question from a user
It makes no rational sense to me that total testosterone “far more important”…. even for starting dose. When subjects can have the same total testosterone and wildly different free testosterone levels due to SHBG and other factors. Total testosterone can be misleading in many cases. I believe the science will evolve to standardize that importance one day, but medical thought lags and takes time to adjust. Upvote 1 Downvote Reply reply Share Share
AlphaMD's Answer
Maybe think of it a different way. Your FT level varies a lot based on your SHBG and your albumin levels. And since no one knows to what degree your body will respond to TRT, initial dosing, for the TRT virgins, is always based on your TT level. Subsequently, if you have an adequate TT but an inadequate FT, adjusting dosing frequency will have a greater impact on your FT than just adjusting your total TRT dose.
More data is always better, but until you actually know how an individual responds to treatment, they are just numbers. Like they teach in medical school, “treat the patient, not the number.”
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