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CPE-006 · Diagnosis
HG-04: Borderline total testosterone
Borderline total testosterone. Evaluates total testosterone 300 to 350 ng/dL.
Active rulePriority 5Testosterone engine v1.0.0
Condition
- total testosterone 300 to 350 ng/dL
- compatible symptoms
What it reports
- Borderline: free testosterone may be informative when binding proteins are abnormal
- Calculated free testosterone (Vermeulen) is shown when SHBG is available
Recommended next steps (for physician review)
- Measure SHBG and consider a calculated or equilibrium-dialysis free testosterone
- Repeat the morning total testosterone
Diagnostic boundary
- No free-testosterone threshold is applied: cutoffs are assay-specific.
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-VERMEULEN-1999Vermeulen A, Verdonck L, Kaufman JM. A critical evaluation of simple methods for the estimation of free testosterone in serum. J Clin Endocrinol Metab. 1999;84(10):3666-3672.Supports: Calculated free testosterone from total testosterone, SHBG and albumin
Cases where this rule fires
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