Testosterone Booklet

Testosterone in men booklet

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Assess your symptoms

Take the Aging Male Syndrome Self Assessment

Aging Male Symptoms (AMS)

The AMS self assessment is well suited to assist in both the diagnosis of testosterone deficiency and for the monitoring of treatment in patients using testosterone replacement therapy.

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Disease Insight

Conditions & treatment options.


Diagnosing Testosterone Deficiency in Men

How do Doctors Measure Testosterone Levels?

Testosterone is produced during sleep. The highest levels of testosterone in the body occur when you wake up in the morning.

These levels slowly decrease during the day and are at their lowest in the late afternoon and early evening.

Blood tests taken to measure testosterone levels provide a snapshot of levels at that point in time only. To get an accurate measure, it is important to combine blood testing and clinical assessments conducted through tests such as the Aging Male Symptoms questionnaire.

Getting the Most Accurate Blood Results

The testes do not store testosterone. Once produced, it is secreted into the blood stream and quickly picked up by the protein sex-hormone binding globulin (SHBG).

Up to 99% of all testosterone produced in the testes is carried around the body by SHBG.

Testosterone not carried by SHBG, known as “free testosterone”, is critical to determining how well testosterone can work in the body.

Doctors should measure both testosterone levels (called ‘free’ and ‘total testosterone’) and SHBG levels, in order to get a truly accurate assessment of testosterone levels in the body.

SHBG levels are affected by:

  • Aging
  • Smoking
  • High alcohol intake
  • Insulin
  • Oral estrogens
  • Some other medications

If SHBG levels are not taken into account lab results can be misleading.

Understanding Lab Results

An accurate diagnosis will include a measure of FAI (free androgen index), total and free testosterone.

FAI is calculated as follows:

Total testosterone ÷ SHBG level x 100 = FAI

This calculation is done automatically by the pathology lab.

Generally, an FAI reading of 70 or less is cause for concern. With a reading below 50 indicating that testosterone supplements may be of benefit.

Before prescribing testosterone, your doctor must take into account factors such as:

  • Pre-existing illnesses
  • Physical health
  • Hormonal health
  • Psychological and mental health

Getting the Most Accurate Clinical Assessment Results

Symptoms of testosterone deficiency are consistent, regardless of the cause:

  • Changes in mood (fatigue, depression, anger)
  • Decreased body hair (feminization)
  • Decreased bone mineral density and possibly resulting in osteoporosis
  • Decreased lean body mass
  • Decreased muscle strength
  • Decreased libido and erectile quality
  • Increased abdominal fat
  • Rudimentary breast development (man boobs)
  • Low or zero sperm in the semen

The Aging Male Symptoms (AMS) questionnaire is a tool used to support diagnoses of testosterone deficiency in men. It can also be used to monitor treatment in patients.

The AMS questionnaire is made up of 17 questions in three key areas:

  • Mind (5 questions)
  • Body (7 questions)
  • Sexual (5 questions)

All questions can be answered on a self-rating score of 1-5. Scores range from a low total of 17 to a high total of 85. Scores greater than 50 are considered severe.

You can take the Aging Male Symptoms questionnaire here and your confidential results will be emailed directly to you.

Find out about treatment options available on the next page.

Next page: deficiency treatment

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