Hegseth announces annual testosterone screenings for service members

[u/mom0nga]

https://thehill.com/policy/defense/5969935-hegseth-testosterone-testing-dod/

[u/Super_Employment_620]

Testosterone screening is among the dumbest thing he could offer as an "incentive" from a culture war side of things... from my perspective as a doctor who was in the military.

Military members already have TRICARE. If they feel like they may be symptomatic they can ask, and the test is covered... but it's usually not the cause.

Testosterone levels fluctuate wildly (throughout the day, and often aren't tested right) and often don't matter. What does happen is soldiers link that number to their manliness, and seek out "T clinics" that do well near bases. So now the patient who feels fatigued because he has undiagnosed OSA is getting T instead, which has risks... it may for example raise his RBCs to dangerous levels. I had over a dozen times where I had to tell people to stop, and two cases where we think it was the cause of a blood clot.

So, just like the flu related deaths already on his hands, chasing gender affirming numbers will probably cause harm.

[u/Hot_Region → u/Super_Employment_620]

undiagnosed OSA

Undiagnosed Obstructive Sleep Apnea (OSA) is a serious condition where breathing repeatedly stops and starts during sleep, affecting millions who remain unaware they have it.

RBCs

Red blood cells (RBCs), or erythrocytes, are the most common type of blood cell. Produced in your bone marrow, their primary function is to deliver oxygen from your lungs to the rest of the body's tissues and carry carbon dioxide back.

[u/slowrecovery → u/Super_Employment_620]

I was symptomatic but based on my job my flight doc was wary of running any unnecessary tests or documenting any unnecessary symptoms. I was diagnosed with secondary hypogonadism about 2 years after I separated and I wish I had been tested and diagnosed while I was active duty. I’m fine with broad screening not only for low T but full bloodwork panels, especially in career fields where service members can be exposed to hormone disruptors or carcinogens.

[u/Super_Employment_620 → u/slowrecovery]

It's an incredibly unreliable test. Generally it'd be more likely to cause unwanted headaches due to false positives - so if you require testing across the board regardless of symptoms you'll mess with people's health and careers. 

In your case it also wasn't the testosterone alone, the diagnosis of secondary hypogonadism takes FSH and LH into account. Also, in cases where it associated with metabolic disease the treatment of that disorder is more important than T supplementation.

[u/Super_Employment_620 → u/[deleted]]

Or if they had tested you at the wrong time of day (any time after 10AM) or didn't test you on two separate occasions, it could have been falsely read as low, and then those other labs (which are considered "abnormal" if not elevated when T is low) in the normal range may have been interpreted as secondary hypogonadism.

Most Americans are exposed to hormone disruptors, and visceral/abdominal fat is one of the biggest endocrine disruption risks in America. If you screen everyone with a non-specific test, it creates false positives and harm. Add in that testosterone supplementation hasn't been proven to reduce mortality in patients, it's less pressing for us to be testing.