Testosterone replacement therapies
Studies:







References [1,2,3]
Diseases associated with hypogonadism
HIV - particularly in wasting syndrome
End stage kidney disease
COPD, moderate-to-severe
Type 2 diabetes
Obesity



Average age
of sample
Average
testosterone level
∼ 95% CI
Average free
testosterone level
∼ 95% CI
55
(N=1667)
517 ng/dl
(17.9 nmol/l)
167 - 867 ng/dl
(5.8 - 30 nmol/L)
11.5 ng/dl
(0.4 nmol.l)
2.9 - 20.1 ng/dl
(0.10 - 0.70 nmol/l)
62
(N=947)
459 ng/dl
(15.9 nmol/l)
145 - 773 ng/dl
(5.03 - 26.8 nmol/L)
9.3 ng/dl
(0.32 nmol/l)
3.3 - 15.3 ng/dl
(0.11 - 0.53 nmol/l)
68
(N=584)
414 ng/dl
(14.4 nmol/l)
94 - 734 ng/dl
(3.3 - 25.5 nmol/L)
7.1 ng/dl
(0.25 nmol/l)
1.9 - 12.3 ng/dl
(0.066 - 0.43 nmol/l)



Total testosterone3 Free testosterone
(calculated)1
Free testosterone
(equilibrium dialysis)2
Bioavailable2
231 - 850 ng/dl
(8 - 29.5 nmol/l)
4.8 - 25 ng/dl 52 - 280 pg/ml
(1.5 - 3.2%)
40 - 250 ng/dl
(9 - 46% of total)


Conditions that may DECREASE
SHBG levels
Obesity
Kidney disease (Nephrotic syndrome)
Hypothyroidism
Use of corticosteroids,
progestins, and androgenic steroids
Acromegaly (growth hormone tumors)
Diabetes
Conditions that may INCREASE
SHBG levels
Aging
Hyperthyroidism
Use of estrogens
Use of seizure medications
HIV
Liver cirrhosis
Vegan diet



Medications that may cause low testosterone
Anabolic steroids
Antipsychotics
raise prolactin levels
(risperidone, haloperidol, etc.)
Corticosteroids
(daily doses of ≥ 15 mg)
Estrogens
GnRH antagonists
(e.g. degarelix)
GnRH agonists
(e.g. leuprorelin, triptorelin, goserelin)
Ketoconazole
(inhibits steroidogenesis)
Metoclopramide (Reglan®)
(raises prolactin levels)
Opiate pain medication (morphine, hydrocodone, etc.)
(suppress GnRH synthesis)
Progesterones
Seizure and mood stabilizer medications