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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Primary hypogonadism induced by steroids
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<blockquote data-quote="Cataceous" data-source="post: 220303" data-attributes="member: 38109"><p>This is still much less of an issue with primary hypogonadism. In secondary hypogonadism the upstream regulation of testosterone production is damaged, resulting in an unnaturally low set point for serum testosterone, e.g. 200 ng/dL. Any attempt to exceed this low set point with exogenous testosterone results in a reduction of endogenous production via HPTA suppression. Consider a thermostat analogy, in which house temperature represents serum testosterone, and the furnace represents the testicles. Secondary hypogonadism is like having your thermostat stuck on 50° F in the winter. The furnace is fine, but it's not being asked to make enough heat. If you then bring in an external space heater to force the temperature above 50° (use exogenous testosterone) then the stuck thermostat is rendered inactive and the furnace is not used (HPTA shutdown).</p><p></p><p>In your primary gonadism, however, the regulatory set point for serum testosterone is still ok. For example your natural set point might be 600 ng/dL. The problem is that the testicles can't make that much, so you have this situation where excessive LH reflects the unsatisfied demand for more testosterone. As you add exogenous testosterone, nothing much happens upstream until you near the natural set point. This is great, because it means you can push your serum testosterone up to a normal level, and only when going higher will negative feedback begin to suppress the HPTA. In the heating analogy, primary hypogonadism is like having a poorly operating furnace that can only heat your house to 50°, even though the thermostat is demanding more heat to try to reach the setting of 70°. In this case an external heater can bring the temperature up to normal—70° before the thermostat kicks off (HPTA shutdown).</p><p></p><p>Natesto is special because its short half-life means it can be used with secondary hypogonadism without too much HPTA suppression. The heating analogy become more of a stretch, but it's sort of like pulsing the external heat where it's needed, and far enough from the defective thermostat that it doesn't detect the heat and turn off. So your furnace provides the heat to maintain 50°, while the pulsed external heater keeps you comfortable.</p></blockquote><p></p>
[QUOTE="Cataceous, post: 220303, member: 38109"] This is still much less of an issue with primary hypogonadism. In secondary hypogonadism the upstream regulation of testosterone production is damaged, resulting in an unnaturally low set point for serum testosterone, e.g. 200 ng/dL. Any attempt to exceed this low set point with exogenous testosterone results in a reduction of endogenous production via HPTA suppression. Consider a thermostat analogy, in which house temperature represents serum testosterone, and the furnace represents the testicles. Secondary hypogonadism is like having your thermostat stuck on 50° F in the winter. The furnace is fine, but it's not being asked to make enough heat. If you then bring in an external space heater to force the temperature above 50° (use exogenous testosterone) then the stuck thermostat is rendered inactive and the furnace is not used (HPTA shutdown). In your primary gonadism, however, the regulatory set point for serum testosterone is still ok. For example your natural set point might be 600 ng/dL. The problem is that the testicles can't make that much, so you have this situation where excessive LH reflects the unsatisfied demand for more testosterone. As you add exogenous testosterone, nothing much happens upstream until you near the natural set point. This is great, because it means you can push your serum testosterone up to a normal level, and only when going higher will negative feedback begin to suppress the HPTA. In the heating analogy, primary hypogonadism is like having a poorly operating furnace that can only heat your house to 50°, even though the thermostat is demanding more heat to try to reach the setting of 70°. In this case an external heater can bring the temperature up to normal—70° before the thermostat kicks off (HPTA shutdown). Natesto is special because its short half-life means it can be used with secondary hypogonadism without too much HPTA suppression. The heating analogy become more of a stretch, but it's sort of like pulsing the external heat where it's needed, and far enough from the defective thermostat that it doesn't detect the heat and turn off. So your furnace provides the heat to maintain 50°, while the pulsed external heater keeps you comfortable. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone Basics & Questions
Primary hypogonadism induced by steroids
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