The elephant in the room is your SHBG is binding up the majority of your testosterone SHBG+T which is not the active form of testosterone. SHBG is a protein made inside the liver and isn’t reversible, the liver basically dictates SHBG production and you deal with it by throwing excess androgens at it to suppress it.
The high SHBG situation is making things look better than they really are, excess androgens lowers SHBG and you will need at least 35 nmol/L to ever have enough Free T. Most doctors don’t even know what SHBG does, a complete lack of understanding.
If you were somehow able to reduce SHBG by 50%, again not reality, you would see Total T closer or below 10 nmol/L and your situation would still see Free T on the lower end. Doctors are taught in range is normal, but for testosterone this is not true because of how the endocrine system functions. An example, if you get your ferritin tested and you score 65, next week you levels will be about the same, but your testosterone levels are always changing, fluctuating from one day to the next.
You could have a Total T of 17 nmol/L today, tomorrow your Total T could be 8 nmol/L. So you get tested on the day when levels are 15 nmol/L instead of tommorow when your Total T is 8 nmol/L, expect now you are a candidate for TRT if you test on the second day instead of the first. Most men need to have higher than mid range Free T levels to feel normal with no symptoms, some even need Free T levels to be at the top of the reference ranges.
The majority of sick care or socialized medicine doctors, endocrinologist’s receive zero education in sex hormones in medical school which is why your endo has made a gross error failing to understand the implications of high SHBG and that your T production is quite low if you remove the high SHBG from the equation.
It’s common to see doctors worldwide fail miserably at properly diagnosing a testosterone deficiency, most don’t have enough education to make the diagnosis because sex hormones has been ignored for many decades do to a false belief TRT causes prostate cancer creating the situation we face today, complete and utter ignorance getting a proper diagnosis. You need TRT or things will not get better because SHBG increases as we age binding up more and more Free T as Total T value increases and again the latter is the inactive form of testosterone.
Spend enough time on T-Nation or any other forum and you’ll see men in your same situation being told they are normal and they all share one common denominator, high SHBG and Free T on the lower end. When you have tens of thousands on men searching the internet trying to find out what the F*** is wrong with them after being told by their doctor that they are normal, you know something isn’t right and that’s why you’re here on T-Nation.
This tells you doctors are getting it wrong.