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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
Testosterone Okay, Other Values Puzzling: Opinions, Please
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<blockquote data-quote="tareload" data-source="post: 233832"><p>[URL unfurl="true"]https://forums.t-nation.com/t/realistic-trt-recomp-progress/253389/3912[/URL]</p><p></p><p><img src="https://aws1.discourse-cdn.com/tnation/uploads/default/original/4X/8/b/a/8baf9eb09db02f3d7d4c7698859d0938404295db.png" class="bbImage" alt="" data-url="https://aws1.discourse-cdn.com/tnation/uploads/default/original/4X/8/b/a/8baf9eb09db02f3d7d4c7698859d0938404295db.png" style="" /></p><p></p><p></p><p>[ATTACH=full]25631[/ATTACH]</p><p></p><p></p><p>[URL unfurl="true"]https://academic.oup.com/jcem/article/95/4/1810/2597149[/URL]</p><p></p><p>[ATTACH=full]25630[/ATTACH]</p><p></p><p></p><h3>Compensated hypogonadism</h3><p>A relatively large number of men (9.5%) were identified as having compensated hypogonadism (<a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">3</a>, <a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">9</a>). The frequency of this condition showed a clear increase with age (<a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">Fig. 1</a>, <em>inset</em>) forming the largest LOH category (21.1%) in the 70- to 79-yr age group. Although smokers are overrepresented in compensated hypogonadism, there was no significant difference in total T, fT, or SHBG between smokers and nonsmokers in this group (data not shown). Excluding smokers from the analyses did not make any difference to the risk factor associations in any of the hypogonadal groups (<a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">Table 2</a>). The explanation linking smoking with compensated hypogonadism remains unclear. Compensated hypogonadism was associated predominantly with physical symptoms. This is compatible with previous studies showing an inverse relationship between LH and muscle strength independent of T (<a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">10</a>) and a lack of association between LH and libido (<a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">32</a>). Although T levels in the compensated group remained above the thresholds for sexual symptoms, they may be insufficient to maintain previous levels of physical functions (<a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">33</a>, <a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">34</a>). Given its wide normal range, it is possible that T had declined from previously high normal to current low normal levels in men with compensated hypogonadism. High LH may therefore be a biomarker for T decline within the reference range, indicating a readjustment of the HPT feedback set point in aging to compensate for deficiencies in testicular function and/or defective T feedback at the hypothalamic-pituitary level (<a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">35</a>). A possible alternative explanation for the occurrence of physical symptoms in compensated hypogonadism may be the slightly lower mean fT in this group compared with eugonadal men (<a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">Table 1</a> and <a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">Fig. 2</a>). However, after stratifying this group into those with low (<230 pmol/liter) or normal fT, low fT levels were not associated with increased symptoms (sexual or physical) after adjusting for age and other confounders (data not shown).</p><p></p><p>Compensated hypogonadism may be analogous to subclinical hypothyroidism (high TSH and normal thyroid hormone levels) (<a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">36</a>) where it is accepted that most patients will go on to develop overt hypothyroidism and T4 replacement is indicated (<a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">37</a>, <a href="https://www.excelmale.com/forum/javascript%3A;" target="_blank">38</a>). Our results suggest that elevated LH levels in compensated hypogonadism are not an isolated laboratory finding but significantly associated with physical symptoms. This lends support to the conclusion that it represents a genuine clinical subgroup of LOH. This condition may, therefore, be a forerunner of overt primary hypogonadism, being characterized by both elevated LH and higher age. Men with increased comorbidity and/or other as yet undefined factors may eventually progress from compensated to overt primary hypogonadism. The follow-up data in EMAS should provide verification to this hypothesized natural history of LOH.</p><p></p><p>The higher SHBG level in compensated hypogonadism could be an important proximal factor in the development of compensated hypogonadism and the higher E2 in the same group may be a potential mechanism. However, the present cross-sectional data cannot dissect out the complex but potentially important interrelationships, and more research on this aspect is warranted.</p></blockquote><p></p>
