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question from a user

If a guy has normal TT but high SHBG (thus low FT) is TRT the best option?

AlphaMD's Answer

Hypogonadism can be diagnosed with a low total testosterone and/or a low free testosterone. Technically, either scenario qualifies someone for TRT.

Logically speaking, someone with a normal TT and low free T due to elevated SHBG could potentially reverse hypogonadal symptoms by lowering SHBG through lifestyle changes and supplementation, thereby raising free T into the normal range.

Also, evaluating for other medical reasons for the high SHBG would often be warranted, like elevated insulin levels (pre-diabetes) or thyroid issues. We also see high SHBG in people who consume alcohol regularly or have low body fat percentage.

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