How to Avoid a Mad "T" Party: Evaluation and Management of Male Hypogonadism

madman

Super Moderator
One of the big boys in the field!

Dr. Anawalt!

Pay attention to the Q&A (43:20-56:30) especially when it comes to testing free testosterone!




43:20-46:27 - How do we assess for free testosterone?

* There's a direct antibody assay (IA) that measures free testosterone it is notoriously inaccurate and notoriously underestimates the true free testosterone as much as 30% so you should never use that but it is cheap, its easy, its quick so all labs offer it









1762123575673.webp
 
Classic Klinefelter Syndrome
1762124437704.webp





Klinefelter Syndrome
1762124566263.webp





This is some of the best data we have on men with Klinefelter's Syndrome.

↑↑ FSH & LH in Klinefelter syndrome
1762124706140.webp
 
Free Testosterone
1762125815777.webp





Should we order an assessment of free testosterone? YES

1762125917822.webp





 
Common causes of hypogonadism
1762126083107.webp





Dr. Bradley Anawalt

This is a different way of thinking about hypogonadism and I think this is the way we should think about it in 2025, REVERSIBLE vs IRREVERSIBLE.

Reversible vs. irreversible hypogonadism
1762126249948.webp
 
Dr. Bradley Anawalt

This is a picture of Hershey kisses drawn by me and this is the kisspeptin neurons that regulate the hypothalamus to make GnRH to and create the onset of puberty



Kisspeptin neurons
1762127118264.webp
 
Dr. Bradley Anawalt

For the first time in a 100 years we have data from randomized controlled trials placebo controlled



4 major clinical testosterone outcomes trials since 2016
1762127469969.webp

1762127746035.webp





Dr. Bradley Anawalt

This is the summary and Im going to circle the major outcome points here

1762127931809.webp





In terms of adverse events.

1762127999521.webp
 

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

Beyond Testosterone Podcast

Online statistics

Members online
2
Guests online
322
Total visitors
324

Latest posts

Back
Top