An andrologist write:
Provided that FSH is in the normal range, this probably merely
represents a mild primary gonadal failure associated with ageing.
Diabetes, smoking and heavy alcohol intake might accelerate this.
LFTs might be interesting to exclude a problem secondary to abnormal
hepatic metabolism of steroids but I don't think that low SHBG would
be involved - if anything this would increase circulating free
testosterone.
I wouldn't do an LHRH test unless there is evidence of pituitary
failure.
How about a semen analysis as a marker for testicular function.
Jonathan Kay
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