BPA and Low Testosterone

Questions: 1. What question would you ask Hercules to guide/help you build a potential diagnosis?2. Based on the answers of Hercules to your questions, you decided to measure total testosterone serum levels. Why?3. You decided to measure free testosterone levels in plasma. Therefore, what was your answer to that question? Why? Answers: 1. To build a potential diagnosis the following questions can be asked to Hercules: What are your complaints? What medications are you having currently? What is your job nature? What is your daily routine? Do you smoke or drink? How frequently do you smoke or drink? Tell me something about any of your prior medical complications, if any and also if there is any family history of any particular disease, like: blood pressure, diabetes, obesity and so on? 2. It is recommended that total plasma testosterone level more than 400ng/dL in male can be considered as normal and total plasma testosterone level less than 200ng/dL can be treated as hypogonadal and those with 200-400ng/dL can be considered depend on clinical manifestation, if symptomatic (Dobs, Norwood, Potts, Gould Chitra, 2013). In this case study, the total plasma testosterone levels for Hercules was 275ng/dL. Hence, it can me said that the range is within the borderline and he is symptomatic, means he complained about his lack of interest in sex. So, care need to be taken regarding this matter. As Hercules has complained about his decreased libido, it is significant to order for free testosterone levels. Total testosterone is applied for diagnosis. It measures the bound testosterone with the proteins and also which is not bound (Shindel, 2008). Free testosterone is ordered if the sex-hormone binding globulin is abnormal within the blood. 3. If plasma testosterone levels were higher than the reference values then the patient does not have Low-T syndrome. It is seen that Hercules has complained about fatigue, weight gain, decreased libido and changes in mood. In regards with these clinical manifestations, Hercules needs to get the treatment to reduce the chances of being affected with Low-T syndrome. References Dobs, A., Norwood, P., Potts, S., Gould, E., Chitra, S. (2013). Testosterone 2% Gel Can Normalize Testosterone Concentrations in Men with Low Testosterone Regardless of Body Mass Index.The Journal Of Sexual Medicine,11(3), 857-864. doi:10.1111/jsm.12411 Shindel, A. (2008). Subjective sexual response to testosterone replacement therapy based on initial serum levels of total testosterone.Yearbook Of Urology,2008, 195-196. doi:10.1016/s0084-4071(08)79155-3