Address low calorie intake or chronic dieting
Increase overall calorie intake if under-eating
Reduce excessive endurance exercise
Improve insulin sensitivity
Lose excess body fat if overweight
Increase protein intake if low
Ensure adequate carbohydrate intake if very low-carb
Treat hyperthyroidism if present
Review medications that can raise SHBG
Reduce alcohol intake
Correct estrogen excess if present
Treat liver disease if present
Optimize sleep
Manage stress
Check and correct nutrient deficiencies
Discuss testosterone-raising treatment with a clinician if appropriate