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







Avsnitt(388)

Episode 394: 402. Cardiovascular Risk Factors, Zilebesiran, Shared Decision Making

Episode 394: 402. Cardiovascular Risk Factors, Zilebesiran, Shared Decision Making

https://www.nejm.org/doi/10.1056/NEJMoa2415879?url_ver=Z39.88-2003&rfr_id=ori:rid:crossref.org&rfr_dat=cr_pub%20%200pubmed Key Findings: Classic Risk Factors: The five risk factors examined were hype...

18 Juli 202515min

Episode 393: 404. 3 quick articles you might want to know about (oral semaglutide, tiktok, and GLP1 thyroid cancer)

Episode 393: 404. 3 quick articles you might want to know about (oral semaglutide, tiktok, and GLP1 thyroid cancer)

GLP1 might cause thyroid cancer in mice but the evidence is drastically lacking in humansOral semaglutide is expensive for an NNT of 50 at 4 yrsTiktok videos of skin care are a scam

25 Juni 202512min

Episode 392: 403. 3 Papers, 1 Podcast - One Guideline Changer

Episode 392: 403. 3 Papers, 1 Podcast - One Guideline Changer

https://jamanetwork.com/journals/jama/article-abstract/2834040amiloride is realistically equal to spironolactone for resistant HTNhttps://journals.lww.com/ajg/abstract/2025/05000/higher_rate_of_sponta...

16 Juni 202514min

Episode 391: 402. Functional disability after clinically significant extracranial bleeding: a secondary analysis of ASPREE

Episode 391: 402. Functional disability after clinically significant extracranial bleeding: a secondary analysis of ASPREE

https://www.jthjournal.org/article/S1538-7836(25)00109-6/fulltextAntithrombotic agents, like aspirin and anticoagulants, are essential for treating many cardiovascular conditions. However, a common si...

5 Juni 20257min

Episode 390: 401. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension

Episode 390: 401. Add-On Treatment With Zilebesiran for Inadequately Controlled Hypertension

https://jamanetwork.com/journals/jama/article-abstract/2834632SummaryThe article examines the effectiveness and safety of zilebesiran, an RNA interference therapeutic agent, when used in combination w...

4 Juni 20258min

Episode 389: 400. CRP, Lipoprotein A, LDL for cardiac risk assessment

Episode 389: 400. CRP, Lipoprotein A, LDL for cardiac risk assessment

https://www.nejm.org/doi/full/10.1056/NEJMoa2405182?query=recirc_Semantic  Key Takeaways Extended Predictive Value of Biomarkers: High-sensitivity C-reactive protein (CRP), LDL cholesterol, and lipop...

29 Maj 20259min

Episode 388: 399. Use of albumin-adjusted calcium measurements in clinical practice

Episode 388: 399. Use of albumin-adjusted calcium measurements in clinical practice

Desgagnés N et al. Use of albumin-adjusted calcium measurements in clinical practice. JAMA Netw Open 2025 Jan 21; 8:e2455251. (https://doi.org/10.1001/jamanetworkopen.2024.55251)Overall, total calcium...

27 Maj 20257min

Episode 387: 398. Which is Better, Tirzepatide or Semaglutide?

Episode 387: 398. Which is Better, Tirzepatide or Semaglutide?

https://www.nejm.org/doi/10.1056/NEJMoa2416394At 72 weeks, the mean percentage decrease in weight was significantly greater with tirzepatide than with semaglutide (20% vs. 14%). Gastrointestinal side ...

21 Maj 20258min

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