From the Guidelines
An elevated Sex Hormone Binding Globulin (SHBG) level of 334 nmol/L is significantly above the normal range and warrants medical evaluation to identify and address the underlying cause, which may include liver disease, hyperthyroidism, or other factors, as suggested by the American Association for the Study of Liver Diseases 1. The normal range for SHBG is typically 20-130 nmol/L in men and 30-135 nmol/L in women. High SHBG levels can reduce the amount of free testosterone and estrogen available in the body, potentially causing symptoms like decreased libido, erectile dysfunction in men, or menstrual irregularities in women. Several factors can cause elevated SHBG, including:
- Hyperthyroidism
- Liver disease, as liver disease can disrupt the normal production and regulation of SHBG, leading to elevated levels 1
- Eating disorders
- Excessive exercise
- Certain medications, especially estrogens and oral contraceptives
- Aging Treatment depends on identifying and addressing the underlying cause rather than treating the SHBG level directly. Your doctor will likely order additional tests, including:
- Thyroid function tests
- Liver function tests
- Free hormone levels, as recommended by the American Diabetes Association for men with diabetes who have symptoms or signs of hypogonadism 1 While waiting for medical consultation, it is essential to:
- Maintain a balanced diet with adequate protein and healthy fats
- Moderate exercise if excessive
- Avoid alcohol, which can further stress the liver, as noted in the context of liver disease and reproductive health 1 Do not stop any prescribed medications without medical advice, even if they might be contributing to high SHBG levels. In the context of hypogonadism, which may be related to elevated SHBG, testosterone replacement therapy may be considered, but its safety and efficacy must be carefully evaluated, particularly in older men, as noted in the guidelines for pharmacotherapy for obesity 1.
From the Research
Elevated SHBG at 334
- Elevated SHBG levels have been associated with various health conditions, including cardiovascular disease and hypogonadism 2, 3.
- Studies have shown that SHBG levels can be influenced by testosterone replacement therapy, with some treatments resulting in decreased SHBG levels 4, 5.
- Age and baseline SHBG levels may be used to identify clinical subgroups that respond differently to testosterone replacement therapy 3.
- Liver iron overload has been linked to elevated SHBG concentrations and moderate hypogonadotrophic hypogonadism in men without genetic haemochromatosis 6.
- The effects of elevated SHBG levels on health outcomes are complex and may depend on various factors, including the underlying cause of the elevation and the presence of other health conditions 2, 3.
Possible Causes of Elevated SHBG
- Testicular insufficiency 4
- Hypogonadotropic hypogonadism 4
- Liver iron overload 6
- Testosterone replacement therapy 5, 3