What is HYPOGONADISM and How is it Diagnosed?

Male hypogonadism is a clinical condition in which the testes do not produce androgen (testosterone).  In order to diagnose hypogonadsim, a male should be experiencing (1) symptoms associated with a deficiency, as well as (2) have a laboratory finding of serum testosterone below accepted levels. [i]

Symptoms and Signs of Hypogonadism:  Suggestive symptoms of low T include, but are not limited to:

  • Low libido;
  • Erectile dysfunction;
  • Decreased muscle mass and/or strength;
  • Increased body fat;
  • Decreased bone density;
  • Loss of energy/fatigue;
  • Sleep problems;
  • Depression[ii]

The problem with associating these symptoms with low T is that many of these symptoms occur in other conditions or are physiologically associated with the aging process itself.  Accordingly, these symptoms should be corroborated with a laboratory diagnosis of low T.

Laboratory Diagnosis:  According to the Mayo Clinic, a normal reference range of total T levels in adult men over the age of 19 years is 240-950 ng/dl.[iii] Male hypogonadism results from low secretion of T and is generally characterized as concentrations of total T below 240 ng/dl (< 240 ng/dl).  However, laboratory testing of T levels can have reliability issues and can vary wildly based upon a subject’s pre-test activities.  T levels are subject to variation, which can lead to misclassification. Exercise, diet, illness, certain medications, and even the time of day can all have an influence on T levels.  In fact, research has shown that T levels can vary considerably between morning and afternoon as much as an average of 50%[iv],[v]So for example, if a man had his T levels checked in the morning, when they are generally the highest, and had levels of 450 ng/dl, which is well within the normal range, it is entirely possible that his T levels could experience a normal drop to below 225 ng/dl later in the afternoon, falsely indicating he has hypogonadmism.  As such, T levels are a relatively crude guideline and should not be used alone in diagnosing and treating hypogonadmism. Rather, in addition to low T levels, men should have clinical symptoms mentioned above.

Feel free to reach out to any of the attorneys in our office for more information on testosterone therapy and its link to serious cardiac injuries by calling 888-888-2110 today.

 

[i]American Society for Reproductive Medicine, 2008;90:S83–7, “Androgen deficiency in the aging male.”

[ii]Geriatrics. 2007 Sep; 62(9):15-8, “Review Testosterone replacement in elderly men”

[iv]J Clin Endocrinol Metab. Mar 2009; 94(3): 907–913, “The Effect of Diurnal Variation on Clinical Measurement of Serum Testosterone and Other Sex Hormone Levels in Men”

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