormones through the blood. SHBG also binds a hormone such as estradiol.

Since sex hormone-binding globulin is a special form of protein, like all proteins in our body, it is formed in the tissues of the human liver. Accordingly, diseases of this organ can lead to deviations in the amount of SHBG in the human body. The amount of this protein is also affected by gender, age and physique of a person, as well as the presence of certain types of diseases that have a direct impact on SHBG.

What is SHBG in men?

Since this protein is a testosterone-binding protein, it converts its free form into a bound one, which reduces the activity of testosterone and blocks its effect on the male body. Moreover, a large amount of SHBG has a bad effect on male sexual function, lowering it. So doctors pay special attention to this, and first of all, a man with a problem with sexual function is prescribed tests for SHBG.

What is SHBG in women?

In women, the blood contains mainly the female sex hormone - estrogen, and free testosterone is half as much as in men, therefore, the amount of SHBG in the female body is approximately twice as much as in the male. How badly it affects the body of a man, and the increase in free on the body of a woman.

Norms and deviations, reasons for deviation.

As mentioned above, in men and women, there are definitely different amounts of SHBG in the blood. Its content is also influenced by the age of the person. The table below shows the average amount of protein depending on the sex and age of the person.

Age, years	Women, nmol/l	Men, nmol/l
0-2	<64	<97
2-4	33-135	27-110
4-6	23-100	37-148
6-8	30-121	20-114
8-10	26-128	38-132
10-12	16-112	21-150
12-14	19-89	13-102
14-60	18-114	13-71
60-70	17-140	15-61
70-90	39-154	15-85

SHBG abnormalities in the male body.

Such norms are possible only with a normal and healthy body that does not have deviations and diseases. If there are disorders in the male body, namely a decrease in erection, growth of breasts and adipose tissue according to the female type, in which the buttocks begin to increase and a second chin appears, in these cases you should consult a doctor who will prescribe tests and appropriate treatment.

Deviations from the norm are influenced by factors such as:

The age of the examined patient has one of the most important influences on the content of SHBG in the blood of a man.
Presence of cancer
Increased body fat
The presence of inflammatory processes in the internal organs
Violation in the endocrine system, as well as a violation of the general hormonal background as a consequence of stress
And, of course, heredity.

All these factors have a huge impact on the content of globulin that binds sex hormones. In the event of an increase in the level, consider diseases such as:

Increased secretion of thyroid hormones
Benign tumors in the prostate
Diseases such as hepatitis, AIDS, HIV.

The increased presence of SHBG in the male body means that free testosterone is reduced and you should immediately consult a doctor, as the female hormone begins to predominate, which can lead to changes in the male body.

At a reduced level, the following pathologies are usually observed:

For connective tissue diseases
Decreased secretion of thyroid hormones
Serious liver diseases such as cirrhosis
Pathological proliferation of bone tissue
Cushing's syndrome
Impaired insulin secretion
Hereditary elevated state of testosterone in the blood.

The consequences of deviating from the norm are varied. With age, a decrease in the concentration of SHBG is observed in a man; in principle, it is believed that such a deviation does not need medical intervention, another thing is when the readings are increased. An increased indication can cause such consequences as acne on the skin, a decrease in potency, such a deviation can cause an aggressive state, especially in adolescents.

Deviation of SHBG in the female body.

The presence and amount of globulin that binds sex hormones in the female body, as well as in men, can be influenced by many factors, consider the main ones:

Thyroid dysfunction
The presence or absence of a woman's pregnancy
As well as in men, the concentration of SHBG is also affected by the age of the patient.
The presence of bacterial and viral infections
Taking hormonal drugs
Increased body weight.

A deficiency in the presence of SHBG in women indicates the presence of such pathologies as:

Acromegaly
Polycystic ovaries
As well as in men, the presence of such a pathology as Cushing's syndrome
The development of oncological diseases of the genital organs and mammary glands
Diabetes

An increased concentration of globulin that binds sex hormones manifests itself against the background of such diseases as:

Hyperthyroidism
Increased estrogen production associated with cancer of the reproductive system
Taking drugs with a high content of estrogen.

