Evaluation of candidates for testosterone therapy

madman

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Jansen stresses that testosterone is not a cure-all and often requires adjunct evaluation and management of other conditions such as sleep apnea or thyroid disorders.

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In this video, Robert Jansen, MD, a urologist with Atlantic Urology Specialists in South Carolina, outlines his approach to evaluating candidates for testosterone replacement therapy (TRT). He emphasizes that although lab values are important, his primary focus is on a patient’s symptoms. Many men with low testosterone may feel fine and not require treatment, whereas others with symptoms such as fatigue, depression, sexual dysfunction, and low motivation may benefit from therapy. Jansen begins by taking a comprehensive medical history to identify other conditions or medications that might affect testosterone levels. He ensures low testosterone is documented, and if levels are borderline or normal but symptoms persist, he checks free testosterone. Additional labs include a pituitary panel (FSH, LH, prolactin), vitamin D, and fasting insulin for those at risk for prediabetes. This information guides a personalized treatment plan.

Jansen also addresses common misconceptions about TRT. He stresses that testosterone is not a cure-all and often requires adjunct evaluation and management of other conditions such as sleep apnea or thyroid disorders. Erectile dysfunction, for instance, may not resolve with TRT alone and may need separate treatment. He educates patients that without lifestyle changes, TRT may not be effective long-term. Some patients also fear TRT may cause cancer or heart problems. Jansen reassures them, citing literature showing no link to increased cancer risk—especially prostate cancer—and that cardiovascular risks are minimal or even questionable. Overall, patient counseling, symptom assessment, and a comprehensive evaluation are key to successful TRT management.
 
 

hCG Mixing Calculator

HCG Mixing Protocol Calculator

TRT Hormone Predictor Widget

TRT Hormone Predictor

Predict estradiol, DHT, and free testosterone levels based on total testosterone

⚠️ Medical Disclaimer

This tool provides predictions based on statistical models and should NOT replace professional medical advice. Always consult with your healthcare provider before making any changes to your TRT protocol.

ℹ️ Input Parameters

Normal range: 300-1000 ng/dL

Predicted Hormone Levels

Enter your total testosterone value to see predictions

Results will appear here after calculation

Understanding Your Hormones

Estradiol (E2)

A form of estrogen produced from testosterone. Important for bone health, mood, and libido. Too high can cause side effects; too low can affect well-being.

DHT

Dihydrotestosterone is a potent androgen derived from testosterone. Affects hair growth, prostate health, and masculinization effects.

Free Testosterone

The biologically active form of testosterone not bound to proteins. Directly available for cellular uptake and biological effects.

Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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