SEX HORMONE BINDING GLOBULIN (SHBG) CLINICAL PEARLS (EVEN THOUGH WE DON’T TEST IT)
Commonly when we talk with all of you smart clinicians, you have done additional work-up besides our DUTCH testing. Many will run thyroid panels, CBC, metabolic panels, food testing, stool testing, etc. and we are asked about SHBG.
SHBG is a glycoprotein binding globulin made primarily in the liver that requires calcium and zinc to form. Its job is to preferentially bind up DHT, testosterone, androstenediol (not androstenedione), estradiol, and then estrone in that order. DHEA, but not DHEA-s, can bind weakly to SHBG.
Progesterone and cortisol bind to transcortin (AKA Cortisol Binding Globulin – CBG).
SHBG is degraded in the extra-cellular space therefore it does not come through the urine as the fully formed glycoprotein, but degraded into piece and parts by your immune system. As a result, it is not tested in the DUTCH testing.
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