The Endocrine Society

so 260 to 900 that's the range in the basically the entire rest of the world they use nanomoles per liter so a different unit and the range is 9 to 31. it's different in different regions so take that with a grain of salt but those are the approximate ranges that we're talking about and so the first thing is that you'd need to have low testosterone on consecutive days in separate blood tests fasted the other equally important thing is that you must have symptoms.

The Endocrine Society, for example, focus on sexual dysfunction and sex-related symptoms.

So impotency, erectile dysfunction, and so forth.

Those are kind of the key symptoms, but also lethargy, a loss in body hair, fluctuations in body weight, If things like low bone density, if you're prone to fractures and things like this, depression might fit into it a little bit as well.

Well, it is vague.

That's kind of the problem.

So major organizations like the Endocrine Society, the American Neurological Association, the European Association of Urology, they all have these very specific stringent guidelines, which we've already mentioned.

You have to have testosterone levels, total testosterone that is measured on multiple consecutive days in the morning, fasted, it needs to be below the normal range, and you have to have clinical symptoms that are usually centered around sexual dysfunction.

Those evaluations could result in inappropriate testing, inaccurate results in diagnosis, and over-treatment that could cause harm, including infertility.

Medical experts, including the Endocrine Society and the American Urology Association, have recommended against blanket screenings for these reasons.

Still, the Pentagon has moved forward with the plans, releasing clinical guidance in September.

Now understand, for the most part, this has been paused by the military.

So how long should your eating window be? Which leaves us deducing how long should the fasting window be? Let me break the study down for you.

It was published by the Endocrine Society and it was a meta analysis.

So they looked at over 161 different studies to glean this information.

The head of the study and this meta-analysis was done out of the Salk Institute, which is a very well-respected institute when it comes to medical information.

Let's focus now on that primary aldosteronism for a little while, because as you said, our understanding here has changed so much.

And there's actually been some guideline based recommendations, one from the Endocrine Society, one in the large hypertension guidelines from AHA that have really shifted our approach to things.

Can you go over what those guidelines say and how they differ?

You know, Neil, it's been an eye opener for me.

But as I alluded to earlier, I think it's much more common than we think.

And these guideline documents are really sort of indicating that.

So if you look at the 2025 Endocrine Society guidelines, that has really put their nickel down on this.

And they have made a huge move towards universal screening.

If you're in a different country, use different metric systems, just multiply it by 2.5, okay, whatever that number is.

Now, the Endocrine Society has actually come out and said, what we see is that we have complications starting around 150 nanograms per milliliter.

So we're well under that number.

So if your number, if your blood tests are showing 150 and above, certainly you need to go down.

What they showed in the military, these were low.

They were below the CDC standards and the Endocrine Society standards.

These were low.

And in men who have symptoms,