How to Decide If and When to Take the Plunge?

Got it. Thanks man. I’ll talk to my doc about it, we’ll see what he wants to do.

Also anyone have other ideas how to lower SHBG, besides the obvious quitting smoking. I heard low carb can increase SHBG which sucks because I like low carb for weight control. I also heard nettle extract? But I’m hesitant as it has AI and 5-alpha reductase inhibitor activity, seems like it might screw things up. Any other ways to optimize naturally? I’m waiting to hear back from the doctor but in the meantime might as well do what I can

Don’t worry about lowering shbg. Increase androgens and shbg will work itself out.

You are right on that line. Personally, I would change the diet. Drop the low carb and eat clean all the time. Quit smoking. And see where I was in 3 months. Your body is producing ample testosterone. That is a big plus. It’s in there naturally to use. Do not aim to lower SHBG with specific supplements. But do eat a diet rich in vegetables and whole grain carbs(oats, brown rice etc ). Yes TRT will lower your SHBG. But given your numbers, I see an outcome with health changes where your total T could increase to near 800. SHBG would lower naturally and your free t would be firmly mid range. If symptoms persist and you still don’t feel better. Then jump on TRT.

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Yeah this sounds like good advice - thanks guys. I definitely lean more towards seeing what i can do naturally before i commit to a lifelong replacement regimen.

Just to summarize what I’ve found so far in my research as to ways to lower high SHBG-

  • eat plenty of protein and plenty of calories while exercising enough to avoid gaining weight ( will do)
  • eat more carbohydrates as ketosis increases SHBG (not sure if I’m sold as I do love keto style eating)
  • avoid basically any psychoactive substances - caffeine, nicotine, alcohol, prescription meds, etc, as all are known to increase SHBG… (I’m on board with everything but the caffeine)
  • supplement boron, d3, and fish oil ( done)

Anything that I’m missing from the list?

Edited to add - nettle extract has been suggested as well but I’m not sold due to the inhibitory effects at aromatase and 5-a reductase, seems like it might cause problems.

My plan right now is to optimize all of the above with the exception of carbs, nettle, and caffeine for three months, then recheck labs. We’ll see what can be done

You will get transient increases in SHBG by exercising.