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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Endocrinology & Clinical Biochemistry joint statement on male hypogonadism
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<blockquote data-quote="madman" data-source="post: 257732" data-attributes="member: 13851"><p><em><strong>Future directions for harmonizing testosterone reference ranges in UK labs to minimize variation among clinicians and centers, making treatment thresholds more robust.</strong> Method-specific reference ranges using LC-MS/MS, like cortisol cut-offs in the cosyntropin test, may help, but resource limitations hinder implementation. The role of age-specific reference ranges and cut-off values for obese and non-obese men remains uncertain. Follow current guidance until more data is available.</em></p><p></p><p></p><p></p><p></p><p><strong>Key take-home points:</strong></p><ul> <li data-xf-list-type="ul"><em>Total testosterone levels should be tested in men with symptoms of adult male hypogonadism using morning, fasting blood samples when not acutely ill</em></li> <li data-xf-list-type="ul"><em>Testosterone levels vary during the day, with higher levels in the morning and lower levels in the afternoon</em></li> <li data-xf-list-type="ul"><em>Nightshift workers have different testosterone patterns due to their sleep schedules</em></li> <li data-xf-list-type="ul"><em>Testosterone levels drop during acute illness, so testing is not recommended during that time</em></li> <li data-xf-list-type="ul"><em>A total testosterone value <8 nmol/L with suggestive symptoms indicates hypogonadism and may benefit from treatment</em></li> <li data-xf-list-type="ul"><em>Total testosterone >12 nmol/L is unlikely to represent hypogonadism, except in specific cases</em></li> <li data-xf-list-type="ul"><em><em>Calculated free testosterone is not diagnostically useful beyond total testosterone when SHBG is within the reference range</em></em></li> <li data-xf-list-type="ul"><em><em>Checking SHBG is recommended in men with conditions that may cause abnormal SHBG levels and in those with borderline total testosterone</em></em></li> <li data-xf-list-type="ul"><strong><em><strong>Direct measurement of free testosterone using equilibrium dialysis followed by MS is the recommended reference method</strong></em></strong></li> <li data-xf-list-type="ul"><em>This method is not available in routine clinical practice in the UK</em></li> <li data-xf-list-type="ul"><strong><em><strong>Other direct measurement methods are inaccurate and not recommended</strong></em></strong></li> </ul></blockquote><p></p>
[QUOTE="madman, post: 257732, member: 13851"] [I][B]Future directions for harmonizing testosterone reference ranges in UK labs to minimize variation among clinicians and centers, making treatment thresholds more robust.[/B] Method-specific reference ranges using LC-MS/MS, like cortisol cut-offs in the cosyntropin test, may help, but resource limitations hinder implementation. The role of age-specific reference ranges and cut-off values for obese and non-obese men remains uncertain. Follow current guidance until more data is available.[/I] [B]Key take-home points:[/B] [LIST] [*][I]Total testosterone levels should be tested in men with symptoms of adult male hypogonadism using morning, fasting blood samples when not acutely ill[/I] [*][I]Testosterone levels vary during the day, with higher levels in the morning and lower levels in the afternoon[/I] [*][I]Nightshift workers have different testosterone patterns due to their sleep schedules[/I] [*][I]Testosterone levels drop during acute illness, so testing is not recommended during that time[/I] [*][I]A total testosterone value <8 nmol/L with suggestive symptoms indicates hypogonadism and may benefit from treatment[/I] [*][I]Total testosterone >12 nmol/L is unlikely to represent hypogonadism, except in specific cases[/I] [*][I][I]Calculated free testosterone is not diagnostically useful beyond total testosterone when SHBG is within the reference range[/I][/I] [*][I][I]Checking SHBG is recommended in men with conditions that may cause abnormal SHBG levels and in those with borderline total testosterone[/I][/I] [*][B][I][B]Direct measurement of free testosterone using equilibrium dialysis followed by MS is the recommended reference method[/B][/I][/B] [*][I]This method is not available in routine clinical practice in the UK[/I] [*][B][I][B]Other direct measurement methods are inaccurate and not recommended[/B][/I][/B] [/LIST] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Endocrinology & Clinical Biochemistry joint statement on male hypogonadism
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