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Test Code SXHBG Sex Hormone-Binding Globulin (SHBG), Serum

Additional Codes

Epic: LAB2832

Mayo: SHBG

Reporting Name

Sex Hormone Binding Globulin, S

Useful For

Diagnosis and follow-up of women with symptoms or signs of androgen excess (eg, polycystic ovarian syndrome and idiopathic hirsutism)


An adjunct in monitoring sex-steroid and anti-androgen therapy


An adjunct in the diagnosis of disorders of puberty


An adjunct in the diagnosis and follow-up of anorexia nervosa


An adjunct in the diagnosis of thyrotoxicosis (tissue marker of thyroid hormone excess)


A possible adjunct in diagnosis and follow-up of insulin resistance and cardiovascular and type 2 diabetes risk assessment, particularly in women


In laboratories without access to bioavailable testosterone or equilibrium dialysis-based "true" free testosterone assays, sex hormone-binding globulin measurement is crucial in cases when assessment of the free testosterone fraction (aka free androgen index or calculated free testosterone) is required. At Mayo Clinic Laboratories, both bioavailable testosterone (TTBS / Testosterone, Total and Bioavailable, Serum) and free testosterone (TGRP / Testosterone, Total and Free, Serum) measurements are available. Free testosterone (TGRP) is measured by equilibrium dialysis, obviating the need for sex hormone-binding globulin measurements to calculate free androgen fractions.

Performing Laboratory

Mayo Clinic Laboratories in Rochester

Specimen Type


Specimen Required


Preferred: Red top

Acceptable: Serum gel

Specimen Volume: 0.5 mL

Specimen Minimum Volume

0.4 mL

Specimen Stability Information

Specimen Type Temperature Time Special Container
Serum Refrigerated (preferred) 14 days
  Frozen  60 days

Reference Values



Tanner Stages*

Mean Age

Reference Range (nmol/L)

Stage I



Stage II



Stage III



Stage IV



Stage V



*Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for boys at a median age of 11.5 (±2) years. For boys, there is no definite proven relationship between puberty onset and body weight or ethnic origin. Progression through Tanner stages is variable. Tanner stage V (young adult) should be reached by age 18.



Tanner Stages*

Mean Age

Reference Range (nmol/L)

Stage I



Stage II



Stage III



Stage IV



Stage V



*Puberty onset (transition from Tanner stage I to Tanner stage II) occurs for girls at a median age of 10.5 (±2) years. There is evidence that it may occur up to 1 year earlier in obese girls and in African American girls. Progression through Tanner stages is variable. Tanner stage V (young adult) should be reached by age 18.



Males: 10-57 nmol/L

Females (non-pregnant): 18-144 nmol/L

Day(s) and Time(s) Performed

Monday through Friday; 5 a.m.-3 p.m.

Saturday; 6 a.m.-3 p.m.

Test Classification

This test has been cleared, approved or is exempt by the U.S. Food and Drug Administration and is used per manufacturer's instructions. Performance characteristics were verified by Mayo Clinic in a manner consistent with CLIA requirements.

CPT Code Information


LOINC Code Information

Test ID Test Order Name Order LOINC Value
SHBG Sex Hormone Binding Globulin, S 13967-5


Result ID Test Result Name Result LOINC Value
SHBG Sex Hormone Binding Globulin, S 13967-5

Clinical Reference

1. Pugeat M, Crave JC, Tourniare J, Forest MG: Clinical utility of sex hormone-binding globulin measurement. Horm Res 1996;45:148-155

2. Tehernof A, Despres JP: Sex steroid hormone, sex hormone-binding globulin, and obesity in men and women. Horm Metab Res 2000;32:526-536

3. Kahn SM, Hryb DJ, Nakhle AM, Romas NA: Sex hormone-binding globulin is synthesized in target cells. J Endocrinol 2002;175:113-120

4. Hammond GL: Access of reproductive steroids to target issues. Obstet Gynecol Clin North Am 2002;29:411-423

5. Elmlinger MW, Kuhnel W, Ranke MB: Reference ranges for serum concentrations of lutropin (LH), follitropin (FSH), estradiol (E2), prolactin, progesterone, sex hormone binding globulin (SHBG), dehydroepiandrosterone sulfate (DHEA-S), cortisol and ferritin in neonates, children, and young adults. Clin Chem Lab Med 2002;40(11):1151-1160

Method Description

IMMULITE 2000 sex hormone-binding globulin (SHBG) is a solid-phase, 2-site chemiluminescent immunoassay. A polystyrene bead is coated with a monoclonal antibody specific for sex hormone-binding globulin (SHBG). The patient sample, diluted 1 in 20, and alkaline phosphatase-conjugated anti-SHBG (polyclonal) are added to the bead and incubated. SHBG in the sample is bound to form an antibody sandwich complex. Unbound conjugate is then removed by washing, after which substrate is added. The chemiluminescent substrate, a phosphate ester of adamantly dioxetane, undergoes hydrolysis in the presence of alkaline phosphatase to yield an unstable intermediate. The continuous production of this substance results in the sustained emission of light. The photon output is proportional to the concentration of SHBG in the sample.(Package insert: IMMULITE SHBG 2000, July 2008)

Analytic Time

Same day/1 day

Reject Due To

Gross hemolysis Reject
Gross lipemia OK

Method Name

Automated Chemiluminescent Immunometric Assay