Hypogonadism laboratory findings

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Laboratory Findings

Testosterone lab test

• Diagnosis of hypogonadism in males is based on two successive low free testosterone level (<0.17-0.31 nmol/L) and total testosterone level (<9.7-10.4 nmol/L).
• If it is confirmed to be hypogonadism, the next step will be measurement of the gonadotropins hormones LH and FSH to detect the cause of the hypogonadism:
  • High gonadotropin hormones leve indicates primary hypogonadism and it is called hypergonadotrophic hypogonadism.
  • Low gonadotropin hormones level indicates secondary hypogonadism and it is called hypogonadotrophic hypogonadism.
• After detecting the site of impairment, further tests need to be performed to determine the exact cause of the disease.

Hormone tests, including checks of blood levels of estrogen, FSH, LH, testosterone, and thyroid, prolactin. These tests can help doctors identify the cause of hypogonadism.

Low Testosterone can be identified through a simple blood test performed by a physician. Normal testosterone levels range from 298 - 1098 ng/dl. Low levels should be confirmed by checking the sex hormone–binding globulin and calculating the free testosterone with a calculator such as http://www.issam.ch/freetesto.htm.

Physicians measure gonadotropins (LH and FSH) to distinguish primary from secondary hypogonadism. In primary hypogonadism the LH and/or FSH are usually elevated, while in secondary hypogonadism both are normal or low.

Hypogonadism is often discovered during evaluation of delayed puberty, but ordinary delay which eventually results in normal pubertal development and reproductive function is termed.