Sure 58 nmol/L is on the higher end but by no means extremely high!
People make to big a deal over high SHBG and it's effects on FT levels which is understandable if one has a lower/average TT level as it would result in sub-par FT levels but everyone needs to understand that due to the newer research/understanding of SHBG:T binding.....one does not need to run extremely high TT levels (as in well over 1200 ng/dL) in order to achieve a healthy FT.
If you truly want to know where your FT levels sit than you would need to use the most accurate testing methods such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best) or simply use the newer calculated TruT method (which has been shown to be on par with results obtained by the gold standard Equilibrium Dialysis).
It is available online to the general public for free.....
TruT Free Testosterone Calculator by FPT
As an example if one has an SHBG level of 58 nmol/L (high) than using the newer calculated TruT method one would only need to hit a TT level of 1000 ng/dL to achieve a FT level just slightly over the top end of the reference range of 16-31 ng/dL.
TT 1000 ng/dL, SHBG 58 nmol/L, Albumin 4.3 g/dL (mean) than FT is 32.70 ng/dL (just slightly over the top end of the reference range of 16-31 ng/dL)
View attachment 8299
* highlighted in green- refer to the linear law-of-mass-action model/equation Vermueulen (cFTV)
*highlighted in blue- refer to the new Multi-step Dynamic Binding Model with Complex Allostery (TruT calculated)
Read this and take it in!
[0387] Relation between Percent FT with Total Testosterone and SHBG. Intra-dimer complex allostery suggests that SHBG can regulate FT fraction over a wide range of total testosterone concentrations without getting saturated. Indeed, it was found that percent FT calculated using the new model changed very modestly over a wide range of total testosterone concentrations. In contrast, the Vermeulen's equation suggests a negative relation between percent FT and total testosterone. Furthermore, as SHBG concentrations increase, percent FT calculated using our new model shows only a modest decline in contrast to the marked decline in percent FT calculated using Vermeulen's equation.
Regarding higher/high SHBG.....everyone needs to understand this point clearly:
*Furthermore, as SHBG concentrations increase, percent FT calculated using our new model shows only a modest decline
Most men do well having FT levels in the 30-30+ ng/dL range.
So much for a man with highish/high SHBG needing to run a TT level 1200-1500 ng/dl to achieve a healthy FT level.