In case of violation of the normal functioning of the reproductive system, you should immediately contact your doctor to prescribe the correct and timely treatment.

Analysis for the content of SHBG in the blood.

Analysis for SHPG.

This examination is prescribed by endocrinologists, urologists, gynecologists, reproductive specialists, andrologists. An analysis for the content of SHBG is carried out in the laboratory, and venous blood in the amount of 10 ml should be taken. After that, plasma is separated in a special centrifuge, into which marker substances are subsequently added, when they interact with SHBG, they begin to emit a glow, which is measured with a luminometer. According to these measurements, the concentration of globulin that binds sex hormones in the blood is determined.

Indications for analysis for the content of SHBG in men.

Consider some deviations in the normal functioning of the body of a man:

Some patients observe such a phenomenon as intolerance to a drug such as insulin in diabetes mellitus.
A sharp decrease in sexual desire of the so-called male libido, as well as erectile function
Acne rashes on the skin, the so-called acne
infertility diagnosis
Stress also has a great influence on the decrease in SHBG concentration in men.
Rapid fat gain
Reducing the content of steroid hormones
Also, an appointment for an analysis can follow with a significant decrease in the immunity of a man's body.

Before donating blood, you should follow the necessary rules, which will allow you to more accurately determine SHBG in the blood. It is definitely worth canceling two days in advance, since their presence in the analyzes can change the actual concentration of protein in the body. You should also stop taking alcoholic beverages and smoking. Blood sampling is carried out in the morning and on an empty stomach, it is allowed to drink water in the morning, in no case tea or juice.

Indications for analysis of the content of SHBG in women.

An analysis for globulin that binds sex hormones in women is prescribed mainly for violations of reproductive function. HIV testing may also be done. Sometimes a study of free testosterone is prescribed, and the patient donates blood to determine the concentration of substances such as albumin, estradiol, androgens.

To prescribe an examination, the doctor indicates such deviations and pathologies as:

Ovarian disease (polycystic)
Violation of the normal functioning of the thyroid gland, inflammatory processes in it
Eruptions on the skin, mainly on the face of the patient
In regular menstrual irregularities
The onset of gestational diabetes during pregnancy
Hair loss both on the head and on other parts of the skin.

During preparation for the examination, the patient is advised to stop taking hormonal drugs, oral contraceptives and androgen-containing products at least a week before blood sampling for SHBG analysis in women. It is forbidden to eat food for 8-10 hours, have sexual intercourse for three days, as otherwise it can cause a hormonal surge and give inaccurate readings of the SHBG content in the patient's blood. You should also completely calm down before taking blood, it is advisable to sleep well beforehand, and avoid stressful conditions.

Treatment of deviations from the norm.

If the results of the analysis reveal an increase in the content of SHBG, a number of clarifying studies are assigned. You should contact such specialists as: endocrinologist, gastroenterologist, andrologist. An ultrasound scan of the liver is prescribed, since this protein is produced in the cells of this organ. The patient should have a biochemical, liver enzyme, HIV, and hepatitis test to rule them out at the time of diagnosis.

After an accurate diagnosis, treatment is started, which is prescribed according to the results of the examination. After the patient undergoes treatment, he is sent for re-analysis for the content of sex hormone-binding globulin. Usually, with the complete recovery of the patient, the hormonal background normalizes automatically, but if normalization does not occur, then prophylactic drugs and food are prescribed:

High-fiber foods (vegetables, fruits, some whole grain and bran breads)
Preparations containing estradiol in a small amount
Vitamins that have a positive effect on the male body (D3)
Beans, apricots, grapes or raisins. These products contain boron, the reduction of which adversely affects the male genital organs.
To normalize the hormonal background, specialized drugs are prescribed (Proviron, Exemestane)
Lean meats, nuts, spinach, veal liver, and dark chocolate. These products contain such useful trace elements as magnesium and zinc.

During treatment, it is advised to completely abandon the intake of alcoholic beverages, as they adversely affect male sexual functions.

