What does a high SHBG result mean?

A high SHBG (sex hormone-binding globulin) level means that more sex hormones like testosterone and estradiol are bound in the blood, making less free hormone available. This can result from hyperthyroidism, liver disease (e.g., hepatitis, cirrhosis), estrogen therapy, pregnancy, eating disorders (anorexia), or genetic factors. Elevated SHBG reduces free androgen levels, potentially causing symptoms in men such as low libido, erectile dysfunction, fatigue, and muscle loss. In women, it may affect menstrual cycles. Importantly, a single SHBG value is not diagnostic; it must be interpreted alongside total testosterone, free testosterone, estradiol, LH, FSH, and TSH. Reference ranges vary by lab, age, and sex. The evidence for these associations is well-established (human-moderate). Note: SHBG is also influenced by lifestyle factors like diet, insulin levels, and exercise. A high level is not inherently pathological but requires medical evaluation to identify the underlying cause.