The clinical practice of titrating androgen replacement therapy to achieve optimal functional levels, using highly individualized metrics that extend beyond simple total serum hormone concentration. This precision relies on correlating patient symptoms and clinical markers with bioavailable hormone levels and specific androgen metabolite ratios. The goal is to maximize the anabolic and cognitive benefits while strictly avoiding supraphysiological levels and adverse effects.
Origin
This term reflects the maturation of hormone replacement therapy from a generalized, one-size-fits-all approach to a highly personalized model driven by advanced laboratory testing and pharmacogenomics. It is a direct response to the need for safer, more effective dosing strategies that acknowledge individual metabolic variability.
Mechanism
Precision dosing is achieved by integrating advanced diagnostic data, such as salivary or dried urine testing for free hormones and metabolites, with the patient’s clinical response. The mechanism involves a dynamic adjustment of dose, frequency, and delivery route to maintain stable, physiological hormone levels throughout the day. This careful titration prevents receptor downregulation and minimizes the conversion of androgens into unwanted estrogenic or potent metabolic byproducts.
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