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Blood test shows low testosterone. Cause?

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General & Family Physician
Practicing since : 2001
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Hi I am a male aged 50 and have been through various blood tests recently with my GP to be told that i need to be referred to an endocrinologist as I have very low testosterone. What could be the causes of this.
Posted Wed, 10 Apr 2013 in Thyroid Problem and Hormonal Problems
Answered by Dr. Michelle Gibson James 1 hour later
HI, thanks for using healthcare magic

Testosterone is made in the testes . The testes is influenced by hormones released in the pituitary gland and the hypothalamus in the brain.
Low testosterone can be related to the testes themselves or factors affecting the pituitary gland or hypothalamus.

The hypothalamus releases a hormone called gonadotropin releasing hormone (GnRH) which travels to the pituitary causing it to release other hormones ( FSH and LH). Those hormones then travel to the testes to stimulate testosterone production and release.

Low testosterone can occur if the testes are unable to respond to these hormones to make testosterone. This is called primary hypogonadism. This may be due to infection , drugs, toxins, radiation, problems with the enzymes/chemicals needed to make testosterone.

Any lesion or mass of the pituitary or hypothalamus can also result in low testosterone production because they cannot stimulate the testes.

It is more common for it to be related to the testes primarily.
A blood test checking the levels of the hormones released in the pituitary or hypothalamus would determine if it is primary (related to the testes ) or secondary ( to the pituitary or hypothalamus).

i hope this helps, feel free to ask any other questions
Above answer was peer-reviewed by
Follow-up: Blood test shows low testosterone. Cause? 51 minutes later
Hi there

Many thanks for your response. I have had many blood tests and all the Dr has said is that i have low testosterone. She has referred me to an endocrinologist and im waiting on the appointment. Would further tests be blood tests only. I have had a scan on my testes as i have a small lump in one of them but my GP advised me that the scan had come back showing the lump but she said they are not concerned with it at this time. Im just wondering what to expect when i get the appointment with the endocrine dr and what possible treatments i might get. I haven't had sexual relations with my wife for such a long time now the thought just does not enter my mind. My wife says that I have errections sometimes when I am sleeping and sometimes I get them in the morning. But I have no 'urge' to make love.
Answered by Dr. Michelle Gibson James 11 minutes later
Further blood tests to check the level of FSH and LH would be needed. If these tests suggest that the problem is related to the pituitary or hypothalamus then imaging would likely be suggested to see if there is any structural abnormality with these areas.

Decreased testosterone can be associated with decreased libido.

The endocrinologist may suggest testosterone replacement therapy, this can come in varied forms : pills, patches, gels or injections.
If there is any problems with the pituitary or hypothalamus, additional treatment may be required. The exact nature would depend on the specifics of the problem.

Please feel free to ask anything else
Above answer was peer-reviewed by
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