If the examination reveals a low content, in this case a series of tests are also prescribed, as a result of which the disease is diagnosed as a result of which the deviation is caused. Among the main pathologies, a long-term stressful state and a violation of male erectile function are distinguished. For the exact prescription of medications, you should consult a doctor. Usually, after a course of treatment, the restoration of the norm of the content of SHBG occurs independently.

Treatment of abnormalities in men.

Globulin, which binds sex hormones in women, must always be kept normal, since the general hormonal state of the female body is envy of it. Special analyzes reveal deviations, based on research data, the attending physician establishes a specific course of treatment.

With an increased level of SHBG in women, doctors prescribe medications that reduce its content. These drugs include synthetic hormonal drugs, they are made in the form of tablets or injections ( Anastrozole, Exemestane, Proviron). In parallel with a decrease in the level of protein, a course of treatment of diseases associated with this deviation is carried out.

With a reduced level of this protein, the so-called statins are prescribed, their dosage is formed for each separately, taking into account individual characteristics. Since estrogen is the main female hormone, they try to maintain its normal level in the first place.

In addition to medications, the attending physician may prescribe some anti-stress drugs and tranquilizers. We should not forget about traditional medicine, which includes the use of motherwort, decoction of sage, St. John's wort and horsetail.

Related videos

Sex binding globulin. hormones: main functions

First you need to talk about what specific role globulin plays in the human body. There are four of them, but they are all very important. So they are the following:

Binds sex hormones, as well as drugs and other substances.

Globulin carries vitamins and other substances throughout the human body.

Acts as a defender of the body against infections, toxins, foreign proteins, etc.

Responsible for blood clotting.

As you can see from the list, binding gender. hormones is not the only task that the globulin protein performs. The work of many body functions directly depends on this protein. If there are any deviations from the given norm, there are violations in the work of not only the reproductive system.

The norm of globulin in a woman's body

As discussed above, this article will go into great detail about sex-binding globulin. hormones in women. The norm of globulin depends on how old the woman is. When the age is from 8 to 10 years, the norm should be equal to 26-128 nmol per liter. From 10 years to 12 years, the norm changes slightly: from 16 to 112 nmol per liter. Further, from 12 to 14 years, the globulin rate varies from 19 to 89 nmol per liter. And the last indicator of the norm in a woman from 14 to 60 years old is from 18 to 114 nmol per liter.
An increase in globulin levels may occur in a pregnant woman. The increase occurs during all three cycles of pregnancy. The highest level of globulin occurs in the third semester of pregnancy. The lower limit can be 1680 and the upper limit is 3880. These values are absolutely normal and do not pose any danger to both mother and child.
Of course, after a woman turns 60, the level of protein increases, but not much. Basically, the increase is 12 percent per year. It is these indicators that are the norm for a healthy woman. Even a slight deviation from this norm is unacceptable.

Low globulin in women

Sex binding globulin. hormones in women may be below normal. But with what it can be connected? There are several reasons for such a low level of globulin, namely:

Diabetes.

Cirrhosis of the liver.

Improper functioning of the excretory system.

Polycystic ovary syndrome.

An increase in the concentration of androgens in the blood.

These are the main reasons why sex-binding globulin. hormones, in women becomes below normal. In this case, it is necessary to immediately begin a course of treatment.
As you can see, the main reasons for this are chronic diseases. This means that you don't have to wait for your globulin levels to start to drop. It is necessary to take tests and consult with specialists regularly, at least once a year. Unfortunately, many people, due to their laziness or lack of time, rarely go to doctors, which makes it possible to identify the disease only when it is already running. It is important to understand that if deviations from the norm are detected in the early stages, treatment can go faster and easier.

Treatment for low globulin levels

In medicine, it is not uncommon for sex-binding globulin. hormones, lowered in women. What to do? This question is often asked by many women who have been diagnosed with this condition. And you need to do the following. If sex-binding globulin. hormones, lowered in women, treatment cannot be delayed. Doctors generally prescribe so-called statins to increase protein levels. There is no single treatment regimen in medicine. The reason is that the approach to treatment depends on the situation, on how low the globulin level is.
In order for the treatment to be productive, doctors prescribe a detailed diagnosis of the woman's body in order to identify the reason why the globulin level was reduced. Diagnosis won't take long. It gives a complete picture of the state of the woman's body. Basically, the treatment is prescribed by a general practitioner or endocrinologist, in some cases, an oncologist.

