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Originally posted by @socalurologyinstitute on TikTok · 103s|Watch on TikTok
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Auto-generated transcript of @socalurologyinstitute's video. Quoted here for educational fact-check commentary; original creator retains all rights to the video content.

  1. 0:00SHBG, Sex Hormone Binding Globulin. What is that? And how do I lower it or how should I deal with that?
  2. 0:08What's sex hormone binding globulin? Well, in our body we have a globulin which is a protein
  3. 0:14that binds testosterone. And sometimes men's testosterone in their body is okay, but a lot of it is
  4. 0:21bound up and inactive and unavailable and that's sex hormone binding globulin. So how do we use
  5. 0:27SHBG? Well, we really only use it in one situation to make the right diagnosis. So often men come to
  6. 0:36people like me as they dock. I feel terrible. I'm tired. My doctor checked my testosterone. My
  7. 0:43total testosterone was 600. What do I do? And then when we do the free testosterone and sex hormone
  8. 0:50binding globulin, we find of that 600, a lot of it is bound up, and we make the right diagnosis and
  9. 0:56the available testosterone to that man is low and he's available or appropriate to get
  10. 1:03testosterone replacement. Once someone is on testosterone replacement, I don't really monitor the SHBG.
  11. 1:10We do check it, but we don't do anything about it. Some doctors or some experts tell you how to
  12. 1:16lower your SHBG. I don't think that's very true. I think the SHBG is what it is. It does increase
  13. 1:24with age and sometimes with age, the SHBG binds up the testosterone. We have to add more testosterone.
  14. 1:31SHBG is used and appropriate in one setting to make the right diagnosis. Once you have the right
  15. 1:37diagnosis, it is what it is and hopefully you're on a good therapy program.

SHBG and TRT: what your lab result actually means

Dr Gary Bellman | SoCalUrology

TikTok creator

12.0K viewsWatch on TikTok

Quick answer

SHBG is a serum glycoprotein that binds testosterone with high affinity, reducing its bioavailability. In men presenting with hypogonadal symptoms but borderline total testosterone, measuring SHBG to calculate free or bioavailable testosterone is supported by Endocrine Society guidelines (Bhasin et al., 2018). However, SHBG continues to influence free testosterone interpretation throughout TRT and can shift due to age, liver function, thyroid status, and route of testosterone administration, making it a clinically relevant variable beyond initial diagnosis.

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What this exact clip is really saying

This FormBlends review is specific to "SHBG and TRT: what your lab result actually means" from Dr Gary Bellman | SoCalUrology. We read the clip as a TRT social video fact-checks claim about Testosterone, then separate the useful signal from what a short social video cannot prove. The page-specific claim focus is: SHBG is a serum glycoprotein that binds testosterone with high affinity, reducing its bioavailability.

The reason this review is not generic is the source wording and the canonical claim label "trt should i worry about my shbg level trt shbg hormonereplaceme." In this clip, the useful excerpt is: "SHBG, Sex Hormone Binding Globulin." That wording changes the review because it points to Testosterone evidence, safety, and patient-fit context, not a one-size-fits-all protocol.

The source trail for this page is checked against Cardiovascular Safety of Testosterone-Replacement Therapy (2023), Testosterone therapy in men with androgen deficiency syndromes: an Endocrine Society clinical practice guideline (2010), and Functional testosterone deficiency in aging men: Clinical impact, diagnostic pathways, and treatment strategies (2026), plus the creator's own wording. Testosterone decisions still need an eligibility review, medication-interaction screen, access check, and quality-control review before anyone treats a social clip as medical advice.

Free testosterone predicted symptom improvement in hypogonadal men on TRT more reliably than total testosterone in Goldman et al.
People who land here are usually comparing the Testosterone claim with [object Object].
The strongest next step is to compare the claim with FormBlends' Testosterone guide, evidence notes, and provider review path before acting.

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Claim being checked

SHBG is a serum glycoprotein that binds testosterone with high affinity, reducing its bioavailability.

FormBlends verdict

Testosterone evidence, safety, and patient-fit context

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Use the clip as a claim to verify, not a treatment plan

What it helps with

  • SHBG is a serum glycoprotein that binds testosterone with high affinity, reducing its bioavailability. In men presenting with hypogonadal symptoms but borderline total testosterone, measuring SHBG to calculate free or bioavailable testosterone is supported by Endocrine Society guidelines (Bhasin et al., 2018). However, SHBG continues to influence free testosterone interpretation throughout TRT and can shift due to age, liver function, thyroid status, and route of testosterone administration, making it a clinically relevant variable beyond initial diagnosis.
  • The Endocrine Society 2018 guidelines (Bhasin et al.) recommend measuring free or bioavailable testosterone in men with borderline total testosterone and symptoms, supporting the creator's diagnostic framing.
  • Free testosterone predicted symptom improvement in hypogonadal men on TRT more reliably than total testosterone in Goldman et al. (2020, Andrology), meaning SHBG keeps mattering after diagnosis.

