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2 changes: 1 addition & 1 deletion Algorithm Explanation.md
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## 20) 内源性睾酮压制(transfem,辅助抗雄激素,默认锚定基线)

- **状态**:雌二醇通过下丘脑/垂体负反馈压制 LH/FSH,从而降低内源性睾酮。生理剂量下仅为**部分**压制(transfemscience.org intro;Leinung 2018:E2 < 50 pg/mL 时 TT ~160 ng/dL,E2 100–150 pg/mL 时 ~50 ng/dL);完全压制到女性范围通常需要超生理剂量雌二醇或抗雄激素/GnRH 激动剂(Misakian 2025 PMID 40639470:睾丸未切除者注射雌二醇单药 82.6% 达 TT < 50 ng/dL)。睾丸切除后睾酮降至 ~10–30 ng/dL 并在继续雌二醇下稳定(van der Sluis 2022 PMID 36201493)。因此本模型把雌二醇的压制作为**抗雄激素的辅助前提**,而非替代。
- **状态**:雌二醇通过下丘脑/垂体负反馈压制 LH/FSH,从而降低内源性睾酮。生理剂量下仅为**部分**压制(transfemscience.org intro;Leinung 2018:E2 < 50 pg/mL 时 TT ~160 ng/dL,E2 100–150 pg/mL 时 ~50 ng/dL);完全压制到女性范围通常需要超生理剂量雌二醇或抗雄激素/GnRH 激动剂(Misakian 2025 PMID 40639470:睾丸未切除者注射雌二醇单药 82.6% 达 TT < 50 ng/dL)。睾丸切除后睾酮降至 ~10–30 ng/dL 并在继续雌二醇下稳定(Collet 2023 PMID 36201493)。因此本模型把雌二醇的压制作为**抗雄激素的辅助前提**,而非替代。

- **模型**:给定基线睾酮 $T_0$(ng/dL,来自用户首次血检),在雌二醇浓度 $E$(pg/mL)下的剩余分数
$$
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2 changes: 1 addition & 1 deletion docs/todo/day/024-phase-a6-assay.md
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## References

- [Rosner 2013 — Estradiol Assay Comparison](https://pubmed.ncbi.nlm.nih.gov/23457408/)
- [Rosner 2013 — Estradiol Assay Comparison](https://pubmed.ncbi.nlm.nih.gov/23463657/)
2 changes: 1 addition & 1 deletion docs/todo/day/025-phase-a7-covariate.md
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## References

- [Stanczyk 2022 — popPK template](https://pubmed.ncbi.nlm.nih.gov/36574387/)
- [Stanczyk 2022 — population PK model for transdermal steroid delivery](https://pubmed.ncbi.nlm.nih.gov/36574387/)
- [Alotaibi 2026 — Metoprolol PK in Trans Women](https://pubmed.ncbi.nlm.nih.gov/42878231/)
2 changes: 1 addition & 1 deletion docs/todo/day/027-phase-a9-pkdebug.md
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## References

- [Stanczyk 2022 — popPK template](https://pubmed.ncbi.nlm.nih.gov/36574387/)
- [Stanczyk 2022 — population PK model for transdermal steroid delivery](https://pubmed.ncbi.nlm.nih.gov/36574387/)
2 changes: 1 addition & 1 deletion docs/todo/day/028-phase-b-plan-transmasc.md
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## References

