Read "Jakes Thing" by Kingsley Amis. (Not to spoil it but the relevant bit
for clinical chemists is on the last page. However, you'll have to read the
whole book to put it into context).
Robert Forrest
> -----Original Message-----
> From: [log in to unmask]
> [mailto:[log in to unmask]]On Behalf Of Dr J.
> Falconer Smith
> Sent: 10 December 1998 10:58
> To: [log in to unmask]
> Subject: Andrology clinics
>
>
> I have been approached by a consultant colleague who is setting
> up an Andrology
> Clinic (yes, Viagra has reached the East Midlands!).
>
> He has come across a subset of male patients with a variety of symptoms
> including impotence and in one case a combination of breast
> enlargement and
> apparent reduction in penile size. These patients also have a
> variety of other
> medical problems, commonly diabetes.
>
> However in addition the subset in question also have a slightly low serum
> testosterone in the range 6-8nmol/L (our quoted reference range is
> 9.7-37nmol/L). In some where SHBG (sex hormone binding globulin)
> has been
> measured this is also low. Gonadotrophins have been normal.
>
> My understanding is that such modest abnormalities in
> biochemistry are unlikely
> to be the cause of symptoms but I would be grateful for input
> from any one with
> expertise in this area.
>
> Because my colleague feels he is the final arbiter in these cases
> he is anxious
> not to miss a treatable cause.
>
> Questions
> 1. Is there anything else the lab should be offering?
>
> 2. Is there ever any indication for doing an LHrH (luteinising
> hormone releasing
> hormone) test in male patients with this combination of finding?
>
> 3. Are reference ranges for serum testosterone for 50 and 60 year
> old males the
> same as for younger patients and if not are there other ranges out there?
>
> 4 Is anyone aware of any established medical andrology clinics in
> the UK (or I
> guess anywhere prepared to communicate by email) that have
> expertise in these
> sorts of problems.
>
> Either reply to the mailbase or directly to me ([log in to unmask]) as
> you feel is
> appropriate.
> Many thanks in advance as usual!
>
> James Falconer Smith
>
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