High globulin levels in women

Sex binding globulin. hormones are often high. This is also facilitated by various factors. The main factors are the following:

HIV infection.

Hepatitis.

Thyroid.

Taking hormonal drugs that contain estrogens.

These are the main reasons why globulin levels can rise above normal. As with a decrease in the norm of globulin, its increase must be corrected. High globulin levels are treatable. Thanks to new drugs, this disease can and should be fought. The result of the treatment will not be long in coming.

High globulin treatment

If the level of globulin is elevated, the doctor may prescribe steroid drugs to his patient. But before prescribing the drug, the doctor conducts a full course of examination of the patient to find out the cause of the high level of globulin. The patient can take these medicines either in the form of tablets or in the form of injections. It is important not to stop treatment and bring the process to the end. Otherwise, the result may be lost.

Sex binding globulin. hormones in women when to take tests

In order to find out the exact content of globulin in the blood, it is necessary to pass all the tests. Mostly women take them on the days of the menstrual cycle. It is worth remembering that if you want to take an analysis for the level of globulin, you must first consult with your doctor. It is the attending physician who gives the direction for the tests. A woman takes blood from a vein.

Indications for passing the analysis

A woman can take an analysis, guided by her desire. And it will absolutely not be a waste of time. Unfortunately, the percentage of such people who always take care of their health is small. As a result, women come to see a doctor in whom the deviation from the norm of globulin is visible by eye. So! You can understand that a woman may have problems with globulin with the naked eye. But you don't have to get ahead of yourself. Everything must be said in order. So, in medicine, there are indications for taking an analysis for the content of globulin in the body. The indications for blood donation are as follows:

Climax.

Baldness or a lot of dandruff.

Decline in sex drive.

Polycystic ovaries.

Infertility.

Violation of menstruation.

Knowing these indications and guided by them, the doctor must send the patient for testing, after which, if the diagnosis is confirmed, he will be able to prescribe treatment.

How to properly prepare for the test

In order for a woman to prepare for testing for sex-binding globulin. hormones, certain conditions must be met. These conditions are:

Three days before the test, the intake of absolutely any hormonal drugs is stopped.

Sexual contact before testing should be avoided.

Blood is given on an empty stomach and in the morning.

In addition to what is listed in the list, it is also forbidden to drink tea and coffee. Only water is allowed to drink. If you neglect these rules, it is likely that the results of the analyzes will be incorrect. Basically, they are ready a day after blood donation.
It is worth remembering that only a doctor is engaged in deciphering the analyzes! Treatment is prescribed only by a specialist. Self-medication is unacceptable.

Conclusion

So, now we can summarize the above in this article. It is unacceptable to increase or decrease the level of globulin in the human body. In case of the slightest deviation, treatment should be started immediately. It is necessary at least once a year to consult with specialists and take tests. You can not stop treatment, because the entire result may be lost and you will have to start all over again.

Publication date: 05/23/17

In this article, we will consider why sex hormones should bind to globulin, what this protein is, where it is formed and how it is determined. We will also highlight the main reasons for the change in this indicator in women and give brief information about the methods of treating the identified pathologies.

Introduction

Most of the biologically active substances are contained in the blood in the form associated with transport proteins in order to act not on the body as a whole, but only on the cells of target organs that have corresponding receptors on their surface. Sex steroid hormones - testosterone and estrogens - are transported in the blood in a similar way.

The protein by which they are carried is produced by liver cells and is called testosterone-estradiol-binding globulin (TESH). Synonyms are also female sex hormone-binding globulin (SHBG) and sex steroid-binding globulin.
Chemically, it is a glycoprotein with a molecular weight of approximately 86,000. SHBG binds and transports hormones such as testosterone, estradiol, progesterone, dihydrotestosterone, androstenedione. This type of globulin has a greater affinity for male sex hormones, that is, in the presence of estradiol and androgens, it is more likely to contact the latter.

