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Let me add one caveat: Anecdotally, men seem more likely to have trouble when SHBG is driven much below 20 nMol/L. One hypothesis is that SHBG also aids intracellular androgen signaling, implying that low levels may reduce androgenic activity. A corollary is that low SHBG reduces androgenic activity relative to estrogenic activity, with the resulting imbalance able to cause symptoms. These ideas should be considered speculative, however.