The 28-year-old male patient presented with acute-onset vertigo, nausea, vomiting, and unsteady gait. The patient reported abusing testosterone and ********** for at least 6 years. He stated that he self-administered 325mg of testosterone every other day in addition to using an unspecified amount of **********. According to the study authors, magnetic resonance imaging of the patient's brain showed “small acute infarcts involving the left cerebellum and brainstem and was suggestive of an embolic pattern.” Laboratory findings revealed a total testosterone level of 2626ng/dL, a calculated free testosterone level of 5104pmol/L, and an estradiol level of 22.3pg/mL. Additional testing found elevated LDL and total cholesterol (TC) levels in addition to a low HDL level (LDL: 186mg/dL; TC: 225mg/dL; HDL: 18mg/dL). The patient's triglyceride level was normal (104 mg/dL). The patient was initiated on atorvastatin 80mg daily and was counseled on the discontinuation of exogenous testosterone.
