About this episode

The episode discusses who truly needs testosterone replacement therapy and the complexities surrounding its prescription and diagnosis.

Most men who start testosterone never needed it, and some who genuinely do never get treated. In the final episode of the Signal series, Dr. Jordan Feigenbaum and Dr. Austin Baraki work through who actually needs testosterone replacement, who got sold it, and what the evidence says about the risks that scared the field for a decade. We cover the blinded trial where men couldn't tell real testosterone from placebo, what the heart and prostate data actually show now that we have the trials, what testosterone does to fertility, and the framework we use to decide. We also close the story of Mark, the patient whose lab result started the series. This is educational content, not medical advice. Talk to your physician about your personal situation. Here we cover the real diagnosis of testosterone deficiency, primary versus secondary low testosterone, how the system both over- and under-prescribes, the SHBG trap that makes a normal level look low, the gray-zone crossover study, what replacement should actually target, why most men quit within a year, testosterone as a male contraceptive, the TRAVERSE cardiovascular results, the saturation model and prostate safety, the blood side effect…

People in this episode

Host: Dr. Jordan Feigenbaum

Guest: Dr. Austin Baraki

Topics covered

• testosterone replacement
• testosterone deficiency
• health risks
• fertility
• over-prescription
• medical diagnosis

Keywords

• testosterone
• replacement therapy
• fertility
• low testosterone
• SHBG trap
• cardiovascular results
• medical advice

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