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Suggest Treatment For Low Testosterone Level
Question: I have low testosterone 206
What can be done about it
What tests are there to check my pituitary glands
What can be done about it
What tests are there to check my pituitary glands
Brief Answer:
Low T
Detailed Answer:
The diagnosis of low testosterone can be challenging.
This matter is best managed by an endocrinologist who performs a thorough in-person examination.
Testosterone levels are best checked in the morning before 9 am. Fasting is not necessary. Checking later in the day gives lower values as testosterone concentrations fall during the course of the day, even in normal individuals.
If testosterone levels are below 300 then it is advisable to recheck a week later to confirm that this is truly the case. The second time it is generally recommended to test
FSH
LH
CBC
CMP
PSA
Lipids
and if the FSH and LH are not elevated above upper limit of normal then
Prolactin and
Ferritin
8 am cortisol
TSH
Free T4
are generally ordered.
If FSH and LH are high then a KARYOTYPE is done.
If the testosterone is below 150 or if they are complaints like headache, visual disturbances or nausea/vomiting then an MRI of the pituitary is recommended.
Free testosterone is a better test than total testosterone. It must be performed with the ideal method which is called 'Equilibrium Dialysis'. The two reputed national laboratories use this method.
If this cannot be achieved then Free testosterone can be indirectly estimated using 2 tests
Albumin (which is part of the CMP) and
SHBG (Sex Hormone Binding Globulin)
Free online calculators are available to make this determination
Low T
Detailed Answer:
The diagnosis of low testosterone can be challenging.
This matter is best managed by an endocrinologist who performs a thorough in-person examination.
Testosterone levels are best checked in the morning before 9 am. Fasting is not necessary. Checking later in the day gives lower values as testosterone concentrations fall during the course of the day, even in normal individuals.
If testosterone levels are below 300 then it is advisable to recheck a week later to confirm that this is truly the case. The second time it is generally recommended to test
FSH
LH
CBC
CMP
PSA
Lipids
and if the FSH and LH are not elevated above upper limit of normal then
Prolactin and
Ferritin
8 am cortisol
TSH
Free T4
are generally ordered.
If FSH and LH are high then a KARYOTYPE is done.
If the testosterone is below 150 or if they are complaints like headache, visual disturbances or nausea/vomiting then an MRI of the pituitary is recommended.
Free testosterone is a better test than total testosterone. It must be performed with the ideal method which is called 'Equilibrium Dialysis'. The two reputed national laboratories use this method.
If this cannot be achieved then Free testosterone can be indirectly estimated using 2 tests
Albumin (which is part of the CMP) and
SHBG (Sex Hormone Binding Globulin)
Free online calculators are available to make this determination
Note: For more information on hormonal imbalance symptoms or unmanaged diabetes with other comorbid conditions, get back to us & Consult with an Endocrinologist. Click here to book an appointment.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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