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CPE-006 · synthetic case TESTO-FX-08
Normal testosterone with fatigue and low mood
A 45-year-old with total testosterone 520.
Purpose: A 45-year-old with total testosterone 520.
Inputs the engine received
Testosterone and hormones
- Total testosterone, sample 1
- 520 ng/dL
Symptoms and findings
- Age
- 45 years
- Fatigue
- Yes
- Depressed mood
- Yes
What the engine reports
Detected clinical pattern
Testosterone Not Low on the Value Entered
No biochemical deficiency from this value. The symptoms have other causes to consider.
Differentials, pitfalls and contradicting signals
- Other causes of the symptoms: depression, sleep disorders, thyroid disease, anemia, medications.
Evidence and rule trace · 1 rules
HG-15Testosterone not low despite symptoms
Inputs: total testosterone 520 ng/dL · 2 symptom(s)
No biochemical testosterone deficiency; non-specific symptoms have other causes.
Evidence
- EV-ES-TRT-2018 · Bhasin S, Brito JP, Cunningham GR, et al. Testosterone Therapy in Men With Hypogonadism: An Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 2018;103(5):1715-1744.
Physician adjudication required. Clinical decision support for physician review. This output identifies laboratory patterns and cautions. It does not diagnose, find the cause, or recommend starting, stopping or dosing testosterone therapy. Physician adjudication is required.
Change the values
The same engine, starting from this case. Change any value and watch the pattern and the rule trace react.
Against typical adult male reference intervals
Testosterone and hormones
- <264
- 264–299
- 300–350 borderline
- >350
4.3 g/dL is assumed when left empty.
Symptoms and findings
Possible reversible contributors
Testosterone therapy context
More testosterone cases
TESTO-FX-01
Low libido and erectile dysfunction, testosterone never measured
A 48-year-old with sexual symptoms and fatigue.
TESTO-FX-02
One low testosterone
Total testosterone 218 ng/dL on a single morning sample.
TESTO-FX-03
Low on two samples with a primary pattern
Testosterone 205 and 190 with LH 22 and FSH 31.
TESTO-FX-04
Secondary pattern with obesity and diabetes
LH 1.2 and FSH 2.0 with BMI 36.
TESTO-FX-05
Raised prolactin with low testosterone
Prolactin 95 ng/mL.
TESTO-FX-06
Headache, visual field loss and prolactin 310
Possible pituitary mass effect.
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