SHBG is made in the liver and there's little you can do about it expect play it where it is by adjusting your TRT protocol to compensate. You will need supraphysiological doses of testosterone to get enough free testosterone, something an insurance doctor won't be able to do for you.
The moment your total testosterone goes over the reference ranges, doctors will freak out and lower your dosage. Free testosterone is what matters, in reality if you scored 2500 total testosterone and had the same free testosterone as a man in the high normal ranges say 850, you would be at no greater risk then he.
Total testosterone is in a bound state and biounavailable and in your case should be ignored, free testosterone is your only concern since it's the free portion of the hormone that does all the magic. I've seen countless men beat their heads against a wall trying to lower SHBG with a magical elixir, don't waste your time.
Stop alcohol intake and things that raise SHBG, adjust your TRT protocol. I would concern myself with the long term effects of low free testosterone, heart disease, dementia, alzheimer's and cardiovascular disease.
If you need referrals for doctors that know what needs to be done and won't freak out at supraphysiological doses of testosterone, I can recommend Defy medical who offers telemedicine where I'm a patient.
