20 year old male with rheumatoid arthritis and primary hypogonadism.
Moderately high ethanol intake and smokes marijuana.
Last total testosterone (prior to a testosterone implant) was 22nmol/l
(normal 9-38) with sex-hormone-binding-globulin (SHBG) of 421 nmol/l
(normal 9-60 nmol/l) measured by in-house ELISA giving free androgen
index of 52 (normal >400).
We are aware of a link between ethanol and elevated SHBG but not to
this degree. We wonder aboout a possible inflammatory mechanism,
although would welcome any thoughts or feedback.
Dr Chris Florkowski
Christchurch, New Zealand
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