Factors affecting SHBG levels

The age of the patient

The concentration of estrogens and androgens;

the state of the function of the adrenal glands and kidneys;

the presence or absence of obesity;

The functional state of the liver;

the concentration of hormones produced by the thyroid gland;

Therapy with androgen drugs;

Presence or absence of pregnancy.

The activity of sex hormones depends on the amount of SHBG in the blood. The susceptibility of target organ tissues is lower with a high content of globulin, and vice versa. Normally, about half of all sex hormones contained in the blood are associated with SHBG. The remaining 50% is attached to another protein - albumin, but the connection with it is weaker, so the hormones are more easily detached and affect the reproductive and other organs that are sensitive to them. Thus, only 1-2% of the resulting sex hormones affect the sexual functions of the body. The rate of globulin that binds to sex hormones in women ranges from 7.2 to 100.0 nmol / l.

In children, SHBG can be much higher than 100.0 nmol/L. With the onset of puberty, the concentration in the blood of SHBG decreases, and in the postmenopausal period, on the contrary, it increases. Upon reaching the age of 60 years, the content of TESG increases by an average of 1-1.5% annually.

The amount of globulin in the blood largely depends on the level of sex hormones. Estrogens contribute to an increase in the index, androgens reduce it. This explains the fact that women have twice as much globulin in their blood as men. With insufficient synthesis of estrogens, not only the content of SHBG decreases, but also free estradiol.

However, the main factor affecting the concentration of SHBG is the functional activity of the liver, where this substance is produced. With liver failure, the synthesis of SHBG is significantly reduced, respectively, the biological activity of sex hormones increases, especially estradiol, which already has a reduced affinity for SHBG.

These circumstances explain the fact that with liver failure in men, manifestations of gynecomastia develop, in women this leads to cycle disorders and oncological diseases (benign or malignant) of the uterus, mammary glands.

Methods of determination and indications

The study of the concentration of globulin that binds steroid sex hormones is carried out in the laboratory using immunochemiluminescent technology. The patient is taken 10 ml of blood from a vein. Blood for analysis is taken in the morning on an empty stomach. 30-60 minutes before the analysis, it is necessary to refrain from smoking, emotional and physical exertion, from sexual intercourse a day before, and stop taking hormonal drugs (if possible) for three days.

For the diagnosis of certain diseases, an indicator such as the free testosterone index is used. This is the ratio of total testosterone to SHBG. In women, this index is usually around 0.8-11%.

Indications

The purpose of determining the level of SHBG is to assess the hormonal balance of the reproductive system. Such an examination may be necessary in the following cases:

infertility;

Decreased sex drive

Signs of an increased content of androgens in women (endocrine tumors, cysts, pathologies of the adrenal glands, etc.);

Suspicion of polycystic ovaries;

Irregular menstruation

The need to determine the risk of developing severe preeclampsia during pregnancy.

In most cases, the analysis of the level of globulin is carried out in conjunction with the determination of the content of various sex hormones, for example, prolactin, estrogens, luteinizing hormone, gestagens, etc. You may also need to study the hormones of the thyroid gland, pituitary gland, adrenal glands, ultrasound of the internal genital organs, liver, adrenal glands. To determine the state of the liver, such biochemical indicators as alanine aminotransferase, asparagine aminotransferase, alkaline phosphatase, bilirubin are often determined, and a thymol test is performed.

The essence of the method

The immunochemiluminescent method for the determination of SHBG is based on an immunological reaction between an antigen and an antibody, resulting in the formation of immune complexes. In this case, the antigen is globulin, and antibodies to it are contained in special test tubes included in the analysis kit. They also add antibodies labeled with a radioactive isotope. The tubes with the reaction mixture are incubated for 2 hours and then their radioactivity is measured using a gamma counter. The device determines the concentration of the hormone in the blood by the intensity of the radiation. For quality control, special calibrators are used.

The determination of the indicator is carried out in serological laboratories by experienced doctors of clinical and laboratory diagnostics strictly according to the instructions for the reagent kit. All test tubes are labeled and numbered according to their destinations in order to eliminate errors. The results of the analysis are evaluated by the attending physician (endocrinologist or gynecologist).

