AACE Medical Guidelines for Evaluating and Treating Hypogonadism

[The_Skeptic]

The American Association of Clinical Endocrinologists Medical Guidelines for Clinical Practice for the Evaluation and Treatment of Hyponadism in Adult Male Patients - 2002 Update


http://www.aace.com/pub/pdf/guidelines/hypogonadism.pdf

[HeadDoc]

good find!

[marianco]

Here is the updated 2006 guideline from the Endocrine Society for Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes:

http://www.endo-society.org/quickcon...line053006.pdf

I like this guideline since it is written clearly.

The target testosterone level to achieve with replacement therapy was clarified to be at the midpoint of the reference range. This means for a reference range of 300-1000 ng/dl, treatment should achieve a testosterone level of 650.

The guideline is fairly simple, not including other options such as using HCG or considering other factors such as DHT or estrogen levels. It is more rigid in requiring the testosterone level be generally under 300 ng/dl. But it is a good starting point and is clear enough for family practitioners to use. For example, I like the use of starting doses and monitoring guidelines for labs. Practitioners who lack experience will feel more comfortable when given starting doses and clear monitoring guidelines.

[marianco]

Here are the Endocrine Society's 2006 guidelines for Adult Growth Hormone Deficiency:

http://www.endo-society.org/quickcon...ormoneBook.pdf

[The_Skeptic]

Originally Posted by marianco

Here are the Endocrine Society's 2006 guidelines for Adult Growth Hormone Deficiency:

http://www.endo-society.org/quickcon...ormoneBook.pdf

Thanks Marianco. Is this updated every year?

[van-man]

I am curious, I have read several studies like this one lately while trying to come up with a formula for my next cycle. And I can not find anything that gives any insight into the effects of compounds like avodart or finastride on testosterone as it pertains to anabolism. Moreover, does stopping the conversion of test to DHT reduce its effectiveness? Does it somehow cause more testosterone to circulate as SHBG bound testosterone, or something else? I asked my doctor, he's pretty old school, and he seems to think that these products might limit testosterones effectiveness. Although when pressed, he does concede that it is just a hunch. I am aware of the libido consequences of cutting too deep into DHT levels; and have had great success in finding research to clarify this, but nothing of the former.

It is becuause of the heavy aromitization that I have steered clear of testosterone in the past, but when push comes to shove ya' just can't live without the classics. So, this time I've been flirting with the idea of combining .5mg of avodart and arimidex ED for the duration of the heavy part of my cycle. Any thoughts or insights on how this might effect the overall usefullness of the testosterone?

thanks

[HeadDoc]

if you start to do avodart, the PSA numbers cannot be taken at their value. As progesterone opposes DHT, you might consider progesterone OR see if adding pregnenolone will increase your progesterone.

[love_en]

After reading both the 2002 and 2006 guidlines, I now understand why I should not expect any help from a doctor. By means of an ink mark on paper, I am not hypogonadal. Even though I have all of the symptoms of low testosterone and a replacement dose causes a profound, yet gradual remission of symptoms. It bothers me, that the Total T by Age sticky was generated by work done in Europe. IOW, your total T is above 300, here is a prescription for Viagra and Prozac.

[MrT]

Originally Posted by marianco

Here is the updated 2006 guideline from the Endocrine Society for Testosterone Therapy in Adult Men with Androgen Deficiency Syndromes:

http://www.endo-society.org/quickcon...line053006.pdf

I like this guideline since it is written clearly.

The target testosterone level to achieve with replacement therapy was clarified to be at the midpoint of the reference range. This means for a reference range of 300-1000 ng/dl, treatment should achieve a testosterone level of 650.

The guideline is fairly simple, not including other options such as using HCG or considering other factors such as DHT or estrogen levels. It is more rigid in requiring the testosterone level be generally under 300 ng/dl. But it is a good starting point and is clear enough for family practitioners to use. For example, I like the use of starting doses and monitoring guidelines for labs. Practitioners who lack experience will feel more comfortable when given starting doses and clear monitoring guidelines.

Some Doctors take into account symtoms but I think many will feel that under 300 is a hardline that must not be crossed. In my case that would have been unfortunate as I was just above 300 and feeling like crap. HRT (Androgel) is making me feel 1000x better. And I'm at just above 700 now so I guess my Doctor has it pretty close.

[HeadDoc]

great reads here. Have a couple in trx. Husband gave up on TRT which was poorly done and overdosed. While there are other reasons for this couple's unhappiness, the hypogonadism is a contributor.

I'll be passing at least one of these articles on to him.

[pmgamer18]

Originally Posted by HeadDoc

great reads here. Have a couple in trx. Husband gave up on TRT which was poorly done and overdosed. While there are other reasons for this couple's unhappiness, the hypogonadism is a contributor.

I'll be passing at least one of these articles on to him.

Also have him get Dr. Shippens bood "The Testosterone Syndrome" some of it is dated but still a dam good read.

[JanSz]

Originally Posted by pmgamer18

Also have him get Dr. Shippens bood "The Testosterone Syndrome" some of it is dated but still a dam good read.

On 14th Annual International Congress On Anti-Aging Medicine
Dr. Shippen will have Masters Seminar Series
Hormones and Aging: Innovative Strategies for Testing and Treatment for Men and Women
http://www.worldhealth.net/event/Eug...n_Workshop.php


Copy from its description:
"You will be given Dr. Shippen's unique simplified Protocols for "The Diagnosis and Treatment of Male and Female Aging Transitions" which will be immediately useful in your practice. These simplified protocols will outline the diagnostic testing and many treatment options available. This will help to determine the best options for different individuals and for different complex clinical situations."

How to get this protocols?
I made my chiropractor call and asking for it, offering to pay as if he attended the seminar,
($395), he did not get good answer.
======================================
This series will provide intensive focus on:

Basic endocrine concepts that help in the understanding of individualized approaches to diagnosis and treatment needed to provide optimal replacement.
Unique new conceptual information that is guaranteed to enhance your current methods of hormone therapy.
One half day on strategies for men and one half day on hormonal treatment and replacement strategies for women.
One on one discussions of complex case analysis.
You will learn:

The major hormonal linkages and how to integrate individualized patterns of these hormones into custom treatment protocols.
How to diagnose the different types of male hormonal deficiencies and the differing treatments required for successful treatment of these different individual patterns.
Testing protocols I use for screening and diagnostic evaluations.
How to easily identify treatment target levels more accurately,a key to effective individualized replacement more is not always better.
The common reasons for treatment failures and how best to get positive results quickly.
How best to identify and manage the E2/Testosterone balance
A successful medical protocol for the successful treatment of endometriosis.
How to identify and treat the various stages of peri-menopause and the menopausal transition in easy staging and treatment options.
Unique new successful hormone "boosting" methods which can generate normal testosterone levels as an alternative to replacement option.
Unique new concepts of hormone "Pulse dosing" strategies for hormone replacement in both men and women, a key endocrine concept that results in improved responses and successful replacement at lower doses.
Prolactin as a critical factor to hormonal balance and how prolactin management can improve sexuality, weight loss, insulin sensitivity and diabetic control.
You will be given Dr. Shippen's unique simplified Protocols for "The Diagnosis and Treatment of Male and Female Aging Transitions" which will be immediately useful in your practice. These simplified protocols will outline the diagnostic testing and many treatment options available. This will help to determine the best options for different individuals and for different complex clinical situations.