---
title: "What does a low SHBG mean?"
type: biomarker-interpretation
url: "https://www.test-well.com/biomarkers/shbg/low"
biomarker: SHBG
direction: low
reference_range:
  - "Male, age 18+: 16.5 – 55.9 nmol/L"
  - "Female, age 18+: 24.6 – 122 nmol/L"
reviewed_at: 2026-09-06
review_status: reviewed
date_published: 2026-09-05
---

# What does a low SHBG mean?

> Low SHBG is strongly associated with insulin resistance — excess weight, type 2 diabetes, fatty liver, PCOS — and with hypothyroidism, anabolic steroid or testosterone use, and glucocorticoids. It raises free testosterone relative to total, which contributes to acne and hair growth in women with PCOS. Low SHBG is also an independent marker of future type 2 diabetes risk.


## What is the normal range for SHBG?

- Male, age 18+: 16.5 – 55.9 nmol/L
- Female, age 18+: 24.6 – 122 nmol/L



## What are the common causes of low SHBG?

1. Insulin resistance, obesity, type 2 diabetes, fatty liver
2. PCOS
3. Hypothyroidism
4. Androgens: testosterone therapy, anabolic steroids
5. Glucocorticoids, progestins, growth hormone excess

## What symptoms go with low SHBG?

- Women: acne, excess hair, irregular periods
- Men: often none; reflects metabolic risk

## What do clinicians usually check next?

- Fasting insulin, A1c, lipid panel
- TSH
- Free testosterone to interpret hormone symptoms

Follow-up tests at TestWell: [Lipid Panel](https://www.test-well.com/tests/lipid-panel) ($24.99), [TSH (Thyroid Stimulating Hormone)](https://www.test-well.com/tests/tsh) ($26.99), [TSH + Free T4](https://www.test-well.com/tests/tsh-with-free-t4) ($27.99).

## How do you recheck SHBG?

| Test or panel | Type | Price | Fasting | Results |
| --- | --- | --- | --- | --- |
| [Testosterone, Free & Total + SHBG](https://www.test-well.com/tests/testosterone-free-total-shbg) | Test | $69.99 | No | 3–5 business days |

Plus one $6 lab processing fee per order; physician authorization included.

## Common questions

### Is low SHBG bad?

It's a metabolic warning sign more than a problem in itself — it tracks insulin resistance and predicts diabetes risk. Weight, activity and blood-sugar improvements raise it.

## Related

- [What does a high SHBG mean?](https://www.test-well.com/biomarkers/shbg/high)
- [SHBG reference ranges](https://www.test-well.com/biomarkers/shbg)
- [Total Testosterone reference range](https://www.test-well.com/biomarkers/total-testosterone)
- [Free Testosterone reference range](https://www.test-well.com/biomarkers/free-testosterone)
- [Estradiol reference range](https://www.test-well.com/biomarkers/estradiol)

## Sources

- [Mayo Clinic Labs](https://www.mayocliniclabs.com/test-catalog/overview/9285)

---

Medically reviewed by Youmna DiStefano, MD (Medical Reviewer, TestWell); last reviewed 2026-09-06. Review policy: https://www.test-well.com/editorial-policy

Canonical page: https://www.test-well.com/biomarkers/shbg/low
Machine-readable catalog: https://www.test-well.com/api/catalog.json · MCP server: https://www.test-well.com/mcp · Overview for agents: https://www.test-well.com/llms.txt

Prices are cash-pay, in USD, and include physician authorization; every order adds one flat $6 lab processing fee. Educational content is not a diagnosis — discuss results with a clinician.