Causes of low globulin content

Insufficient SHBG content in women occurs under the following conditions:

Diseases characterized by impaired metabolic processes in the connective tissue (rheumatism, lupus erythematosus, scleroderma, periarteritis nodosa and other so-called collagenoses);

PCOS (polycystic ovaries);

nephrotic syndrome, accompanied by renal failure and increased loss of protein in the urine (with glomerulonephritis, chronic kidney disease);

hyperandrogenism (one of the signs is hirsutism, i.e. the appearance of hair in places atypical for women - on the stomach, back, in the face);

pathologies of the thyroid gland, characterized by a violation of its hormonal function (hypothyroidism, hyperthyroidism);

acromegaly and gigantism (observed with excessive synthesis of growth hormone - somatotropin in adults and children, respectively);

· diabetes;

prolactinoma - a tumor of the pituitary gland that secretes excess prolactin levels in women;

liver diseases accompanied by a violation of its protein-synthesizing function (chronic hepatitis, cirrhosis, tumors);

Incorrectly selected dosages of hormonal drugs;

adrenogenital syndrome (a hereditary disease associated with excessive production of androgens in the adrenal cortex and accompanied by hirsutism and other symptoms of a woman's virilization);

If the reason for the change in the level of SHBG is the intake of hormonal drugs, then their dose is adjusted under laboratory control, if possible canceled or replaced with other drugs.

Correction of thyroid function is determined by the level of its hormonal activity. If the patient has hypothyroidism, replacement therapy with iodine-containing hormones and iodine preparations is used. In the hyperthyroid state, drugs are used that reduce the production of gland hormones. Thus, treatment should directly affect the underlying disease that led to the disruption of globulin production.

Conclusion

The level of sex steroid-binding globulin is a diagnostically valuable indicator hormones and hormonal status in women in the detection of a number of diseases of the reproductive sphere in women. But when evaluating the result, it is necessary to take into account the general condition of the body, existing chronic diseases, ongoing therapy and other factors that can affect the level of SHBG. For a more accurate diagnosis of pathologies, additional laboratory and instrumental studies are required to determine the initial cause.

Sex hormone-binding globulin (SHBG)

Sex hormone-binding globulin (SHBG) is a liver-produced protein that combines with testosterone, dihydrotestosterone (DHT) and estradiol (estrogen) and transports them into the blood in a metabolically inactive form.

Russian synonyms

Sex steroid-binding globulin, SHBG, SSSG, testosterone-estradiol-binding globulin.

English synonyms

Sex Hormone Binding Globulin, Testosterone, Free Testosterone, Bioavailable Testosterone.

Research method

Electrochemiluminescent analysis.

Units

Nmol/l (nanomoles per liter).

What biomaterial can be used for research?

Venous blood.

How to properly prepare for research?

Eliminate physical and emotional overstrain 30 minutes before the study.
Do not smoke for 30 minutes prior to the study.

General information about the study

SHBG is a protein produced by the liver. It binds to testosterone, dihydrotestosterone (DHT), and estradiol (estrogen) and transports them into the bloodstream. The content of SHBG in the bloodstream depends on the age of the person, gender, on the intensity of the production of testosterone or estrogen. In addition, SHBG levels in the blood are affected by liver disease, hyperthyroidism, hypothyroidism, and increased body weight.

The amount of testosterone available for use by body tissues depends on fluctuations in SHBG levels. In the normal state, 40% to 60% of testosterone is bound to SHBG, and most of the rest is weakly bound to albumin. And only about 2% of free testosterone is directly available to the tissues.

The total testosterone test does not distinguish between bound and unbound testosterone - it only determines the amount of the hormone in general. In many cases, it is enough to determine the excess or lack of hormone production in the body, however, if the SHBG indicator deviates from the normal level, then the detected level of total testosterone is not an accurate reflection of the amount of the hormone available to the tissues of the body.

Currently, SHBG analysis is not used very often - in most cases, tests for total and free testosterone provide enough information.

What is research used for?