- [Defreyne 2019 — Transmasculine Hormone Therapy](https://pubmed.ncbi.nlm.nih.gov/31027545/)
- [Madsen 2021 — Erythrocytosis in Trans Men](https://pubmed.ncbi.nlm.nih.gov/33904934/)
- [Madsen 2021 — Erythrocytosis in Trans Men](https://pubmed.ncbi.nlm.nih.gov/33599731/)
- [Turner 2019 — SC Testosterone Undecanoate PK](https://pubmed.ncbi.nlm.nih.gov/31384715/)
- [Figueiredo 2022 — SC Testosterone Injections](https://pubmed.ncbi.nlm.nih.gov/34698352/)
340 changes: 340 additions & 0 deletions src/data/pkReferences.ts
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/**
* Papers and guidance used by the pharmacokinetic model work tracked from
* issue #200 onward. Kept as static data so the Credits page still loads
* nothing from third parties.
*
* Each row is a link plus one line saying what the model uses it for. The
* list is deliberately grouped; a flat list of fifty citations is hard to
* scan. Add new sources to the group they inform.
*/
export interface PkReference {
/** Short citation, written to be scanned rather than copied. */
name: string;
/** PubMed, DOI, or the guidance page itself. */
href: string;
/** Journal and what the model uses the source for. */
desc: string;
}

