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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Dr Saya Presents a Case Study for Possible Upper Limit of Physiologic Estradiol Levels in a Male
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<blockquote data-quote="Dr Justin Saya MD" data-source="post: 39944" data-attributes="member: 12687"><p>I would stress that this is only an interesting observation at this point, but fun to think about nonetheless. If this were found to be true in a general sense (i.e. increasing estradiol levels from LOW range (12pg/mL) up into NORMAL range (12 -> 22pg/mL) resulted in HPTA stimulation and thus increased testosterone levels (I will need to repeat similar study with LH/FSH for better data), it could imply that the regulatory mechanisms of the HPTA are more complex than currently believed...both positive and negative feedback AND perhaps a concentration-dependent relationship determining whether the feedback is positive or negative (i.e. estradiol exerts positive feedback up to a certain point, after which negative feedback kicks in). Obviously just purely scientific speculation, but really fun to think about, isn't it? </p><p></p><p>I also want to be clear that I am NOT taking a position that giving estradiol to a male patient that presents with both low T and E may enhance testosterone levels...this was merely an intriguing and thought-provoking observation at this point. Treating a non-MTF male with estradiol would create the perfect environment for a no-defense slam dunk gynecomastia malpractice case and would likely give my malpractice carrier an aneurysm!</p><p></p><p>Lastly, even though I realize to some the "subject matter" of this study may be offensive, I urge everyone to keep an open mind and not allow personal judgment or prejudices to cloud the medical/scientific discussion. I personally am very grateful for the unique perspective into the function and physiology of sex hormones that treating a very selective group of MTF/FTM transgenders has given me. I feel it has broadened my understanding and expertise and, ultimately, made me a better physician for ALL of my patients.</p></blockquote><p></p>
[QUOTE="Dr Justin Saya MD, post: 39944, member: 12687"] I would stress that this is only an interesting observation at this point, but fun to think about nonetheless. If this were found to be true in a general sense (i.e. increasing estradiol levels from LOW range (12pg/mL) up into NORMAL range (12 -> 22pg/mL) resulted in HPTA stimulation and thus increased testosterone levels (I will need to repeat similar study with LH/FSH for better data), it could imply that the regulatory mechanisms of the HPTA are more complex than currently believed...both positive and negative feedback AND perhaps a concentration-dependent relationship determining whether the feedback is positive or negative (i.e. estradiol exerts positive feedback up to a certain point, after which negative feedback kicks in). Obviously just purely scientific speculation, but really fun to think about, isn't it? I also want to be clear that I am NOT taking a position that giving estradiol to a male patient that presents with both low T and E may enhance testosterone levels...this was merely an intriguing and thought-provoking observation at this point. Treating a non-MTF male with estradiol would create the perfect environment for a no-defense slam dunk gynecomastia malpractice case and would likely give my malpractice carrier an aneurysm! Lastly, even though I realize to some the "subject matter" of this study may be offensive, I urge everyone to keep an open mind and not allow personal judgment or prejudices to cloud the medical/scientific discussion. I personally am very grateful for the unique perspective into the function and physiology of sex hormones that treating a very selective group of MTF/FTM transgenders has given me. I feel it has broadened my understanding and expertise and, ultimately, made me a better physician for ALL of my patients. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Side Effect Management
Dr Saya Presents a Case Study for Possible Upper Limit of Physiologic Estradiol Levels in a Male
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