You've been told your testosterone is low. Now What? To answer these questions, we need to look deeper - at the relationship between testosterone, SHBG, and insulin resistance, and what that interplay reveals about the connections among hypogonadism, visceral obesity, and metabolic syndrome. How It Works on the Inside Insulin resistance - and the chronically elevated insulin levels that follow - signals the liver to reduce its production of sex hormone-binding globulin (SHBG)