Symptomatic androgen deficiency develops only when both total and free testosterone decline in obese men who may have incident biochemical secondary hypogonadism: Prospective results from the EMAS.
Giulia RastrelliTerence W O'NeillTomas AhernGyörgy BártfaiFelipe F CasanuevaGianni FortiBrian G KeevilAleksander GiwercmanThang S HanJolanta Slowikowska-HilczerMichael E J LeanNeil PendletonMargus PunabLeen AntonioJos TournoyDirk VanderschuerenMario MaggiIlpo T HuhtaniemiFrederick C W Wunull nullPublished in: Clinical endocrinology (2018)
These longitudinal data demonstrate the importance of FT in the diagnosis of hypogonadism in obese men with low TT and SHBG. The concurrent fall in TT and FT identifies the minority (27.3%) of men with hypogonadal symptoms, which were not present in the majority developing low TT with normal FT.