If you feel great on it and have no symptoms then sure. If you don’t feel great on it and continue to have symptoms then there are other protocols to try (trt etc)
This is great and clearheaded advice. Shows that youre open to discussion and not hard lining against it like the AI topic. Even though I am going to drop my AI after 8 weeks in. Currently Im following my doctors protocol since Im paying him money to treat me. At some point the responsibility will be 100% mine. So far Im very happy. Lust for life can have a price tag, but its nothing compared to the price I was paying with my health. Thanks Danny
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The difference is that hcg will not harm you. An AI will harm you.
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The information given at 14:50 about the reference range is unfortunately incorrect and misleading.
The ref range is NOT established on the basis of men that were sent to a lab by their urologist because of having symptoms.
Travis et al, 2017 established the currently most used T reference range. In order to prevent a geographic disbalance they used 4 cohorts from different regions in the US and EU. These studies are done to get information on a representative cohort of young healthy people (at baseline) and to follow their course as they age. The ref range for men age 19 to 39 was established from 1185 apparently healthy and nonobese men from the Framingham cohort and the SIBLOS cohort.
Whether the general approch of establishing a ref range is applicable for T or not is a whole other topic due to the many cofounding factors that can present as androgen deficient symptoms clinically. But saying that the ref range is based on old, symptomatic and sick people is just nonesense. Scientifically complete nonsense. Its a sales pitch, he should know better. Nonsense.
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@johann77 thank you very much for sharing this. I’m going to look into it and share your thoughts with the two individuals in this video. I appreciate the input.
@johann77 out of curiosity, why is it that:
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Every lab company uses different ranges.
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Labcorp lowers their ranges in both low and high by hundreds of points in the last 3 years.
I think there needs to be some clarification on HCG. It is my understanding that it shares the exact same alpha and beta subunits as LH with HCG having an additional 24 amino acid structure that primarily affects its duration of action(similar to although not completely analogous with adding an ester to the Testosterone molecule). HCG plays a wider role and has more functions in the pregnant woman than a man. But in a man, it doesn’t just act as LH…it is for all intents and purposes LH. Would you argue that Testosterone Cypionate is not natural to a man because it isn’t straight T? I’d be curious to hear the Dr.’s thoughts on this.
Second this. T nation should be at the forefront of dispelling this myth that the ranges are based on a sick population. It opens up the argument that everyone should be on T. ‘The average sick guy is 600 but the average real healthy man is 1000 kind of thinking’. It makes one sound like they are trying to maximize prescriptions and not health.
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Its all about the availability of a T reference standard (calibrant) that CDC released in their effeorts to harmonize T measurements
https://www.cdc.gov/labstandards/hs_standardization.html
The previous ref range that eg LabCorp used was 348 - 1197 ng/dl. Thats based on an LC-MS method using the data from the Framingham study (Bhasin et al, 2011).
The new reference range is 264 - 916 ng/dl. And thats based on the study from Travis et al., 2017 which used data from 1185 healthy nonobese young men. It also used LC-MS technology and used samples from 4 different cohorts the Framingham samples was one cohort).
Now where does the difference come from?
In short, about 90% of the difference comes from the fact that a newly established calibrant was used to calibrate the results from the different studies to the CDC standard.
About 10% comes from the fact that non obese (BMI <30) young males were studied in the Travis study whereas lean young men were used in the Bhasin study.
In more detail. Different testosterone assays have different responses. They give you different results when measuring the same sample. The assays need to be calibrated if one wants to compare different samples from different labs. Thats why the CDC came up with a testosterone assay standardization program. The study by Travis et al is the first study which made use of the newly established CDC calibrant.
Take a look at figure 1 of Travis 2017, second row. The exact same samples from the Framingham study (FHS) were re measured again using the new calibrant and compared to the original results. You can see that an average of difference of 144 ng/dl was found.
The reference range changed predominantly due to the calibration of the T assay to the CDC standars and not because the population testosterone declined.
