Dr. Charles Mok explains why athletes on testosterone therapy need higher doses than the body's natural range of 280–1100 ng/dL. Binding proteins like SHBG mean most testosterone isn't available to cells, so pharmacologic dosing targets higher blood levels to achieve the desired effect.
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There's difference between the physiologic and pharmacologic blood levels. So the physiologic level for a man, let's say, is 280 to 1100. That's where if you took a hundred men between 18 and 80, that's where they fall. And we would know the guys at the 280 are really kind of. They're usually heavy and they've got low sex drive and other issues associated with low testosterone. That's the physiologic level. But the pharmacologic level is usually on the higher end because your body makes special things like albumin and sex hormone binding globule to kind of gobble up the testosterone sees coming from the outside. So you got to run a little higher than normal physiologic level.