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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
ED ongoing issues
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<blockquote data-quote="madman" data-source="post: 154884" data-attributes="member: 13851"><p><strong><span style="color: rgb(184, 49, 47)">*</span></strong><span style="color: rgb(44, 130, 201)">highlighted in blue- <strong>refer to the new Multi-step Dynamic Binding Model with Complex Allostery (TruT calculated)</strong> </span></p><p></p><p></p><p></p><p></p><p></p><p><span style="color: rgb(44, 130, 201)"><strong>The diagnosis of hypogoandism is based on ascertainment of low total testosterone levels, which can be misleading in conditions listed above in which binding protein concentrations are affected.</strong></span> <span style="color: rgb(44, 130, 201)"><strong>Therefore, in these patients with alterations in binding protein concentrations, the diagnosis should be based on free testosterone levels. </strong></span><strong><span style="color: rgb(26, 188, 156)">The Endocrine Society has published cut-off levels that define low free testosterone levels (Bhasin et al, Testosterone Therapy of Men with Androgen Deficiency Syndromes: An Endocrine Society Guideline. JCEM 2010).</span></strong><span style="color: rgb(26, 188, 156)"><strong> These cut-off levels for free testosterone were based on methods which are demonstrated herein to be inaccurate.</strong></span> <span style="color: rgb(44, 130, 201)"><strong>Using the methods, assays, and/or systems described herein, new cut-offs for defining low free testosterone in men in different decades of age are provided herein. These reference values will facilitate accurate diagnosis of hypogonadism in men. Based on the distribution of free testosterone in men, the lower limit of the normal range is determined to be </strong></span><span style="color: rgb(184, 49, 47)"><strong>114.6 pg/mL. </strong></span></p><p></p><p></p><p><span style="color: rgb(44, 130, 201)"><strong>Using the methods, assays, and systems described herein, the optimal range of free testosterone concentrations that should be targeted in hypogonadal men receiving testosterone replacement therapy have also been determined.</strong></span> The treatment of hypogonadism with testosterone is currently suboptimal. The analyses of clinical trials data described herein demonstrate that a large fraction of hypogonadal men treated with testosterone therapy have testosterone levels in the subtherapeutic range.</p><p></p><p><strong><span style="color: rgb(26, 188, 156)">The current Endocrine Society guidelines suggest the use of total testosterone levels to guide therapy, which as discussed above, do not provide an accurate assessment of the androgen status.</span></strong> <span style="color: rgb(44, 130, 201)"><strong>The free testosterone concentrations, determined the new method described herein, can provide accurate assessment of the adequacy of testosterone therapy in hypogonadal men. Based on the new data on the distribution of free testosterone levels in healthy men the target range of free testosterone has been determined to be </strong></span><span style="color: rgb(184, 49, 47)"><strong>164 to 314 pg/ml (mean+/−1SD).</strong></span> If the on-treatment free testosterone concentrations determined using the methods described herein are outside this range, the dose of testosterone should be adjusted using the methods described herein to achieve testosterone levels in the target therapeutic range to maximize benefits and reduce the risks. Furthermore, the initial dose of testosterone therapy can be determined using the methods, assays, and/or systems described herein, e.g. the dosimeter methods described herein.</p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p></p><p>Again when testing FT the gold standard is Equilibrium Dialysis.....the newer TruT model/algorithm is based off the newer understanding of SHBG:T binding and when compared the newer TruT calculated method is on par with results obtained by the gold standard Equilibrium Dialysis.</p><p></p><p></p><p><strong>"Based on the new data on the distribution of free testosterone levels in healthy men the target range of free testosterone has been determined to be <span style="color: rgb(184, 49, 47)">164 to 314 pg/ml (mean+/−1SD)"</span></strong></p><p></p><p></p><p>Which would convert to <strong><span style="color: rgb(184, 49, 47)">16-31 ng/dl</span></strong></p><p></p><p></p><p></p><p></p><p>If you do not want to trust the newer calculated TruT method so be it.....if anything than start using accurate testing methods such as the gold standard Equilibrium Dialysis or Ultrafiltration.....plain and simple!</p></blockquote><p></p>
