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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Adult Male Hypogonadism: Diagnosis and Management
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<blockquote data-quote="madman" data-source="post: 271415" data-attributes="member: 13851"><p><strong>7. Key Take-Home Points in the Interpretation of Serum Total Testosterone Levels(Based on the Recent SfE/ACB Joint Statement [56,86])</strong></p><p></p><p></p><p><em><strong>• Patients are likely to have hypogonadism if they have suggestive clinical findings, two consecutive (>2 weeks apart) morning (<11:00 a.m.) levels of <8 nmol/L (albeit cross-referenced with local assay bias). T levels > 12 nmol/L make a diagnosis of hypogonadism unlikely (including one level > 12 nmol/L even if the other results are lower). Morning fasting levels in the 8–12 nmol/L range may occur in eugonadal or hypogonadal subjects and thus require further clinical assessment/investigation.</strong></em></p><p><em><strong></strong></em></p><p><em><strong>• T measurements during an acute illness after 11 a.m. are not reliable for diagnosing male hypogonadism. Note that laboratory method bias can affect T results, as can those with an altered circadian rhythm (e.g., night workers).</strong></em></p><p><em><strong></strong></em></p><p><em><strong>• The estimation of free testosterone (<a href="http://www.issam.ch/freetesto.htm;" target="_blank">http://www.issam.ch/freetesto.htm;</a> accessed on 10 November 2023) is helpful in those with SHBG levels above and below the reference range, as it may help identify or exclude hypogonadism even when testosterone levels are ‘normal’ or low, respectively.</strong></em></p><p><em><strong></strong></em></p><p><em><strong>• A low T level measured in a morning sample (<11 a.m.) requires serum prolactin, LH, and FSH measurement to rule out secondary hypogonadism and SHBG measurement (to aid in the interpretation of the T levels, including the estimation of free testosterone). These additional tests, if measured, help to inform decisions concerning the management of potential hypogonadism.</strong></em></p><p><em><strong></strong></em></p><p><em><strong>• The prescription and monitoring of TRT in hypogonadal men, in line with the prevailing clinical guidelines, is the responsibility of the clinicians caring for the patient. When appropriately prescribed, TRT can be associated with great benefits in terms of both quality of life and longer-term health outcomes.</strong></em></p></blockquote><p></p>
[QUOTE="madman, post: 271415, member: 13851"] [B]7. Key Take-Home Points in the Interpretation of Serum Total Testosterone Levels(Based on the Recent SfE/ACB Joint Statement [56,86])[/B] [I][B]• Patients are likely to have hypogonadism if they have suggestive clinical findings, two consecutive (>2 weeks apart) morning (<11:00 a.m.) levels of <8 nmol/L (albeit cross-referenced with local assay bias). T levels > 12 nmol/L make a diagnosis of hypogonadism unlikely (including one level > 12 nmol/L even if the other results are lower). Morning fasting levels in the 8–12 nmol/L range may occur in eugonadal or hypogonadal subjects and thus require further clinical assessment/investigation. • T measurements during an acute illness after 11 a.m. are not reliable for diagnosing male hypogonadism. Note that laboratory method bias can affect T results, as can those with an altered circadian rhythm (e.g., night workers). • The estimation of free testosterone ([URL]http://www.issam.ch/freetesto.htm;[/URL] accessed on 10 November 2023) is helpful in those with SHBG levels above and below the reference range, as it may help identify or exclude hypogonadism even when testosterone levels are ‘normal’ or low, respectively. • A low T level measured in a morning sample (<11 a.m.) requires serum prolactin, LH, and FSH measurement to rule out secondary hypogonadism and SHBG measurement (to aid in the interpretation of the T levels, including the estimation of free testosterone). These additional tests, if measured, help to inform decisions concerning the management of potential hypogonadism. • The prescription and monitoring of TRT in hypogonadal men, in line with the prevailing clinical guidelines, is the responsibility of the clinicians caring for the patient. When appropriately prescribed, TRT can be associated with great benefits in terms of both quality of life and longer-term health outcomes.[/B][/I] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Adult Male Hypogonadism: Diagnosis and Management
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