High sex hormone-binding globulin (SHBG) levels can significantly impact hormone balance and overall health. SHBG is a glycoprotein produced primarily in the liver that binds to sex hormones, such as estrogen and testosterone, regulating their bioavailability in the bloodstream. While it plays a critical role in hormone transport and modulation, an elevated SHBG level may lead to symptoms of hormonal imbalance, even when total hormone levels appear normal. Understanding what high SHBG means, its causes, and how to manage it is essential for those facing issues related to hormone regulation and wellness.
What Is Sex Hormone-Binding Globulin (SHBG)?
SHBG is a protein that tightly binds to sex hormones especially testosterone and estradiol making them biologically inactive. Only unbound or free hormones are considered active and available to cells and tissues. By controlling the proportion of free to bound hormones, SHBG regulates the effects of these hormones on the body.
The Role of SHBG in Hormone Regulation
SHBG is essential for:
- Maintaining proper hormone levels in the blood
- Preventing excessive hormone activity
- Controlling hormone availability to tissues
When SHBG levels are high, less testosterone and estrogen remain unbound, which can result in hormone deficiency symptoms despite normal blood levels of total hormones.
What Causes High SHBG Levels?
There are several underlying factors that can cause elevated SHBG levels in both men and women. Understanding these causes helps in identifying and addressing the root problem.
Common Causes of Elevated SHBG
- Liver disease Since SHBG is produced in the liver, conditions like hepatitis, cirrhosis, or fatty liver can increase SHBG production.
- Hyperthyroidism An overactive thyroid is known to raise SHBG levels.
- Estrogen therapy Taking estrogen-based medications or birth control pills can increase SHBG, especially in women.
- Aging SHBG levels tend to rise with age, affecting hormone availability in older adults.
- Malnutrition or anorexia Poor nutritional status may lead to hormonal imbalances and higher SHBG.
- Genetic factors Some individuals may naturally have higher SHBG due to hereditary reasons.
Symptoms of High SHBG
The symptoms of high SHBG are generally related to the deficiency of free hormones in the body. Because SHBG binds to these hormones, their active form is reduced, leading to signs of hormonal insufficiency.
In Men
- Fatigue or low energy
- Reduced muscle mass
- Low libido or erectile dysfunction
- Mood changes, including depression or irritability
- Loss of body hair
In Women
- Irregular menstrual cycles
- Low libido
- Vaginal dryness
- Mood swings or anxiety
- Difficulty conceiving
Symptoms may vary depending on individual hormone levels and the degree of SHBG elevation. In both genders, high SHBG can affect quality of life and overall health.
Diagnosing High SHBG Levels
Blood tests are the most reliable way to determine SHBG levels. A healthcare provider may recommend the following labs:
- SHBG blood test
- Total testosterone or estradiol
- Free testosterone or free estrogen (calculated or direct)
- Liver function tests
- Thyroid panel
These tests help provide a comprehensive overview of hormonal health and identify whether high SHBG is contributing to low free hormone levels.
Managing High SHBG Naturally
Addressing the underlying cause is essential in reducing SHBG levels. Natural interventions often focus on improving liver health, hormone balance, and lifestyle habits.
Diet and Lifestyle Changes
- Increase protein intake Adequate dietary protein may support healthy SHBG levels.
- Reduce sugar and refined carbs High insulin levels may lower SHBG, so maintaining insulin sensitivity is key.
- Exercise regularly Physical activity improves hormone function and may influence SHBG levels.
- Manage stress Chronic stress can disrupt hormone balance and increase SHBG indirectly.
Improve Liver Health
- Consume antioxidant-rich foods like leafy greens, berries, and cruciferous vegetables
- Limit alcohol intake
- Consider liver-supporting supplements like milk thistle, dandelion root, or NAC (under medical supervision)
Medical Treatments for High SHBG
If high SHBG is causing significant hormonal symptoms, a doctor may recommend treatment options depending on the individual’s overall health and hormone profile.
Options Include:
- Testosterone replacement therapy (TRT)in men to increase free testosterone
- Adjusting thyroid medicationsif thyroid function is contributing to high SHBG
- Hormone-balancing treatmentsfor women experiencing estrogen or progesterone deficiency
It’s important to work with a healthcare provider to find the safest and most effective treatment plan. Overcorrecting SHBG can have unintended consequences, so treatment should always be individualized.
How to Interpret SHBG in Hormone Testing
When evaluating hormone health, SHBG is often overlooked, but it provides important context for interpreting hormone levels. For instance, two people with the same total testosterone levels may have very different symptoms depending on their SHBG levels. Calculating the free androgen index (FAI) or measuring free hormones gives a clearer picture of actual hormone activity in the body.
Why High SHBG Matters
High sex hormone-binding globulin can significantly impact how hormones function in the body, often masking the true picture seen in total hormone tests. By binding to key hormones like testosterone and estrogen, elevated SHBG can result in symptoms of deficiency, even when total hormone levels seem adequate. Addressing the root causes such as liver health, thyroid function, and overall hormone balance is essential for restoring well-being. Whether through natural methods or medical treatments, managing SHBG levels is a critical component of comprehensive hormonal care.