export interface PkReferenceGroup {
title: string;
references: PkReference[];
}

export const PK_REFERENCE_GROUPS: PkReferenceGroup[] = [
{
title: 'Estradiol, SHBG, and free hormone',
references: [
{
name: 'Narinx et al., 2022 — SHBG and the free-hormone hypothesis',
href: 'https://pubmed.ncbi.nlm.nih.gov/36205798/',
desc: 'Cell Mol Life Sci. SHBG binding and free-testosterone interpretation.',
},
{
name: 'Södergård et al., 1982 — Free and bound testosterone and estradiol',
href: 'https://doi.org/10.1016/0022-4731(82)90038-3',
desc: 'J Steroid Biochem. Binding model used for free-hormone fractions.',
},
{
name: 'Dunn et al., 1981 — Steroid binding to SHBG and CBG',
href: 'https://pubmed.ncbi.nlm.nih.gov/7195404/',
desc: 'J Clin Endocrinol Metab. Binding affinities for free-hormone calculation.',
},
{
name: 'Ropponen et al., 2005 — Oral vs transdermal estradiol and SHBG',
href: 'https://pubmed.ncbi.nlm.nih.gov/15784702/',
desc: 'J Clin Endocrinol Metab. Route-dependent SHBG changes.',
},
{
name: 'Rosner et al., 2013 — Estradiol measurement position statement',
href: 'https://pubmed.ncbi.nlm.nih.gov/23463657/',
desc: 'J Clin Endocrinol Metab. Assay limitations behind the estradiol inputs.',
},
{
name: 'Stanczyk et al., 2022 — Population PK of a transdermal steroid',
href: 'https://pubmed.ncbi.nlm.nih.gov/36574387/',
desc: 'PLoS One. Population-PK structure and predicted hormone levels.',
},
{
name: 'Zhang et al., 2024 — Oral estradiol valerate PK',
href: 'https://pmc.ncbi.nlm.nih.gov/articles/PMC11246651/',
desc: 'PMC. Oral EV half-life, Tmax, and exposure used for kE1Pool.',
},
{
name: 'Fiers et al., 2018 — Free testosterone by LC-MS/MS dialysis',
href: 'https://pubmed.ncbi.nlm.nih.gov/29618085/',
desc: 'J Clin Endocrinol Metab. Free-T calculation and assay comparison.',
},
],
},
{
title: 'Transmasculine testosterone: dosage forms',
references: [
{
name: 'Swerdloff et al., 2020 — Oral testosterone undecanoate',
href: 'https://pubmed.ncbi.nlm.nih.gov/32382745/',
desc: 'J Clin Endocrinol Metab. PK of a self-emulsifying oral TU formulation.',
},
{
name: 'Yin et al., 2012 — Oral testosterone undecanoate PK',
href: 'https://pubmed.ncbi.nlm.nih.gov/21474786/',
desc: 'J Androl. Re-examined oral TU pharmacokinetics.',
},
{
name: 'Rogol et al., 2016 — Testosterone nasal gel',
href: 'https://pubmed.ncbi.nlm.nih.gov/26695758/',
desc: 'Andrology. PK of a nasal testosterone gel.',
},
{
name: 'Handelsman et al., 1990 — Testosterone pellets',
href: 'https://pubmed.ncbi.nlm.nih.gov/2115044/',
desc: 'J Clin Endocrinol Metab. Pellet PK and androgen response.',
},
{
name: 'McCullough et al., 2014 — Testosterone pellet review',
href: 'https://pubmed.ncbi.nlm.nih.gov/25999802/',
desc: 'Curr Sex Health Rep. Pellet dosing and duration context.',
},
{
name: 'Figueiredo et al., 2022 — Subcutaneous testosterone injections',
href: 'https://pubmed.ncbi.nlm.nih.gov/34698352/',
desc: 'J Clin Endocrinol Metab. SC injection PK and practicality.',
},
{
name: 'Turner et al., 2019 — Subcutaneous testosterone undecanoate',
href: 'https://pubmed.ncbi.nlm.nih.gov/31384715/',
desc: 'J Endocr Soc. SC TU PK and acceptability.',
},
{
name: 'Mazer et al., 2005 — Testosterone patch vs gel',
href: 'https://pubmed.ncbi.nlm.nih.gov/16422889/',
desc: 'J Sex Med. Steady-state PK and variability by route.',
},
{
name: 'Swerdloff et al., 2000 — Long-term transdermal testosterone gel',
href: 'https://pubmed.ncbi.nlm.nih.gov/11134099/',
desc: 'J Clin Endocrinol Metab. Long-term testosterone gel PK.',
},
{
name: 'Marbury et al., 2003 — Testim vs AndroGel',
href: 'https://pubmed.ncbi.nlm.nih.gov/12673669/',
desc: 'Biopharm Drug Dispos. Comparative topical testosterone gel PK.',
},
],
},
{
title: 'Transmasculine testosterone: safety and context',
references: [
{
name: 'da Silva et al., 2024 — Uterine changes on testosterone',
