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CPE-006 · Diagnosis
HG-02: One low testosterone result, not yet confirmed
One low testosterone result, not yet confirmed. Evaluates first total testosterone below 300 ng/dL.
Condition
- first total testosterone < 300 ng/dL
- second sample not entered
What it reports
- Low total testosterone on a single sample: confirmation is required before it is acted on
Recommended next steps (for physician review)
- Repeat a fasting morning total testosterone on a separate day
Diagnostic boundary
- Not a diagnosis.
Evidence
- EV-ES-TRT-2018Bhasin 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.Supports: Diagnose with symptoms plus unequivocally low testosterone on two morning fasting samples Contraindications and cautions to therapy; monitoring of hematocrit and PSA Evaluation of the type of hypogonadism with LH and FSH
- EV-AUA-2018Mulhall JP, Trost LW, Brannigan RE, et al. Evaluation and Management of Testosterone Deficiency: AUA Guideline. J Urol. 2018;200(2):423-432.Supports: Total testosterone below 300 ng/dL as the threshold; repeat and confirm; fertility counselling before therapy
Cases where this rule fires
Open a case to see this rule fire with real inputs, then change the values until it stops.
TESTO-FX-02
One low testosterone
Total testosterone 218 ng/dL on a single morning sample.
TESTO-FX-06
Headache, visual field loss and prolactin 310
Possible pituitary mass effect.
TESTO-FX-09
Afternoon sample
Testosterone 240 drawn at 3 pm.
TESTO-FX-10
Two low values during acute illness
Both samples were drawn while the patient was in hospital.
TESTO-FX-20
Two samples that disagree
280 ng/dL, then 410 ng/dL.
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