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Enzyme‐Inspired Single Selenium Site for Selective Oxygen Reduction - Zhang - 2025 - Angewandte Chemie International Edition - Wiley Online Library

TRT is generally appropriate when: Total testosterone is consistently below 300 ng/dL on two morning draws (some guidelines use 350 ng/dL as a clinical threshold) Symptoms are present and attributable to testosterone deficiency after ruling out other causes Secondary and reversible causes have been evaluated and addressed where possible No active contraindications are present (prostate cancer, breast cancer, untreated sleep apnea, hematocrit ≥54%) TRT may not be the first step when: Testosterone levels are in the low-normal range (300–400 ng/dL) and symptoms are nonspecific — lifestyle optimization may restore normal function Obesity is a major contributing factor — weight loss alone can raise testosterone by 100–200 ng/dL in some men Sleep apnea is untreated — obstructive sleep apnea profoundly suppresses testosterone and must be addressed first Fertility preservation is a priority — TRT suppresses sperm production

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