href: 'https://pubmed.ncbi.nlm.nih.gov/39049785/',
desc: 'Eur J Endocrinol. Uterine effects of testosterone therapy.',
},
{
name: 'Canbolat et al., 2026 — Uterine and ovarian histopathology',
href: 'https://pubmed.ncbi.nlm.nih.gov/42796076/',
desc: 'J Clin Med. Histopathological effects of testosterone therapy.',
},
{
name: 'Barrera et al., 2023 — Testosterone concerns after hysterectomy',
href: 'https://pubmed.ncbi.nlm.nih.gov/35850361/',
desc: 'J Pediatr Adolesc Gynecol. T management after hysterectomy and oophorectomy.',
},
{
name: 'Reilly et al., 2019 — Knowledge gaps in gender-affirming surgery',
href: 'https://pubmed.ncbi.nlm.nih.gov/31503150/',
desc: 'Obstet Gynecol. Evidence gaps around hysterectomy and oophorectomy.',
},
{
name: 'Light et al., 2014 — Pregnancy after transition',
href: 'https://pubmed.ncbi.nlm.nih.gov/25415163/',
desc: 'Obstet Gynecol. Pregnancy and fertility after testosterone exposure.',
},
{
name: 'Barrero et al., 2023 — Fertility preservation on testosterone',
href: 'https://pubmed.ncbi.nlm.nih.gov/37810944/',
desc: 'Transgend Health. Oocyte retrieval during and after testosterone.',
},
{
name: 'Nackeeran et al., 2022 — Testosterone route and hematocrit',
href: 'https://pubmed.ncbi.nlm.nih.gov/34445892/',
desc: 'J Urol. Route-specific hematocrit changes.',
},
{
name: 'Madsen et al., 2021 — Erythrocytosis in trans men',
href: 'https://pubmed.ncbi.nlm.nih.gov/33599731/',
desc: 'J Clin Endocrinol Metab. Long-term hematocrit risk.',
},
{
name: 'Okano et al., 2025 — Testosterone formulations and hematocrit',
href: 'https://pubmed.ncbi.nlm.nih.gov/39011565/',
desc: 'Andrology. Systematic review of formulation effects on hematocrit.',
},
{
name: 'Okano et al., 2025 — 100 mg testosterone cypionate and erythrocytosis',
href: 'https://pubmed.ncbi.nlm.nih.gov/41052128/',
desc: 'J Sex Med. Randomized pilot on dose and erythrocytosis.',
},
{
name: 'Nimitpanya et al., 2026 — Body fat and composition on testosterone',
href: 'https://pubmed.ncbi.nlm.nih.gov/42170522/',
desc: 'Transgend Health. Short-term body-composition changes.',
},
{
name: 'Lundberg et al., 2024 — Fat, muscle, and cardiometabolic changes',
href: 'https://pubmed.ncbi.nlm.nih.gov/39604308/',
desc: 'J Intern Med. Five-year body-composition context.',
},
{
name: 'Dela Cruz et al., 2023 — Mouse model of pubertal suppression and T',
href: 'https://pubmed.ncbi.nlm.nih.gov/36484619/',
desc: 'Hum Reprod. Preclinical model for transmasculine treatment.',
},
{
name: "T'Sjoen et al., 2019 — Endocrinology of transgender medicine",
href: 'https://pubmed.ncbi.nlm.nih.gov/30307546/',
desc: 'Endocr Rev. Clinical endocrinology and treatment context.',
},
{
name: 'Costa et al., 2018 — Testosterone recommendations for trans men',
href: 'https://pubmed.ncbi.nlm.nih.gov/29913543/',
desc: 'Rev Bras Ginecol Obstet. Brazilian clinical recommendations.',
},
{
name: 'Spanos et al., 2020 — Insulin resistance and body composition',
href: 'https://pubmed.ncbi.nlm.nih.gov/32180895/',
desc: 'World J Diabetes. Metabolic effects of gender-affirming hormone therapy.',
},
{
name: 'Ford et al., 2022 — Body composition and bone health',
href: 'https://pubmed.ncbi.nlm.nih.gov/35509260/',
desc: 'J Hum Nutr Diet. Body-composition and bone outcomes.',
},
{
name: 'Carbonnel et al., 2021 — The uterus in transgender men',
href: 'https://pubmed.ncbi.nlm.nih.gov/34364678/',
desc: 'Fertil Steril. Uterine effects and gynecologic care.',
},
{
name: 'Cheung et al., 2024 — Physical performance on GAHT',
href: 'https://pubmed.ncbi.nlm.nih.gov/37437247/',
desc: 'J Clin Endocrinol Metab. Performance and body-composition context.',
},
{
name: 'Iannantuoni et al., 2021 — Inflammation and leukocyte-endothelium',
href: 'https://pubmed.ncbi.nlm.nih.gov/33032814/',
desc: 'Fertil Steril. Vascular and inflammatory effects of testosterone.',
},
],
},
{
