Posting this because the summary going around does not say what the paper says, and the difference matters for how people here are using it.
Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect. Less adipose tissue means less aromatase activity, so in men testosterone commonly rises and estradiol falls, and SHBG rises as insulin resistance improves — which means total testosterone can rise while free testosterone moves less than expected. In PCOS, improved insulin sensitivity frequently restores ovulation, which is a fertility change people are not always expecting.
Where I think it is weakest: the population was selected and supported in ways a real cohort is not, so I would read the effect size as a ceiling rather than an expectation.
The bit I cannot resolve on my own is why total and free can move differently here, and which of the two is worth tracking. Not looking for reassurance. Looking for the part I have got wrong.
PharmHunterJen said:Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect.
Agreeing with PharmHunterJen, and the qualification matters more than the agreement. One addition: if the lab changes analytical platform between your draws, the comparison breaks and nobody tells you. It is worth asking when a value moves inexplicably.
PharmHunterJen said:Most of the hormonal change here is a consequence of adiposity falling rather than a drug effect.
Pushing back on PharmHunterJen here. I would drop the "get everything" instinct further than this thread does. Every extra test is another chance at a false positive, and incidental findings have their own cost in scans, biopsies and worry.
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View ResultsTaking the question as asked, rather than the general version of it. Quarterly for the first year is convention rather than evidence, and it is defensible for a simple reason: it is roughly the interval over which HbA1c becomes informative again, since it reflects about three months of glycaemia. After the first year, and once doses are stable, annual is reasonable unless something specific is being followed.
If somebody has the primary source to hand I would rather cite it than paraphrase it.
TirzTom said:One addition: if the lab changes analytical platform between your draws, the comparison breaks and nobody tells you.
Can confirm. Same sequence, different timescale.