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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Free Testosterone - Harmonize diagnostic efforts in steroid hormonology
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<blockquote data-quote="madman" data-source="post: 250962" data-attributes="member: 13851"><p><strong>BIOCHEMICAL ASSESSMENT OF MALE ANDROLOGICAL STATUS USING SEX HORMONE-BINDING GLOBULIN AND TOTAL AND FREE TESTOSTERONE IN EUROPEAN CLINICAL LABORATORIES</strong></p><p><em>N. Narinx, K. David, Walravens, G. Snaterse, P. Vermeersch, T. Fiers, B. Lapauw,D. Vanderschueren,L. Antonio</em></p><p></p><p>1 Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Belgium</p><p>2 Department of Laboratory Medicine, University Hospitals Leuven, Belgium</p><p>3 Department of Endocrinology, University Hospitals Leuven, Belgium</p><p>4 Department of Internal Medicine and Pediatrics, Ghent University, Belgium</p><p>5 Department of Laboratory Medicine, Ghent University Hospital, Belgium</p><p>6 Department of Endocrinology, Ghent University Hospital, Belgium</p><p></p><p></p><p><strong>Background</strong></p><p></p><p><em>Male hypogonadism (HG) manifests by one or more signs of androgen deficiency. However, prior to starting testosterone replacement therapy (TRT) in patients with HG, biochemical confirmation of deficient gonadal production of testosterone (T) is necessary.<strong> Despite the recommendation in clinical practice guidelines of assessing circulating total T levels, to date there is no agreement on differentiating low from normal circulating total T. Several studies have demonstrated the potential added value of free T in the context of HG. The</strong> <strong>Endocrine Society (ES) suggests adding free T as an extra biochemical marker when total T is near the lower limit of normal or in men that have condition-altering sex hormone-binding globulin (SHBG) concentrations.</strong></em></p><p><em></em></p><p><em>Surveys conducted in clinical laboratories in the United States of America, the United Kingdom, and the Republic of Ireland uncovered that inconsistencies exist between guidelines on HG and clinical practice. <strong>These studies highlighted a high variability in the methodology of biochemical assessment of male andrological status. Different assay types for total and free T are used, lacking standardization and harmonization between laboratories, resulting in divergent reference values for total and free T. </strong>As the diagnosis of HG and prescription of TRT is highly dependent on biochemical assessment, and TRT is not without risk of adverse events, <strong>harmonization of laboratory practice concerning total and free T is strongly recommended.</strong></em></p><p></p><p></p><p><strong>Objective</strong></p><p></p><p><em><strong>The purpose of our study is to map the diagnostic landscape concerning methodology on biochemical assessment of male andrological status (total T, free T, and SHBG) throughout Europe.</strong></em></p><p></p><p></p><p><strong>Methods</strong></p><p></p><p><em>A web-based survey has been issued to European clinical laboratories via several platforms (including the RBSLM). <strong>The survey contains questions on patient sampling, analytical methodology, reference ranges, and post-analytical phase of SHBG and total, free, and bioavailable T.</strong> Distribution of the survey started on the 1st of September 2022. </em></p><p></p><p></p><p><strong>Results</strong></p><p></p><p><em><strong>As the survey has only just been launched, results are not available at the time of abstract submission. Responses are expected to come in through the course of September and October. By November we will have collected and analyzed preliminary data to present at the RBSLM annual meeting.</strong></em></p></blockquote><p></p>
[QUOTE="madman, post: 250962, member: 13851"] [B]BIOCHEMICAL ASSESSMENT OF MALE ANDROLOGICAL STATUS USING SEX HORMONE-BINDING GLOBULIN AND TOTAL AND FREE TESTOSTERONE IN EUROPEAN CLINICAL LABORATORIES[/B] [I]N. Narinx, K. David, Walravens, G. Snaterse, P. Vermeersch, T. Fiers, B. Lapauw,D. Vanderschueren,L. Antonio[/I] 1 Laboratory of Clinical and Experimental Endocrinology, Department of Chronic Diseases and Metabolism, KU Leuven, Belgium 2 Department of Laboratory Medicine, University Hospitals Leuven, Belgium 3 Department of Endocrinology, University Hospitals Leuven, Belgium 4 Department of Internal Medicine and Pediatrics, Ghent University, Belgium 5 Department of Laboratory Medicine, Ghent University Hospital, Belgium 6 Department of Endocrinology, Ghent University Hospital, Belgium [B]Background[/B] [I]Male hypogonadism (HG) manifests by one or more signs of androgen deficiency. However, prior to starting testosterone replacement therapy (TRT) in patients with HG, biochemical confirmation of deficient gonadal production of testosterone (T) is necessary.[B] Despite the recommendation in clinical practice guidelines of assessing circulating total T levels, to date there is no agreement on differentiating low from normal circulating total T. Several studies have demonstrated the potential added value of free T in the context of HG. The[/B] [B]Endocrine Society (ES) suggests adding free T as an extra biochemical marker when total T is near the lower limit of normal or in men that have condition-altering sex hormone-binding globulin (SHBG) concentrations.[/B] Surveys conducted in clinical laboratories in the United States of America, the United Kingdom, and the Republic of Ireland uncovered that inconsistencies exist between guidelines on HG and clinical practice. [B]These studies highlighted a high variability in the methodology of biochemical assessment of male andrological status. Different assay types for total and free T are used, lacking standardization and harmonization between laboratories, resulting in divergent reference values for total and free T. [/B]As the diagnosis of HG and prescription of TRT is highly dependent on biochemical assessment, and TRT is not without risk of adverse events, [B]harmonization of laboratory practice concerning total and free T is strongly recommended.[/B][/I] [B]Objective[/B] [I][B]The purpose of our study is to map the diagnostic landscape concerning methodology on biochemical assessment of male andrological status (total T, free T, and SHBG) throughout Europe.[/B][/I] [B]Methods[/B] [I]A web-based survey has been issued to European clinical laboratories via several platforms (including the RBSLM). [B]The survey contains questions on patient sampling, analytical methodology, reference ranges, and post-analytical phase of SHBG and total, free, and bioavailable T.[/B] Distribution of the survey started on the 1st of September 2022. [/I] [B]Results[/B] [I][B]As the survey has only just been launched, results are not available at the time of abstract submission. Responses are expected to come in through the course of September and October. By November we will have collected and analyzed preliminary data to present at the RBSLM annual meeting.[/B][/I] [/QUOTE]
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Testosterone Replacement, Low T, HCG, & Beyond
Testosterone and Men's Health Articles
Free Testosterone - Harmonize diagnostic efforts in steroid hormonology
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