“…As androgens bound to SHBG are generally unavailable for bioactivity, alterations in SHBG levels have significant effects on androgen effects. Estrogens, antiestrogens, antiepileptic drugs, age, and hyperthyroidism can increase SHBG levels, whereas exogenous androgens, glucocorticoids, growth hormone therapy, hypothyroidism, obesity, and hyperinsulinemia may decrease SHBG (Gerald & Raj, 2022). Testosterone is also the precursor to hormones with potent peripheral activity, namely dihydrotestosterone formed primarily in the skin, liver, and the genitourinary tract by 5α‐reductase, and estradiol formed by Cyp19 with important effects on bone mineralization, epiphyseal plate closure, and insulin sensitivity (Rodd et al, 2004; Simpson et al, 2002; Swerdloff et al, 2017; Yokota‐Nakagi et al, 2022).…”