To investigate the association between hypogonadal symptoms and free testosterone (FT) levels in men with near-normal total testosterone (T) levels (250-350 ng/dL) and to determine whether a discriminatory threshold for FT exists below which hypogonadal symptoms become more prevalent.
We reviewed the charts of 3167 men who presented to an outpatient men's health clinic. Two hundred thirty-one men had symptoms of "low testosterone" and serum testosterone levels between 250 and 350 ng/dL. We evaluated hypogonadal symptoms using the Androgen Deficiency in the Adult Male (ADAM) and quantitative ADAM (qADAM) questionnaires. Serum levels of T and sex hormone-binding globulin were collected on the same day that men completed their questionnaires. We used linear regression to determine whether a threshold of FT exists for hypogonadal symptoms. We performed univariate and multivariable analyses to evaluate factors that predicted a low FT level.
The median age was 43. 5 years, and the median testosterone and FT levels were 303 ng/dL and 6. 3 ng/dL, respectively. Prevalence and severity of hypogonadal symptoms (ADAM and qADAM) were similar between men with low (
We did not observe a relationship between hypogonadal symptoms and FT in men with near-normal testosterone levels. Symptom-specific FT thresholds could not be defined, as age remains an important confounder.
Urology. 2015 Jul 18 [Epub]
Ranjith Ramasamy, Ron Golan, Nathan Wilken, Jason M Scovell, Larry I Lipshultz
Department of Urology, Baylor College of Medicine, Houston, TX. Department of Urology, Weill Cornell Medical College, New York, NY. , Department of Urology, Baylor College of Medicine, Houston, TX. , Department of Urology, Baylor College of Medicine, Houston, TX. , Department of Urology, Baylor College of Medicine, Houston, TX.