Google ‘labcorp change testosterone reference range’ and you will find a document entitled ‘q & a testosterone reference interval changes (adult men)’
Why is LabCorp changing the testosterone reference
interval?
A: LabCorp is changing to the recently standardized reference
interval for adult males based upon testosterone assays
standardized to the CDC reference method. This change
was driven by the consensus effort for accurate testosterone
testing, which was endorsed by a group of professional
associations, government agencies, and commercial entities
in 2010.1
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The reply from Dr Grant (prior to you writing the above):
They took only 100 men from each cohort, got different results, then used an equation to “harmonize” them. They’re taking averages of averages. So that’s one issue with that study.
I agree that reference ranges for certain ages are obtained from presumably “healthy” people. That doesn’t mean that they’re healthy. And once they start looking at reference ranges in older populations, they are definitely going to see declining health.
Maybe just ask him about the methodology used in this study? Why did they not report the non-harmonized results. Why base things off of such small cohorts (and only two of the cohorts had men <40, I believe). So 200 white men.
It’s interesting for sure.
Will gladly retract what we said about “Sicker” populations being used (we implied ‘symptomatic’). BUT, there are assumptions that went in to this study that these men were, in fact, “healthy”.
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@blizzardtest the subunit with HCG is actually not the same.
Testosterone levels and sperm count levels are falling. This much we know. The standards of measurements are changing as well which is potentially complicating how we can quantify this.
600 ng/dL in a man who has never encountered any form of EDCs (say a man from 200 years ago) will have significantly more ‘bang for the buck’ than the same 600 in today’s men in many cases. I believe that is the argument being made here.
@blizzardtest I forgot to mention, T is T. Yes, cypionate has an Ester but the T is the identical molecule to what we produce naturally. The body cannot differentiate between the two.
Its 1185 men.
Mixing two different topics.
One is the question of whats the range and average T levels of apparently healthy young (lets say <40 years). That’s basically an observation.
And one is the question at which level a person can encounter symptoms of androgen deficiency and/or which level do pose the risk for negative short/longer consequences on health.
Regarding the latter the problem is twofold
- total T is not very well correlated with clinical symptoms. We know that freeT has a much higher correlation with clinical symptoms (and I intentionally use the term correlation and not causation).
- there is a high intersubject variability when it comes to the correlation between T and symptoms. A threshold or a lower reference range will never be able to discriminate 100% between a men really suffering from low T and a men suffering from other disease presenting with similar symptoms.
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Dr Grant agrees with your response. States:
I’m just trying to better understand the methodology of the study.
Seems like they took 100 samples from 2 cohorts (for the men <39), and then ran those with the CDC method. Then used an equation to harmonize the differences across the cohorts.
I think it’s also safe to say, in regards to your statement of “men suffering from other disease presenting with similar symptoms”, that many of those men will never be found to have another disease, and may find significant relief on testosterone.
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The alpha units are identical. And ‘ beta-hCG is mostly similar to beta-LH, with the exception of a Carboxy Terminus Peptide (beta-CTP) containing four glycosylated serine residues that is responsible for hCG’s longer half-life.’
If you look at the function of HCG in the pregnant female and it’s role in early the development of the male sex characteristics I think it’s obvious that HCG was nature’s way to ‘esterify’ LH to prolong its action in fetal development. In the adult male it’s action is identical to LH. Not similar, or just a receptor agonist, but identical. As I mentioned before, I’d be curious to hear the Dr’s thoughts. I feel like I’m hearing your thoughts.
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Curious on your thoughts on hcg mono. As I’ve stated before I take hcg and serms as a way to raise my test instead of full on trt. I am always trying to read about the pros and cons. I just hope I am not doing something stupid that will end up killing me or something.
For what it’s worth I feel fine.my test started at 12. Heresy last two blood tests.
I was referring to the dr in your videos. Or the Dr.s you consult with. But if @johann77 is an expert too then, yes