Diagnosing Low Testosterone

Dr. Loren Grossman, MD, FRCPC, FACP, Endocrinologist, goes over what tests need to be done in order to diagnose low testosterone accurately.

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Dr. Loren Grossman, MD, FRCPC, FACP, Endocrinologist, goes over what tests need to be done in order to diagnose low testosterone accurately.
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Featuring Dr. Loren Grossman, MD, FRCPC, FACP, Endocrinologist

Duration: 1 minute, 57 seconds

So if men are concerned about having a low testosterone, then there are a number of tests that can be done to check for that. They can have blood tests done. It’s important that the tests are done early in the morning, because testosterone does exhibit a circadian rhythm, and higher levels are in the morning.

So they need to go to their lab as soon as the lab opens—6, 7 o’clock to have the blood test done. Later in the afternoon is not sufficient, because levels will drop off, and the normal range that is shown on the lab result is based on an early morning sample.

Other testing to be done as well to help confirm the diagnosis and look for potential causes. Total testosterone by itself is not sufficient to diagnose low testosterone, because testosterone circulates in the blood, bound to other proteins like sex hormone binding globulin and albumin.

So it’s important to measure what’s truly available to the tissues, and that would include a free testosterone, and most importantly, a bioavailable testosterone. As well we need to look at other hormones that control testosterone, so we also need to test for the LH and the FSH, which are the pituitary control hormones, as well as other potential causes of dysfunction, including an estradiol, a prolactin, thyroid function with the TSH, as well as at least the ferritin to look at iron stores and ensure that elevated iron stores are not a cause for anything that may show up in these lab results. And that’s a good general basic assessment for low testosterone and its potential causes.

So for more information about the proper assessment of low testosterone, men can see their family doctor, get the appropriate testing as we’ve discussed, or perhaps refer to an endocrinologist if deemed necessary.

Presenter: Dr. Loren Grossman, Endocrinologist, Toronto, ON

Local Practitioners: Endocrinologist

Quiz: Do You Understand Diagnosing Low Testosterone? ( 0 participated.)

Test your knowledge by answering the following questions:

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You need to your blood test done in the late afternoon, when testosterone levels are at their highest..

1

Total testosterone by itself is not sufficient to diagnose low testosterone.

2

Testosterone does exhibit a circadian rhythm.

3

Testing ferritin ensures that elevated iron stores are not a cause for anything that may show up in your lab results.

4

Testosterone doesn't circulate in the blood.

This content is for informational purposes only, and is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your physician or other qualified healthcare professional with any questions you may have regarding a medical condition.