Dr Susan Hardwick-Smith

So how does the patient feel?

We replace it, get it up to reasonable levels based on

reasonable common sense.

And then if she feels better, that's great.

But it gets missed so often.

I can tell you back in the bucket of things I missed when I was in traditional medicine, I would have done the same thing.

We just were trained to look for stuff that turned red.

Yeah.

So obvious things like what time of day you got your blood drawn.

I have some patients who use their testosterone morning and night.

So we want to measure it in the middle of the day.

Well, not every doctor is going to say that.

If you measure it an hour after you put it on, it's going to look a little higher.

On the other hand, if you missed a dose, it's going to look a little lower.

I mean, there's so many factors that can affect.

We've got to, like you said, look at how the patient's feeling.

If it's a little bit higher than

the consensus suggests it should be, and the patient's feeling well and not having any side effects.

There are so many things that can affect that.

In the United States, we're still instructed, and the consensus paper says, measure total testosterone, not free testosterone.