Sex Hormone-Binding Globulin
Sex Hormone Binding Globulin is a hormone that tightly binds to three sex hormones including estradiol, dihydrotestosterone and hormone testosterone. In the bound state, SBHG transports the hormones in the blood in their inactive biological forms. A change in SHBG levels can affect the amount of the hormones that is available and needed for body tissues.
It is imperative to note that the levels of hormones in blood must always be right. Steroid hormones include estrogens, progesterone, testosterone and DHEA among others. These hormones are fat soluble but the blood is mainly water. Therefore, blood and hormones do not often mix well. Therefore, to correct this, the body produces sex hormone binding globulin. This is a protein produced by the liver to connect with sex hormones or fat loving hormones. The result becomes water soluble hormones that can comfortably move in the blood stream.
More about sex hormone binding globulin
SHBG combines with various hormones in the body to different levels of attraction or affinity. The most significant and strongly bound hormone is dihydrotestosterone or DHT. This is the active form of testosterone and if followed closely by testosterone itself. SHBG shows high levels of affinity despite the fact that it is considerably less for DHEA, progesterone and estrogens.
Estrogens also increase production of SHBG in the liver when the organ is functioning well. Another hormone, Adipnectin that is released by fat cells is also involved in the process.
Production of the hormone in the liver is also reduced by testosterone related hormones. Hypothyroidism, insulin and liver disease can also reduce the production of the hormone. It is therefore imperative to note that reduction of the hormone or low levels of the hormone is often a predictive of diabetes, PCOS, kidney disease, sleep apnea and metabolic syndrome.
Therefore, it is always good to test for SBHG. There is a useful test for checking hormone levels in the body. This is done by collecting urine for 24 hours and measuring the level or amount of hormones that leave the body that same day. In a person with low SHBG, a high amount of testosterone will be high in the urine. This can be interpreted as a person with high total testosterone but in actual sense, the amount of the hormone in the body is relatively low. As a result, it is wise to interpret the urine test results accurately by combining urine test with blood test.
SHBG in men and women
For adult males, testosterone levels and SHBG test can be order to help determine cases of infertility, erectile dysfunction and reduced sex drive. SHBG test with that of testosterone is also helpful when total results of the hormone is consistent with other clinical signs.
Additionally, the test enables health practitioners to assess bioavailable testosterone with a simple testosterone test. An increase of SHBG in men can be associated with low levels of testosterone because of less testosterone ((hypogonadism) that is available to body tissues.
In women, low testosterone levels are produced by adrenal glands and the ovaries. A slight increase in production of the hormone can interfere with balance of hormones and cause symptoms such as missed menstrual periods, acne, excess body and facial hair or hirsutism and , cases of infertility. These cases among others are commonly associated with polycystic ovary syndrome, a condition that is characterized by excessive production of androgens or male sex hormones.
It is then essential to carry out SHBG TESTING to determine and evaluate the excessive production of testosterone or reduced SHBG concentration. The test also helps in evaluating women, who are suspected of having polycystic ovary syndrome (PCOS).
Interpretation of SHBG results
High SHBG levels means less testosterone while a low SHBG level means high total testosterone level in the body. This is however not bound to SHBG and the details are essential in evaluating n individuals overall status and more specifically, conditions that are related to high or low SHBG levels.
Increase SHBG is seen in persons with hyperthyroidism, eating disorders, liver disease, and decreased production of sex hormone, pregnancy and estrogen use.
Decrease in SHBG is closely associated in individuals with Cushing disease, steroid or Androgen use, obesity, hypothyroidism and polycystic ovary syndrome.
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Sources
https://www.urmc.rochester.edu/encyclopedia/content.aspx?ContentTypeID=167&ContentID=shbg_blood
http://www.ncbi.nlm.nih.gov/pubmed/2080856
http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/9285