Very good morning to everyone, welcome to Las Vegas. As everyoneâ€™s getting settled in, Iâ€™ll start with some easy slides first. This meeting is sponsored by Medcrest [phonetic] pharmacy, which to you thank for sponsoring this event. And this morning I am going to talk about some of the miss in hormone replacement. The most important part of my lecture will be the last thirty minutes, and I will sort of set the stage during the first fifteen minutes as to what I am going to get to in the last fifteen minutes.
So, this morningâ€™s lecture is going to be more a lesson on the lines of laboratory tests, and how we misinterpret laboratory test, and as result of misinterpretation we mistreat patients in many different ways that, and Iâ€™m going to show you those ways in which we mistreat.
For those of you who do not know my style, I present something to you and then I enforce that point, and then I come back later and I completely negate that point by showing you how the medical editor [incomprehensible] supports completely opposite of what weâ€™ve been thought and trained. So, for those of you who are not familiar with my style, please be patient.
For the first section I am going to about what we commonly do as far as testosterone replacement in men. And look at the validity of androgen acids. It seems like I cannot pick up a medical journal that does not address that we should not be treating men with testosterone in lesser level is below a certain number. We arbitrarily picked that number out of the blue, based on someoneâ€™s personal preference or someoneâ€™s personal, if youâ€™ll excuse the term, political agenda. They picked this number to try to restrict the prescription of testosterone to men. So let me go through those recent studies to downplay what they are suggesting. Though laboratory acids can support a diagnosis of androgen deficiency in men, they should not be used to exclude it. And thatâ€™s what I frequently see. On a daily basis patients come to me and say: â€śMy doctor says my levelâ€™s not low enough to prescribe it, so therefore I have to suffer for the rest of my life from the symptoms of andropause, because my doctor says my levels arenâ€™t low enough and I donâ€™t deserve it yet. Shame on us for doing that. It is suggested that there needs to be greater reliance on the history and the clinical features, and the symptoms and how the patient feels and functions. Together with the careful evaluation of the symptomatology, and where necessary a therapeutic trial of androgen treatment will be given, what is estrogen FDA approved for?
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