The Medical Benefits of Testosterone: What Every Man Should Know
Testosterone is a critical hormone primarily produced in the testes and, to a lesser extent, the adrenal glands. It plays a vital role in male development, physical health, and overall well-being.
Understanding Free vs. Total Testosterone
When assessing testosterone levels, it’s essential to differentiate between Total Testosterone and Free Testosterone. Total Testosterone includes both the bound and unbound hormone circulating in the bloodstream, whereas Free Testosterone refers to the bioavailable form that is not bound to proteins like SHBG (Sex Hormone Binding Globulin). It is this free form that exerts the most direct physiological effects.
Younger men typically have higher levels of Free Testosterone, which supports energy, mood, libido, and muscle strength. If your healthcare provider is not evaluating Free Testosterone in addition to Total Testosterone, you may not be getting the full picture of your hormonal health.
The Role of Testosterone in the Body
Testosterone contributes to a wide range of bodily functions, including:
Enhancing skeletal muscle strength and cardiac muscle function
Improving blood flow to vital regions such as the coronary and penile arteries
Supporting mental clarity, mood stability, and restful sleep
Regulating fat distribution and preventing abdominal obesity
Promoting libido, reproductive health, and emotional well-being
In some patients with lipid abnormalities, testosterone therapy has even been associated with reductions in LDL cholesterol by up to 100 points.
Estrogen and Testosterone: A Delicate Balance
Contrary to popular belief, estrogen plays a crucial role in male sexual health. While testosterone is the primary androgen, estrogen receptors in the brain are responsible for modulating sexual arousal. Both low testosterone and low estrogen can contribute to reduced libido and increased fat accumulation.
When considering bioidentical hormone replacement therapy (BHRT) for men, maintaining a balanced ratio of testosterone and estrogen is key. An ideal treatment protocol should evaluate:
Total Testosterone
Free Testosterone
Estradiol (Estrogen)
SHBG (Sex Hormone Binding Globulin)
What is SHBG and Why Does it Matter?
Sex Hormone Binding Globulin (SHBG) is a protein that binds to sex hormones, including testosterone, rendering them inactive. While some SHBG is necessary, elevated levels can significantly reduce the amount of Free Testosterone available for use by the body.
Factors that increase SHBG include:
Obesity
Estrogen dominance
Advancing age
Insulin resistance
In fact, elevated SHBG is considered one of the strongest predictors of insulin resistance—more so than cholesterol or BMI.
A healthy SHBG level is approximately 15 pg/mL
Free Testosterone levels typically peak between ages 18 and 22
In men experiencing andropause, the Free T/SHBG ratio may fall below 1.0, with common values between 0.2 and 0.5
Are You Getting the Full Picture?
If you're considering testosterone therapy or already receiving treatment, comprehensive hormone panels are essential. This includes not only Total and Free Testosterone, but also Estrogen and SHBG levels. Incomplete testing can lead to misdiagnosis, improper dosing, or suboptimal outcomes.
If your provider isn't running the full panel, it may be time to seek a more thorough evaluation. Reach out today to ensure you're receiving evidence-based, personalized care.