title: 'HPG axis, anti-androgens, and suppression',
references: [
{
name: 'Misakian et al., 2025 — Injectable estradiol monotherapy',
href: 'https://pubmed.ncbi.nlm.nih.gov/40639470/',
desc: 'Endocr Pract. Estradiol monotherapy suppression of endogenous testosterone.',
},
{
name: 'Cortez et al., 2023 — TREAT study protocol',
href: 'https://pubmed.ncbi.nlm.nih.gov/38133914/',
desc: 'JMIR Res Protoc. Estradiol regimen comparison and safety.',
},
{
name: 'Collet et al., 2023 — Testosterone and adrenal androgens after gonadectomy',
href: 'https://pubmed.ncbi.nlm.nih.gov/36201493/',
desc: 'J Clin Endocrinol Metab. Androgen changes with and without gonadectomy.',
},
{
name: 'Hümpel et al., 1977 — Cyproterone acetate bioavailability',
href: 'https://pubmed.ncbi.nlm.nih.gov/880829/',
desc: 'Contraception. Oral cyproterone acetate pharmacokinetics.',
},
{
name: 'Lee et al., 2009 — Bicalutamide pharmacokinetics',
href: 'https://pubmed.ncbi.nlm.nih.gov/20110037/',
desc: 'Clin Ther. Bicalutamide formulation pharmacokinetics.',
},
{
name: 'Overdiek et al., 1985 — Spironolactone pharmacokinetics',
href: 'https://pubmed.ncbi.nlm.nih.gov/4042530/',
desc: 'Clin Pharmacol Ther. Spironolactone pharmacokinetics.',
},
{
name: 'Zhou et al., 1998 — Medroxyprogesterone acetate pharmacokinetics',
href: 'https://pubmed.ncbi.nlm.nih.gov/9693401/',
desc: 'Contraception. MPA pharmacokinetics after injection.',
},
{
name: 'Sennello et al., 1986 — Leuprolide pharmacokinetics',
href: 'https://pubmed.ncbi.nlm.nih.gov/3083092/',
desc: 'J Pharm Sci. IV and subcutaneous leuprolide pharmacokinetics.',
},
{
name: 'Bouchot et al., 1998 — Triptorelin pharmacokinetics and pharmacodynamics',
href: 'https://pubmed.ncbi.nlm.nih.gov/9701702/',
desc: 'Horm Res. Three-month triptorelin pharmacokinetics and pharmacodynamics.',
},
],
},
{
title: 'Monitoring, assays, and population PK',
references: [
{
name: "O'Connell et al., 2022 — Cardiometabolic outcomes in trans youth",
href: 'https://pubmed.ncbi.nlm.nih.gov/36221797/',
desc: 'J Clin Endocrinol Metab. Cardiometabolic monitoring context.',
},
{
name: 'Hamidi et al., 2019 — Transfeminine hormone therapy',
href: 'https://pubmed.ncbi.nlm.nih.gov/31027544/',
desc: 'Endocrinol Metab Clin North Am. Clinical transfeminine care.',
},
{
name: 'Defreyne et al., 2019 — Transmasculine hormone therapy',
href: 'https://pubmed.ncbi.nlm.nih.gov/31027545/',
desc: 'Endocrinol Metab Clin North Am. Clinical transmasculine care.',
},
{
name: 'Alotaibi et al., 2026 — Metoprolol PK on gender-affirming therapy',
href: 'https://pubmed.ncbi.nlm.nih.gov/42878231/',
desc: 'Xenobiotica. Drug-PK interaction context for GAHT.',
},
{
name: 'Pouw et al., 2024 — Laboratory monitoring of GAHT',
href: 'https://pubmed.ncbi.nlm.nih.gov/38452266/',
desc: 'J Appl Lab Med. Monitoring and assay practice.',
},
],
},
{
title: 'Labels and guidelines',
references: [
{
name: 'WPATH Standards of Care, version 8',
href: 'https://doi.org/10.1080/26895269.2022.2100644',
desc: 'Treatment and monitoring framework for gender-affirming care.',
},
{
name: 'Endocrine Society guideline, 2017',
href: 'https://doi.org/10.1210/jc.2017-01658',
desc: 'Endocrine treatment of gender-dysphoric and gender-incongruent persons.',
},
{
name: 'UCSF Gender Affirming Health Program',
href: 'https://transcare.ucsf.edu/guidelines',
desc: 'Masculinizing and feminizing hormone therapy guidance.',
},
{
name: 'Drug labels and prescribing information',
href: 'https://github.com/xunxunProjects/Oyama-s-HRT-Tracker/blob/main/Algorithm%20Explanation.md',
desc: 'EstroGel, Divigel, Climara, Vivelle-Dot, AndroGel, Angeliq, Xyosted, Aveed, Azmiro, Nebido, and Androcur/Dianette.',
},
],
},
];

export const PK_REFERENCE_COUNT = PK_REFERENCE_GROUPS.reduce(
(total, group) => total + group.references.length,
0,
);
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