To determine the status of male hormones (androgens). For men, it is prescribed for testosterone deficiency, for women - with its excess. Total testosterone may be tested with or before the SHBG test.
To determine the causes of infertility, reduced sexual activity and erectile dysfunction in men, especially when total testosterone levels are not consistent with the clinical picture.
For the diagnosis of polycystic ovary syndrome and diseases characterized by excessive production of androgens.
To assess the existing balance of hormones - along with tests for free testosterone, albumin, prolactin, estradiol and luteinizing hormone.
To determine the level of free androgens by calculating their index (ISA) - together with a test for total testosterone. This makes it possible to find out the amount of testosterone not associated with SHBG: ISA = total testosterone / SHBG.

When is the study scheduled?

If the results of a total testosterone test are not consistent with clinical observations, such as decreased sexual activity in men and hirsutism in women.

What do the results mean?

Reference values

	Age	Reference values
	Less than 1 month	11.8 - 51 nmol/l
	1 month - 1 year	50 - 181 nmol/l
		51 - 158 nmol/l
		48 - 142 nmol/l
		31 - 103 nmol/l
		20 - 100 nmol/l
		16.6 - 77 nmol/l
		9.3 - 75 nmol/l
		32.4 - 128 nmol/l
	Over 50 years	27.1 - 128 nmol/l
	Less than 1 month	10.8 - 71 nmol/l
	1 month - 1 year	60 - 209 nmol/l
		42 - 156 nmol/l
		39 - 146 nmol/l
		38 - 114 nmol/l
		32 - 93 nmol/l
		13 - 63 nmol/l
		10.6 - 54 nmol/l
		18.3 - 54.1 nmol/l
	Over 50 years	20.6 - 76.7 nmol/l

With an elevated SHBG level, it is likely that the free testosterone available to the tissues is much less than the amount shown by the test for total testosterone. If the concentration of SHBG is lowered, then testosterone, not associated with SHBG, is formed more than its total level.

What can influence the result?

The concentration of SHBG is quite high in children - this is normal.
SHBG levels in adults are fairly stable. In men, it rises with age. In postmenopausal women, SHBG levels decrease as ovarian hormonal activity decreases.
Liver disease, hyperthyroidism, and anorexia can contribute to elevated SHBG levels. A decrease in SHBG levels is observed with overweight, hypothyroidism, androgen use, and Itsenko-Cushing's disease.

In the body of men and women there is a glycoprotein, which is responsible for the binding and transmission of sex hormones in the circulatory system. Speaking in a language understandable to the reader, this globulin acts as a shuttle for the sex hormones of men (androgens) and women (estrogens).

This globulin is referred to in the analysis results as SHBG. In addition, the following abbreviations may be used:

SHBG (Sex hormone-binding globulin).

TeBG (Testosterone-estrogen-binding globulin).

Sex-globulin.

ASG - androgen-binding globulin.

SSSG is a sex steroid-binding globulin.

PSSH is sex steroid-binding globulin.

TESH stands for testosterone-estradiol-binding globulin.

This globulin, regardless of its name, is produced in the liver. The rate and amount of globulin produced is influenced by a person's age, as well as the level of sex hormones in the blood. Estrogens contribute to an increase in its level, and androgens, on the contrary, reduce this indicator.

Normal levels of SHBG in the blood of men and women

In men, globulin that binds sex hormones is two times less than in women. An analysis for this protein is carried out when a decrease in the level of androgens is found in a man. Women are advised to donate blood for SHBG with an increase in the amount of estrogen in the blood.

SHBG is determined by ELISA (enzymatic immunoassay), or by ICLA (chemiluminescent immunoassay). The latest study is more recent.

The level of sex hormone-binding globulin can vary depending on the following factors:

The gender of a person.

The age of the person.

The amount of sex hormones in the body.

The presence or absence of obesity.

Taking hormonal drugs.

The quality of the functioning of the adrenal glands and, which also produce hormones.

When interpreting the results of the analyzes, it is required to focus on the norms given in the table.

