Testosterone Deficiency - Establishing A Biochemical Diagnosis.
Testosterone deficiency is a common and often unrecognized disorder impacting the lives of many men. Symptoms related to low testosterone are relatively non-specific and clinicians must therefore ensure that a patients' symptomatology is supported by a biochemical profile suggestive of testosterone deficiency. There are many options available to determine a patient's testosterone level and laboratories will vary in the type of biochemical assessment they provide. In assessing patients with suspected low testosterone, the presence of symptoms and a low total testosterone is usually sufficient to initiate therapy. In equivocal cases, measurement of free or bioavailable testosterone with a reliable assay can further clarify the clinical picture. By understanding the differences between total, free and bioavailable testosterone, and the accuracy and reliability of their measurement, clinicians can better interpret their patients' biochemical testosterone profile.
Department of Surgery, Division of Urology, Mount Sinai & Women's College Hospital , Toronto, Ontario, Canada.
Yonah
Y
Krakowsky
Department of Surgery, Division of Urology, Mount Sinai & Women's College Hospital , Toronto, Ontario, Canada.
Ethan D
ED
Grober
Clin Chem. 2006 Sep;52(9):1777-84
16793931
Can J Urol. 2012 Jun;19(3):6314-8
22704323
Clin Endocrinol (Oxf). 2000 Dec;53(6):703-11
11155092
Clin Endocrinol (Oxf). 2010 Aug;73(2):243-8
20050857
J Androl. 1994 May-Jun;15(3):212-5
7928661
Aging Male. 2004 Sep;7(3):211-8
15669540
Aging Male. 2009 Mar;12(1):21-8
19326293
Horm Res. 1996;45(3-5):148-55
8964574
Metabolism. 2000 Sep;49(9):1239-42
11016912
Steroids. 2003 Dec;68(14):1173-8
14643879
J Endocrinol Invest. 2005;28(3 Suppl):14-22
16042355
J Clin Endocrinol Metab. 2004 Feb;89(2):534-43
14764758
Clin Endocrinol (Oxf). 2003 Jun;58(6):710-7
12780747
Curr Mol Med. 2008 Dec;8(8):816-28
19075678
J Sex Med. 2010 Apr;7(4 Pt 2):1627-56
20388162
Aging Male. 2013 Dec;16(4):164-8
24090209
J Clin Endocrinol Metab. 1999 Oct;84(10):3666-72
10523012
J Urol. 2010 Jun;183(6):2294-9
20400148
J Sex Med. 2010 May;7(5):1948-53
19732301
J Clin Endocrinol Metab. 2010 Jun;95(6):2560-75
20525906
Clin Biochem. 2006 Feb;39(2):97-108
16376328
Maturitas. 2006 Mar 20;53(4):424-9
16140484
Best Pract Res Clin Endocrinol Metab. 2011 Apr;25(2):303-19
21397200
Int J Clin Pract. 2006 Jul;60(7):762-9
16846397
J Clin Endocrinol Metab. 2007 Sep;92(9):3599-603
17595245
J Clin Endocrinol Metab. 1983 Jun;56(6):1278-81
6841562