加载中…
Place · Level 3
30 后 T 缓慢降 1-2%/年 · 真低 T < 300 + 症状 · 测量陷阱 + SHBG · 生活方式优先 · TRT 适应症
cofactor · 1
Resistance training plus enough protein is the pair that actually preserves muscle here: the 15-30% acute testosterone bump after a session is not the point — leucine driving muscle protein synthesis through mTOR is. No special testosterone-boosting programme required.
regulates · 3
OSA is one of LOH's 5 reversible confounders — low T + snoring + daytime sleepiness + neck ≥ 43 cm: trial CPAP 6-12 months before re-testing T.
Male osteoporosis is systematically underdiagnosed: bisphosphonates plus calcium, vitamin D and strength training apply the same way, and where testosterone really is low it should be assessed as hypogonadism — not filed as a women's condition.
Men get no cliff but a slope: testosterone drifts down with age and muscle drifts with it. What matters on this line is the continuity of resistance training and protein intake, not any single testosterone reading.
contrast · 3
Male hormonal ageing and menopause are not the same event: menopause is a cliff — oestrogen down over 90% within a few years, with a defined endpoint. The male curve is a slope; only about 2% meet the clinical definition of hypogonadism, and nine tenths of the fatigue filed under low testosterone is not about testosterone.
Two levels of one subject that should not be merged: testosterone drifting down with age is a population curve, while late-onset hypogonadism is a clinical syndrome with diagnostic criteria — only about 2% actually meet them. Suspect it and measure properly (morning, repeated, total plus free plus SHBG), after ruling out reversible confounders like obesity, sleep apnoea and chronic stress.
≠PCOS
One SHBG mechanism, opposite clinical readings by sex: insulin resistance lowers SHBG, which in men looks like low total testosterone with possibly normal free T, and in women raises free T — the route behind the androgen picture in PCOS.