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Abstract:  Clinicians are confronted daily with patients whose symptoms suggest low levels of sex hormones such as testosterone. Testosterone deficiency may result from a variety of conditions from pituitary tumor to age-related decline in testosterone production (andropause). Diagnosis of low testosterone may be complicated by obesity, depression, diabetes and other chronic diseases, certain medications, and other factors. A range of both serum and saliva tests are available to test testosterone levels, but the best laboratory method for confirming testosterone deficiency is controversial. The results of saliva testing, if performed correctly, have been shown to correlate well with those of serum testing. Despite its greater comfort and convenience and lower cost, however, saliva testing has not yet been accepted into mainstream medicine. Measuring testosterone level is complicated by the fact that hormone release is cyclical and is influenced by many factors, including stress, age, and time of day. Which test result(s) best represents a patient’s true testosterone status has not been resolved. Furthermore, research has shown that sex hormone levels do not correlate well with symptoms. The clinician should rely on both clinical assessment and laboratory data to identify the “normal” testosterone level for each individual, using a concept the author describes as “relative hypogonadism” to determine which patients require testosterone supplementation.

Related Keywords: Robert S. Tan, MD, MBA, AGSF, testosterone, hormone levels, andropause, androgen status, saliva testing, serum testing, hypogonadism, hormone deficiency, men

Related Categories: HRT

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