The Testosterone Test Most Doctors Are Getting Wrong

madman · 2026-09-18T16:08:43-0500

Dr. Morgentaler

* Symptoms follow free testosterone not total

In this episode, Dr. Brandon and Dr. Morgentaler talk about why doctors are still cautious about testosterone and why free testosterone may be a better measure than total testosterone for identifying deficiency.

Timestamps

00:00 Testosterone Backlash Explained — They explore why testosterone still faces resistance in medicine despite decades of research on its biology, benefits, and safety.

04:29 Why Doctors Stay Skeptical — They discuss outdated cancer and heart-risk fears, limited medical-school training, and why many doctors remain uncomfortable prescribing testosterone.

11:32 Free vs Total Testosterone — Dr. Morgentaler explains why free testosterone is the biologically active portion and why total testosterone alone may not tell the full story.

15:38 Free Testosterone Debate — They break down the medical controversy over using free testosterone and discuss new research supporting its importance in identifying deficiency.

19:08 SHBG Masks Deficiency — They explain how high SHBG can make total testosterone look normal or even high while free testosterone remains low and symptoms persist.

24:54 Testing Tips and Wrap — They share how patients can ask for free testosterone and SHBG testing and why symptoms should be considered alongside laboratory numbers.

Thread 'Hormonal Profiles of Men with Highly Elevated SHBG and Primary Testicular Dysfunction Support Free Hormone Hypothesis'

Aug 12, 2026

* In this analysis, we describe the clinical and biochemical features of men with markedly elevated SHBG levels who exhibited unequivocally low free testosterone concentrations, measured using rigorously validated equilibrium dialysis assay. Despite unequivocally low free testosterone concentrations, some of these men showed mid- to high-normal or even total testosterone levels above the reference range, creating a striking divergence between total and free testosterone concentrations. Notably, all met predefined criteria for primary hypogonadism (1). These findings...

madman · 2026-09-18T16:09:31-0500

Thread 'Debate about the Free Testosterone Hypothesis: Useful Tool or Misguided Mirage?'

Jun 28, 2025

Dr. Handlesman and Dr. Anawalt two highlly respected and well known endos in the field!

https://academic.oup.com/jcem/advance-article-abstract/doi/10.1210/clinem/dgaf370/8171633?redirectedFrom=fulltext

Abstract:

In this debate, two clinicians discuss the merits and demerits of the free testosterone hypothesis. Although most clinical guidelines recommend the measurement of free testosterone in the evaluation for male hypogonadism (at least in men with suspected low serum sex hormone binding globulin), there remains controversy about underlying hypothesis that serum...

madman · 2026-09-18T16:10:33-0500

Thread 'Largest dataset of mFT levels to date: male reference ranges spanning a wide age range, using a gold standard Equilibrium Dialysis LC-MS/MS method'

Mar 14, 2026

Sit and dwell on that!

Think of all those overmedicated men on T-therapy gassed up on FT well beyond their natty genetic set-point and unfortunately many off them off the hop!

You can blame all those run of the mill T clinics, kiddie forums loaded with all those numbskulls, throw those blast n cruisers in there too and put the icing on the cake the cesspool of so called gurus polluting gootube!

Gotta love all those kiddie forums loaded with the brainwashed sheep still pushing that more T is better mentality dishing out piss poor advice!

So much misinformation littered on the net its...