#623: Testosterone Testing: What Do the Results Mean? When Does TRT Help? – Austin Baraki, MD

Danny Lennon (0:00)

Hello, and welcome to Sigma Nutrition Radio. My name is Danny Lennon, and you are listening to episode 623 of the podcast. You're very welcome. Today, we're gonna be taking a look at the topic of testosterone, and specifically, what do lab results from testosterone tests tell us? In what situations should they be done in the first place? Second, in what situation should they be acted on? And what are the potential pitfalls in malinterpretation of said results? And this has been a topic that has always been of interest, but has really captured a lot of people in recent times, owing to a number of narratives that we see within media, within social media, even within political discussion around the levels of testosterone we see generally across the population. And specifically, most of this focus gets discussed in the context of men and what is an appropriate level of testosterone, what is too low, there's narratives about declining levels of testosterone over the last number of decades, etc.

And to the point now where, because of the ease of testing for this, people are able to go and get lab tests themselves, even before thinking about probabilities or discussing with a medical professional the probabilities of having low testosterone. And then with a said test result, people are looking for treatments, most notably via testosterone replacement therapy or TRT.

And so to go through this as a number of interesting questions, we need to think about what those tests are measuring, what they actually tell us, and then how the context in which they're done actually adds an important layer to their interpretation. And so how one result on its own doesn't really tell us everything because it could have different meanings depending on that context. And so to go through this, there's probably no better person than Dr. Austin Baraki, who has been on the podcast several times previously. In one of those, we specifically talked about issues related to testing and screening and so on. And that will raise its head again in this particular episode. And so we're going to go through all of this and hopefully by the end, you will have a clearer understanding around testosterone testing, interpretation of those results, et cetera. In the description box where you're currently listening or over on sigmanutrition.com, you will get a list of the resources related to this. So some papers that relate to what we might discuss, a bit more about Dr. Baraki and his background, where you can find him online, and then also previous episodes of the podcast that he has been on. So that will be linked in the description box where you're currently listening. If you are a Sigma Nutrition Premium member, then you will get a set of detailed study notes to accompany this episode. Again, available by clicking through the episode page in the description box or finding that directly on sigmanutrition.com or you will also receive an email with it. If you are listening on the free public feed of the podcast, and you're interested in getting more out of your podcast listening, including getting access to the detailed study notes we provide for each of the episodes, as well as a premium only episode each month, then check out all the benefits of being a premium member at the link in the description box where you're listening right now or of course, again, over at sigmanutrition.com.

So with that, let's get into this conversation between myself and Dr. Austin Baraki.

And here we are. Welcome back to the podcast, Dr. Austin Baraki. How are you doing?

Austin Baraki (3:54)

Doing great. I think I've lost count. It's been a handful of times. We did some stuff on some lab testing and iron deficiency are the main ones that I recall, but good to be back nonetheless.

Danny Lennon (4:03)

Yeah, I'll have to check this. I'm going to guess maybe this is your fourth appearance. I could be wrong. It could be number five, but I will double check that for people and I'll put links to those previous episodes in the description. I encourage everyone to go and check them out. I'm sure if you haven't heard any of those after listening to today's episode, you will be another Dr. Austin Baraki fan just like me.

So let's see how that goes. Very briefly, before we get into this, Austin, before people who maybe haven't come across those episodes or for whatever reason haven't come across, what's the brief outline of who you are, what you do, what your work and interests are, and anything else that might be relevant to what we're going to chat about today?

Austin Baraki (4:44)

Yeah, I am an internal medicine physician, often I guess labeled as a clinician educator. I work in an academic medical center teaching and mentoring junior doctors and medical students seeing acutely ill patients who need admission to the hospital and management on that front. But I also have a lot of other outside interests. I practice some telemedicine. I work in the weight management, kind of cardio metabolic risk management space as well. And then been working with barbell medicine for many years now, over I guess a decade or more at this point in the health, fitness, coaching, performance sort of space as well. So I think that has led to a host of downstream interests that have landed me here a few times in the past. We have our own podcast website, resources, videos and things like that. So a whole lot of interests spanning health and performance and fitness within the clinical realm. Again, for those who have either have heard those prior episodes or who are willing to suffer through them, you will learn about my interests in clinical diagnosis, clinical reasoning, testing, test interpretation, much of which is fortunately or unfortunately going to come through on this episode as well.