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Total Testosterone with Sex Hormone-Binding Globulin (SHBG) Adjustment

Published: August 9, 2026Updated: August 16, 2026

This test measures your total testosterone levels while accounting for how your body binds testosterone to SHBG, a protein that affects hormone availability.

Quick summary

["Understanding your testosterone levels and how SHBG influences them helps assess hormone balance, especially in conditions like hypogonadism or polycystic ovary syndrome (PCOS)."]

Medically reviewed by WellAlly Editorial TeamLast reviewed August 16, 2026Editorial policy

Key facts at a glance

LOINC
21555-8
Short code
Testost SHBG adj SerPl-mCnc
Synonyms
Testost SHBG adj SerPl-mCnc
Category
chemistry
Sample
serum
Container
Red-top tube (SST)
Units
N/A
Ref low
0.4
Ref high
4
Critical range
0.1 N/A – 20 N/A
Fasting
false
Population
adult
Sex
all
Age range
18–65 years
CPT
84443
SNOMED
301343003
Specimen volume
5 mL
Stability
Room temperature: 4h, Refrigerated: 24h, Frozen: 7d
Hemolysis max
500
Lipemia max
1000
Icterus max
500
TAT
4–24 hours
Order
routine

Why This Test Is Done

Your doctor may order this test if you have symptoms of low or high testosterone, such as fatigue, low libido, irregular periods (in women), or changes in body hair. It’s also used to evaluate conditions like hypogonadism, Cushing’s syndrome, or to monitor hormone replacement therapy.

What to Expect Before the Test

No special preparation is needed, but you may be asked to fast for 8–12 hours before drawing blood. Wear a loose shirt for easy access to your arm. If you’re taking medications that affect hormones, mention them to your provider.

What the Results Mean

Testosterone levels vary by age, sex, and health status. SHBG adjustment helps normalize results by accounting for how much testosterone is bound to proteins in your blood, which can affect its biological activity. Your doctor will interpret results in the context of your symptoms and medical history.

Common Conditions This Test Helps Diagnose

This test is particularly useful for diagnosing or monitoring conditions like primary or secondary hypogonadism (low testosterone), hyperandrogenism (elevated testosterone in women), or evaluating hormonal imbalances in menopause or andropause.

Reference range

Adult: 0.4-4.0 mIU/LN/A

Specimen: serum

Take your thyroid medication after the blood draw if applicable. No fasting required.

Clinical interpretation

How abnormal results are interpreted and what conditions they suggest.

◆Associated findings1

Short name

Total Testosterone (with SHBG adjustment)

Frequently asked questions

What does a low or high result mean?
Low testosterone levels (after SHBG adjustment) may indicate hypogonadism, aging, chronic illness, or certain medications. High levels could suggest conditions like Cushing’s syndrome, tumors, or polycystic ovary syndrome (PCOS). Your doctor will consider your symptoms and other test results to guide diagnosis.
How often should I get this test?
Frequency depends on your health status and treatment plan. For example, men with suspected hypogonadism might need retests every 6–12 months, while women with PCOS may require monitoring every 1–2 years or as symptoms change. Follow your doctor’s recommendations.
Can lifestyle changes affect this test?
Yes! Factors like diet (low-fat or high-fat diets can influence SHBG levels), exercise, weight management, and smoking can impact testosterone and SHBG. Avoiding alcohol and maintaining a healthy weight may help stabilize hormone levels. Always discuss lifestyle changes with your provider before making significant adjustments.
  1. 1
    MedlinePlus — Laboratory TestsSource
  2. 2
    Lab Tests OnlineSource
  3. 3
    Mayo Clinic — Tests & ProceduresSource

Click any link to access the full source. PubMed Central (PMC) links provide free full-text access.

This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment.

Medical Disclaimer

This content is for general informational and educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always seek the guidance of a qualified healthcare provider with any questions you have about a medical condition, and never disregard professional medical advice or delay seeking it because of something you read here.

If you think you may have a medical emergency, call your local emergency number or go to the nearest emergency department immediately.

Medically reviewed by WellAlly Editorial Team Last reviewed August 16, 2026. · Read our editorial policy