What it may miss

  • It may not cover eligibility, contraindications, medication interactions, lab history, or dose escalation.
  • Compound access, legal status, and product quality still need a separate safety check.
  • Social video captions rarely show the full evidence base behind a claim.

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What You'll Learn

  • The Endocrine Society 2018 guidelines (Bhasin et al.) recommend measuring free or bioavailable testosterone in men with borderline total testosterone and symptoms, supporting the creator's diagnostic framing.
  • Free testosterone predicted symptom improvement in hypogonadal men on TRT more reliably than total testosterone in Goldman et al. (2020, Andrology), meaning SHBG keeps mattering after diagnosis.
  • SHBG rises roughly 1-2% per year with aging (Harman et al., 2001, JCEM), which is why some men need TRT dose adjustments over time even without major lifestyle changes.
  • Boron supplementation to lower SHBG showed only modest effects in a small study (Naghii et al., 2011) and lacks strong replication. Treating it as a reliable strategy is not evidence-based.
  • Elevated SHBG can be a downstream marker of thyroid dysfunction or liver disease. Dismissing it as unchangeable without ruling out secondary causes is not best practice.
  • Route and frequency of testosterone administration affect SHBG differently. Injections and topical formulations do not produce identical SHBG responses, a nuance the video skips entirely.
  • If you are on TRT and still symptomatic, asking your provider to calculate free testosterone using your current SHBG level is a reasonable, guideline-supported conversation to have.

Our take · Written by FormBlends editorial team · Reviewed by FormBlends Medical Team · This is not a transcript. It is our independent review of the video above.

What did @socalurologyinstitute actually say?

The creator, presenting as a urologist, argued that SHBG has one primary job: helping clinicians make the right diagnosis when a man has a normal-looking total testosterone but still feels terrible. Once someone starts TRT, he said, "it is what it is" and SHBG is not really actionable. He also stated that "SHBG is what it is" and that strategies to lower it are not well-supported. He framed SHBG elevation as part of normal aging that sometimes requires simply adding more testosterone to compensate.

To his credit, the framing around free testosterone and diagnosis is clinically grounded. Men with total testosterone in the "normal" range but high SHBG can have genuinely low bioavailable testosterone, and this is a real diagnostic gap that standard panels miss. That part of his argument holds up.

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About the Creator

Dr Gary Bellman | SoCalUrology · TikTok creator

12.0K views on this video

Should I worry about my SHBG level? #trt #shbg #hormonereplacementtherapy #trtcommunity #fyp

Frequently asked questions

Quick answers based on this video and our medical team review.

What does the video say about the endocrine society 2018 guidelines (bhasin et al.) recommend measuring?

The Endocrine Society 2018 guidelines (Bhasin et al.) recommend measuring free or bioavailable testosterone in men with borderline total testosterone and symptoms, supporting the creator's diagnostic framing.

What does the video say about free testosterone predicted symptom improvement in hypogonadal men on trt?

Free testosterone predicted symptom improvement in hypogonadal men on TRT more reliably than total testosterone in Goldman et al. (2020, Andrology), meaning SHBG keeps mattering after diagnosis.

What does the video say about shbg rises roughly 1-2% per year with aging (harman et?

SHBG rises roughly 1-2% per year with aging (Harman et al., 2001, JCEM), which is why some men need TRT dose adjustments over time even without major lifestyle changes.

What does the video say about boron supplementation to lower shbg showed only modest effects in?

Boron supplementation to lower SHBG showed only modest effects in a small study (Naghii et al., 2011) and lacks strong replication. Treating it as a reliable strategy is not evidence-based.

What does the video say about elevated shbg can be a downstream marker of thyroid dysfunction?

Elevated SHBG can be a downstream marker of thyroid dysfunction or liver disease. Dismissing it as unchangeable without ruling out secondary causes is not best practice.

What does the video say about route?

Route and frequency of testosterone administration affect SHBG differently. Injections and topical formulations do not produce identical SHBG responses, a nuance the video skips entirely.

Educational use only. This fact-check is editorial content for general information. Nothing here is medical advice. Talk to a licensed provider about your specific situation before starting, stopping, or changing any supplement, peptide, or medication regimen.

Read More on This Topic

Our written guides go deeper with dosing details, comparison tables, and medical-team reviewed protocols.

Not medical advice. This video was made by Dr Gary Bellman | SoCalUrology, not by FormBlends. Our write-up above is an editorial review, not a medical recommendation. Talk to your doctor before making any decisions about medications or treatments.