[QUOTE="tareload, post: 233832"] [URL unfurl="true"]https://forums.t-nation.com/t/realistic-trt-recomp-progress/253389/3912[/URL] [IMG]https://aws1.discourse-cdn.com/tnation/uploads/default/original/4X/8/b/a/8baf9eb09db02f3d7d4c7698859d0938404295db.png[/IMG] [ATTACH type="full"]25631[/ATTACH] [URL unfurl="true"]https://academic.oup.com/jcem/article/95/4/1810/2597149[/URL] [ATTACH type="full" alt="1663601531925.png"]25630[/ATTACH] [HEADING=2]Compensated hypogonadism[/HEADING] A relatively large number of men (9.5%) were identified as having compensated hypogonadism ([URL='https://www.excelmale.com/forum/javascript%3A;']3[/URL], [URL='https://www.excelmale.com/forum/javascript%3A;']9[/URL]). The frequency of this condition showed a clear increase with age ([URL='https://www.excelmale.com/forum/javascript%3A;']Fig. 1[/URL], [I]inset[/I]) forming the largest LOH category (21.1%) in the 70- to 79-yr age group. Although smokers are overrepresented in compensated hypogonadism, there was no significant difference in total T, fT, or SHBG between smokers and nonsmokers in this group (data not shown). Excluding smokers from the analyses did not make any difference to the risk factor associations in any of the hypogonadal groups ([URL='https://www.excelmale.com/forum/javascript%3A;']Table 2[/URL]). The explanation linking smoking with compensated hypogonadism remains unclear. Compensated hypogonadism was associated predominantly with physical symptoms. This is compatible with previous studies showing an inverse relationship between LH and muscle strength independent of T ([URL='https://www.excelmale.com/forum/javascript%3A;']10[/URL]) and a lack of association between LH and libido ([URL='https://www.excelmale.com/forum/javascript%3A;']32[/URL]). Although T levels in the compensated group remained above the thresholds for sexual symptoms, they may be insufficient to maintain previous levels of physical functions ([URL='https://www.excelmale.com/forum/javascript%3A;']33[/URL], [URL='https://www.excelmale.com/forum/javascript%3A;']34[/URL]). Given its wide normal range, it is possible that T had declined from previously high normal to current low normal levels in men with compensated hypogonadism. High LH may therefore be a biomarker for T decline within the reference range, indicating a readjustment of the HPT feedback set point in aging to compensate for deficiencies in testicular function and/or defective T feedback at the hypothalamic-pituitary level ([URL='https://www.excelmale.com/forum/javascript%3A;']35[/URL]). A possible alternative explanation for the occurrence of physical symptoms in compensated hypogonadism may be the slightly lower mean fT in this group compared with eugonadal men ([URL='https://www.excelmale.com/forum/javascript%3A;']Table 1[/URL] and [URL='https://www.excelmale.com/forum/javascript%3A;']Fig. 2[/URL]). However, after stratifying this group into those with low (<230 pmol/liter) or normal fT, low fT levels were not associated with increased symptoms (sexual or physical) after adjusting for age and other confounders (data not shown). Compensated hypogonadism may be analogous to subclinical hypothyroidism (high TSH and normal thyroid hormone levels) ([URL='https://www.excelmale.com/forum/javascript%3A;']36[/URL]) where it is accepted that most patients will go on to develop overt hypothyroidism and T4 replacement is indicated ([URL='https://www.excelmale.com/forum/javascript%3A;']37[/URL], [URL='https://www.excelmale.com/forum/javascript%3A;']38[/URL]). Our results suggest that elevated LH levels in compensated hypogonadism are not an isolated laboratory finding but significantly associated with physical symptoms. This lends support to the conclusion that it represents a genuine clinical subgroup of LOH. This condition may, therefore, be a forerunner of overt primary hypogonadism, being characterized by both elevated LH and higher age. Men with increased comorbidity and/or other as yet undefined factors may eventually progress from compensated to overt primary hypogonadism. The follow-up data in EMAS should provide verification to this hypothesized natural history of LOH. The higher SHBG level in compensated hypogonadism could be an important proximal factor in the development of compensated hypogonadism and the higher E2 in the same group may be a potential mechanism. However, the present cross-sectional data cannot dissect out the complex but potentially important interrelationships, and more research on this aspect is warranted. [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Blood Test Discussion
Testosterone Okay, Other Values Puzzling: Opinions, Please
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