Episode 206: 206. Testosterone Replacement Therapy

Episode 206: 206. Testosterone Replacement Therapy

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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Episode 435: 442. 7 article review

Episode 435: 442. 7 article review

we unpack whether rivaroxaban followed by aspirin improves thromboprophylaxis after hip and knee arthroplasty, put oral GLP-1 therapy orforglipron head-to-head with dapagliflozin for type 2 diabetes, ...

10 Sep 33min

Episode 434: 441. Coronary Artery Calcium (CAC) -- Yacky Yack, the details on CAC

Episode 434: 441. Coronary Artery Calcium (CAC) -- Yacky Yack, the details on CAC

Does a Coronary Artery Calcium (CAC) scan still earn its place in modern cardiovascular prevention? This podcast cuts through the headlines to examine the recent research, challenge overconfident conc...

31 Aug 48min

Episode 433: 440. CME Understanding Medical Stats

Episode 433: 440. CME Understanding Medical Stats

OMED lecture on how to understand medical stats

21 Aug 33min

Episode 432: 439. 6 articles in 2026

Episode 432: 439. 6 articles in 2026

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24 Juli 25min

Episode 431: 438. CME- What To Do AFTER PE Diagnosis

Episode 431: 438. CME- What To Do AFTER PE Diagnosis

OMED lecture

21 Juli 26min

Episode 430: edit fix 437. A Brief Review of the Medical Literature!

Episode 430: edit fix 437. A Brief Review of the Medical Literature!

Xin X, et al. Optimal exercise modalities and dosages for blood pressure reduction in adults with prehypertension and established hypertension: A network meta-analysis and dose–response relationship s...

8 Juli 32min

Episode 429: 436. postpartum burnout., asundexian, semaglutide and ETOH, neck infection, varenicline

Episode 429: 436. postpartum burnout., asundexian, semaglutide and ETOH, neck infection, varenicline

Jafari K, et al. Risk factors for pediatric deep neck infection revisit after emergency department discharge for pharyngitis or localized neck symptoms. Ann Emerg Med 2026 May; 87:605. DOI: 10.1016/j....

15 Juni 31min

Episode 428: 435. Evolocumab, Statin and CKD, PCN allergy, MRI vs Rotator Cuff

Episode 428: 435. Evolocumab, Statin and CKD, PCN allergy, MRI vs Rotator Cuff

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