Derek (More Plates More Dates)

And it's resulting in you shooting out more gonadotropins to make more testosterone.

Typically, you will see this reflected in some sort of symptom, either through actual development in adolescence being not adequate or through biomarkers.

It becomes pretty clear because there will be other factors that are clearly outlier oddities in blood work when you see somebody who is not responding adequately.

Like these are very outlier scenarios that I'd be deviating into where people are like, you know, overshooting to try and meet some sort of physiologic activity.

Like most guys are going to be falling into the bucket of they have low gonadotropins or low response to it from age-related decline.

That's more of like, you know, what most people will find relevant.

So I'll start there.

In general, the thing you would be looking to first is, okay, like what are your levels, your total and your free levels?

Do they look good?

Do you have any symptoms?

And let's just say you do have symptoms and you're looking at these numbers and they look okay.

At that point, you would be looking, the actual output from the pituitary is going to be dictating what the signal to your testes is to actually produce testosterone.

So the LH from the pituitary signals to the lytic cells to make the intratesticular testosterone.

So is that signal adequate is one thing to assess, and that has a clinical reference range.

um but also individuals who are primary hypogonadal uh similar to what we talked about when it comes to assessing you know when women are hitting menopause like what kind of would you look to in men if you are not responding and producing adequate testosterone at in the testes like you will be trying to make more luteinizing hormone typically to try and push that signal so it's your body's going to recognize

I'm not getting enough testosterone out of this LH that I'm making.

So the signal isn't sufficient.

I'm not getting enough testosterone and or enough estrogen from that to provide the negative feedback that tells me to stop making GnRH and the other, the pituitary hormones.

So I would just, it would just keep shooting and trying to like probably overshoot you into adequate territory.

So you would, if you're a primary hypergonadal, you would see the reflection typically of high gonadotropins.