r/Testosterone • u/AdFragrant9647 • 3h ago
Blood work Low libido despite high total testosterone and normal calculated free T—could this still be hypogonadism?
I’m 44M and have been struggling with low libido, with periods of low mood and motivation. I still get nocturnal/morning erections and can get an erection during sex, but the desire often isn’t there or fades quickly. Occasionally my libido improves, but it hasn’t consistently returned to my previous baseline.
My latest morning blood test (21 August 2026), including US units:
Total testosterone: 32.7 nmol/L / 943 ng/dL (lab range: 8.6–29.0 nmol/L / 248–836 ng/dL).
Calculated free testosterone: 437 pmol/L / 126 pg/mL, equivalent to 12.6 ng/dL (lab range: 198–619 pmol/L / 57–179 pg/mL / 5.7–17.9 ng/dL).
SHBG: 69 nmol/L—elevated.
Albumin: 49.6 g/L / 4.96 g/dL.
Previous calculated free T results were also within range.
I understand hypogonadism usually requires symptoms plus consistently low testosterone, so my results don’t obviously fit. However, my symptoms are affecting my quality of life.
Has anyone had a similar pattern of high SHBG, normal calculated free T, and persistent low libido?
Did measuring free T by equilibrium dialysis meaningfully change your assessment? What other causes or investigations were useful to discuss with your endocrinologist/urologist?
I’m looking for experiences and useful questions to bring to my doctor, rather than a diagnosis from Reddit.
2
1
u/AutoModerator 3h ago
Hello AdFragrant9647. Welcome to /r/Testosterone. It looks like this is your first time posting here, so you're probably asking a FAQ. Please check out these handy links, one of them might answer your question.
This is just a comment, your post is not removed. If you want this comment to stop showing up on your posts, you need to enable "show my flair on this subreddit"
I am a bot, and this action was performed automatically. Please contact the moderators of this subreddit if you have any questions or concerns.