Hypogonadism laboratory findings

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

Overview

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). It is recommended to be done in the morning as testosterone level is higher in that time.^[1]
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.^[2]

Free testosterone levels:^[3]
- Measuring free testosterone level is indicated in suspected cases of hypogonadism especially if it is suspected that concentrations of sex-hormone-binding globulin are abnormal. It has many calculating methods but the equilibrium dialysis method is known to be better than other methods.
- Free testosterone and others bound to albumin which is known as bioavailable testosterone also can be measured as it gives accurate estimate of the androgen levels.