By switaschek, 19 July, 2020 If s/sx of hypopituitarism, abnl sella on imaging √ other pituitary hormones3
By switaschek, 19 July, 2020 If pt has multiple low total/free T levels, √ LH (+/- FSH); if LH/FSH low/NL, √ prolactin,2,3 iron sat3
By switaschek, 19 July, 2020 Confirm initial low total T w/ 2nd test; 30% of men w/ initially low T will have NL level on repeat; if pt has condition that alters SHBG or initial borderline zone level, √ free T on repeat3
By switaschek, 19 July, 2020 Test early AM total T;2,3 add free T for pts w/ conditions that alter SHBG (eg, obesity, DM, HIV, etc); avoid testing if recent acute illness or certain short-term meds (eg, opioids, glucocorticoids)3
By switaschek, 19 July, 2020 Consider testing in pts w/ s/sx of hypogonadism, select others;2 don’t screen general population3
By switaschek, 17 July, 2020 Gradual decline in T level starts in mid 30s low T affects 20 of men 60 yo 1 dx requires s sx and 2 low levels eval for other causes of low T before considering testosterone replacement tx TRT 2