The Total Testosterone level is meaningless without the SHBG
You hear it everywhere that you need to test your testosterone levels, but they dont tell you how, or what to test for exactly. The Total T level is actually meaningless (to a large degree) without the SHBG. SHBG is a binding protein produced by the liver that binds to sexhormones and makes them unavailable for the body to use, but its more tricky than that. Testosterone bound to SHBG is unavailable for the androgen receptors, and also unavailable to be metabolized, unavailable to be converted into Estradiol (aromatase enzyme) or Dihydro Testosterone (5-alpha reductase enzyme). Its basically an inactive hormone that is just circulating in the blood and doing nothing at that certain moment. However, later it can still detach from the SHBG and then it can attach to AR’s—>(build muscle, stimulate Red Blood Cell production, etc), or convert into Estradiol/DHT, so it is not useless. Since most of the testosterone is getting produced while we sleep (60-70%), SHBG also acts as ,,testosterone storage” in the blood, so it can sustain free androgen levels during the day when we are not producing so much, so the free levels of the sexhormones are not dropping drastically during the day, free T is getting released be detaching from SHBG slowly. In other words its needed, its not the enemy as many men with a poor understanding of this think. Many older guys have Total T levels at around 800-1000, and they are happy about it, meanwhile they dont look anything like a man should look like with high T levels. Why? Because their SHBG is skyhigh (70-100 nmol/l), and essentially they have high T levels not because they are producing so much, but because the Testosterone is not being used by the AR, not getting converted into Estradiol/DHT, and not getting excreated. Its just circulating in your blood doing nothing. What is the takeaway from this? You need an optimal level from SHBG. Naturally in men its very rare to have too low levels of it, what I have found is that the optimal range is around 20-35 nmol/l for feeling your best, having high T benefits, high libido and mental/cognitive benefits.