Questioning Medicine

Episode 206: 206. Testosterone Replacement Therapy


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YES!! Marketing!! No man wants to admit his gonads dont work so they would never say I have hypogonadism. Most men would never say I have andropause cause that is too close to menopause but if you call it low testosterone then all of a sudden men come out of the wood work like cave men to get some of this magical drug they have heard so much about.

YES LIKE LOW T WILL KILL YOU!!!! "could kill you". -https://abcnews.go.com/Health/ActiveAging/story?id=3247773&page=1

https://www.acpjournals.org/doi/10.7326/M19-0882?_ga=2.162179964.190727375.1667239768-1195431333.1667239768&

"It is estimated that approximately 35% of men older than 45 years of age and 30-50% of men with obesity or type 2 diabetes have hypogonadism". 

from endocrine.org. https://www.endocrine.org/patient-engagement/endocrine-library/hypogonadism

 

However, for a 30 yr old male the low end of normal is around 300 ng/dL! YET this is what most websites and recommendations use as the treatment cutoff for all men. 50, 60, 70 yr olds. we compare those testosterone levels of 30 yrs old and make them the standard for 50, 60 ,70 yr olds. 

​​https://www.nejm.org/doi/full/10.1056/NEJMp038207


study found that just watching sports can raise and lower your testosterone levels depending if your team wins or loses. https://pubmed.ncbi.nlm.nih.gov/9811365/

20 minutes apart had variations between the two lab values of 18–28% half of the time and about 25% of the time the variation in the lab test between  27–54%!! Same blood, same person, 20 minutes a part and the test results are 15-54% different!!!!! There is no lab test in the world that i know of with such huge variation.

DJ BrambillaAB O'DonnellAM Matsumotoet al.Clin Endocrinol2007;67:853–62

A study from journal of urology in 2014 showed that testosterone differences in time appears to be of significant concern in those younger than 45 but those older than 45 can likely have their test time frame expanded with no harm or issue. 

 

Welliver RC Jr, Wiser HJ, Brannign RE, et al. Validity of midday total testosterone levels in older men with erectile dysfunction. J Urol. 2014;192:165-169.

https://pubmed.ncbi.nlm.nih.gov/26360789/#:~:text=Objective%3A%20Since%20testosterone%levels%20exhibit,diagnostic%20test%20for%20androgen%20deficiency.


A study in jama internal medicine found that about 25% of those individuals prescribed testosterone had not even had a testosterone level measured even once in the previous year.

https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/1691925?resultClick=3







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