Hypogonadism: High SHBG (sex hormone-binding globulin) can lead to decreased free testosterone, despite normal total testosterone levels. This can cause low libido and erectile issues. However, in this case, free T is normal, so hypogonadism might not be the primary cause, but it's still worth considering due to the symptoms presented.

Thyroid Disorders: Abnormal thyroid function can affect SHBG levels and libido. Hypothyroidism, in particular, can increase SHBG, leading to decreased free testosterone and symptoms like low libido and erectile dysfunction.
Obesity or Metabolic Syndrome: These conditions can increase SHBG and lead to hormonal imbalances, contributing to low libido and erectile issues.
Anxiety or Depression: Psychological factors can significantly impact libido and erectile function, and should be considered, especially if other hormonal or physical causes are ruled out.

Pituitary Tumors: Although rare, pituitary tumors can affect hormone production, including testosterone and thyroid hormones, leading to increased SHBG and symptoms like low libido and erectile dysfunction.
Hemochromatosis: This genetic disorder can lead to iron overload, affecting hormone production and increasing SHBG, which might result in the symptoms described.

Liver Disease: Certain liver conditions can increase SHBG production. While liver disease is a less common cause of the symptoms described, it's an important consideration, especially if there are other indications of liver dysfunction.
Genetic Disorders Affecting SHBG or Testosterone: Rare genetic conditions can directly affect SHBG levels or testosterone production, leading to the symptoms presented. These would be considered if more common causes are ruled out.