[QUOTE="madman, post: 154884, member: 13851"] [B][COLOR=rgb(184, 49, 47)]*[/COLOR][/B][COLOR=rgb(44, 130, 201)]highlighted in blue- [B]refer to the new Multi-step Dynamic Binding Model with Complex Allostery (TruT calculated)[/B] [/COLOR] [COLOR=rgb(44, 130, 201)][B]The diagnosis of hypogoandism is based on ascertainment of low total testosterone levels, which can be misleading in conditions listed above in which binding protein concentrations are affected.[/B][/COLOR] [COLOR=rgb(44, 130, 201)][B]Therefore, in these patients with alterations in binding protein concentrations, the diagnosis should be based on free testosterone levels. [/B][/COLOR][B][COLOR=rgb(26, 188, 156)]The Endocrine Society has published cut-off levels that define low free testosterone levels (Bhasin et al, Testosterone Therapy of Men with Androgen Deficiency Syndromes: An Endocrine Society Guideline. JCEM 2010).[/COLOR][/B][COLOR=rgb(26, 188, 156)][B] These cut-off levels for free testosterone were based on methods which are demonstrated herein to be inaccurate.[/B][/COLOR] [COLOR=rgb(44, 130, 201)][B]Using the methods, assays, and/or systems described herein, new cut-offs for defining low free testosterone in men in different decades of age are provided herein. These reference values will facilitate accurate diagnosis of hypogonadism in men. Based on the distribution of free testosterone in men, the lower limit of the normal range is determined to be [/B][/COLOR][COLOR=rgb(184, 49, 47)][B]114.6 pg/mL. [/B][/COLOR] [COLOR=rgb(44, 130, 201)][B]Using the methods, assays, and systems described herein, the optimal range of free testosterone concentrations that should be targeted in hypogonadal men receiving testosterone replacement therapy have also been determined.[/B][/COLOR] The treatment of hypogonadism with testosterone is currently suboptimal. The analyses of clinical trials data described herein demonstrate that a large fraction of hypogonadal men treated with testosterone therapy have testosterone levels in the subtherapeutic range. [B][COLOR=rgb(26, 188, 156)]The current Endocrine Society guidelines suggest the use of total testosterone levels to guide therapy, which as discussed above, do not provide an accurate assessment of the androgen status.[/COLOR][/B] [COLOR=rgb(44, 130, 201)][B]The free testosterone concentrations, determined the new method described herein, can provide accurate assessment of the adequacy of testosterone therapy in hypogonadal men. Based on the new data on the distribution of free testosterone levels in healthy men the target range of free testosterone has been determined to be [/B][/COLOR][COLOR=rgb(184, 49, 47)][B]164 to 314 pg/ml (mean+/−1SD).[/B][/COLOR] If the on-treatment free testosterone concentrations determined using the methods described herein are outside this range, the dose of testosterone should be adjusted using the methods described herein to achieve testosterone levels in the target therapeutic range to maximize benefits and reduce the risks. Furthermore, the initial dose of testosterone therapy can be determined using the methods, assays, and/or systems described herein, e.g. the dosimeter methods described herein. Again when testing FT the gold standard is Equilibrium Dialysis.....the newer TruT model/algorithm is based off the newer understanding of SHBG:T binding and when compared the newer TruT calculated method is on par with results obtained by the gold standard Equilibrium Dialysis. [B]"Based on the new data on the distribution of free testosterone levels in healthy men the target range of free testosterone has been determined to be [COLOR=rgb(184, 49, 47)]164 to 314 pg/ml (mean+/−1SD)"[/COLOR][/B] Which would convert to [B][COLOR=rgb(184, 49, 47)]16-31 ng/dl[/COLOR][/B] If you do not want to trust the newer calculated TruT method so be it.....if anything than start using accurate testing methods such as the gold standard Equilibrium Dialysis or Ultrafiltration.....plain and simple! [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
When Testosterone Is Not Enough
ED ongoing issues
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