Blood SHBG level:

Person's age	Norm values for women in nmol / l	Norm values for men in nmol / l
Neonatal period, breastfeeding period, under 2 years of age	No more than 97	No more than 64








After 70 years	No more than 85	No more than 166

In childhood, the level of hormone-carrying globulin is increased compared to adults. As a person ages, the amount of this globulin begins to grow again, which occurs during the period of extinction of human sexual functions. In men, a similar situation is observed against the background of age-related androgen deficiency, in which the level of free testosterone begins to fall.

Testosterone is called the main male hormone. It is produced in the testes and testicles from Ledwig cells. In women, testosterone is also present in the body, but normally, it is very small. It is produced by the adrenal glands and ovaries. Also, testosterone in humans in a small amount appears as a result of metabolic processes between corticosteroids.

Testosterone is responsible for the formation of sexual characteristics in adult men, for the formation of the genital organs in the male fetus, for the normal orientation of a person. After the onset of puberty, this main hormone of the male body ensures its sexual functions, makes it possible to continue its race.

The following transformations can occur with testosterone in the blood:

Approximately 2% of free testosterone is always present in human blood. It binds to receptors that are found on target tissue cells. Then enzymes act on it, and testosterone is transformed into dihydrotestosterone, which has a pronounced effect on the body.

A small amount of testosterone binds to other blood proteins, such as albumin or globulin, which is responsible for attaching to cortisol. If the level of SHBG falls for any reason, then it is these compounds that ensure the transport of the hormone to the desired cells. It should be noted that the relationship of testosterone with albumin and other proteins (except for SHBG) is not strong.

The main transport function of testosterone to target cells is performed by globulin, which binds sex hormones. Such a connection is stable and most reliable.

All testosterone that is present in human blood (unbound, bound to SHBG or other globulins and proteins) is total testosterone. After the testosterone molecule is attached to the carrier substance, it loses its activity, but is not destroyed. Free testosterone and bound testosterone in the blood balance each other, since both forms contain biologically active substances. In general, bound and free testosterone are referred to as bioavailable testosterone.

Since testosterone performs significant functions in the human body, SHBG is also considered a very important globulin. It is directly involved in the transport function of androgens, providing a normal human hormonal background.

SHBG and the health of the male reproductive system

SHBG is responsible for the balance of androgens in the male body. When needed, it takes on excess free testosterone. The level of sex hormone-binding globulin affects the level of available testosterone in the blood.

SHBG regulates in the male body not only the level of testosterone, but also estrogen. They are produced in men very little, while about 20% of the total amount of estrogens is carried by SHBG. The situation with hormones is somewhat different in men over the age of 60. They have more female sex hormones in their blood, but SHBG does not take them on itself, since it is mainly involved in the transport of testosterone.

SHBG defines men's health. Its level is influenced by the age of a man, since at different periods of life, the amount of sex hormones in the blood varies.

In addition to SHBG and testosterone, another indicator affects the sexual health of men - the free androgen index (ISA). It characterizes the level of a biologically active substance or free testosterone in the blood. To determine its indicator, you must use the following formula: total testosterone in nmol / l must be divided by sex hormone-binding globulin in nmol / l and multiplied by 100% (T total: SHBG x 100% = ISA).

Normally, the level of ISA in healthy men should be 50%. If this value is below this limit, then hypogonadism or chronic inflammatory processes in the prostate should be suspected. The level of ISA also decreases in men in old age, which is associated with reduced activity of sexual functions.

The level of SHBG is of great importance in the detection of various diseases of the reproductive system. This analysis is prescribed as an auxiliary study in determining the level of total testosterone in the blood, when calculating the level of ISA.

If the level of globulin that carries sex hormones decreases or increases, then this is reflected in the state of the hormonal background as a whole. Such a situation cannot go unnoticed.

If SHBG is elevated, it will promote the growth of prostate tissue, which entails the risk of the formation of cancerous tumors.

Diseases that can lead to an increase in SHBG levels:

In women, during gestation, the level of this hormone can also be increased, but this is a variant of the norm.

Pathologies in which PSPG can be lowered:

Nephrotic syndrome, in which proteins are excreted by the kidneys in large volumes.

Collagen diseases.

High levels of male sex hormones in the female body.

Benign neoplasms of the pituitary gland.