Elevated Total Testosterone Level in an Adult with Erectile Dysfunction

Abha Shrestha,Devish Pyakurel,Keyoor Gautam,Santosh Pradhan,Vivek Pant

doi:10.3126/nmj.v2i2.25987

Abstract

Erectile dysfunction affects a growing number of men with a significant impact on social function. The cause may be medical and psychological both. Of many risk factors for erectile dysfunction, hyperthyroidism can lead to increased total testosterone by an increase in sex hormone-binding globulin secreted from the liver. Here, we present a case of an adult male with a high total testosterone level who complained of erectile dysfunction. On a complete review of medical history and additional laboratory tests, the diagnosis of hyperthyroidism leading to increased total testosterone was made. The complete review of the patient’s history before hormonal analysis helps to troubleshoot the mismatch between clinical symptoms and laboratory results.

Highlights

Testosterone is a male sex hormone that is produced by the Leydig cells in testicles and is responsible for male physical characteristics
About two-thirds of testosterone circulating in the blood is bound to sex-hormone-binding globulin (SHBG) and less than one third is bound to albumin
We present a case of elevated total testosterone in an adult male with erectile dysfunction who was later found to have hyperthyroidism with increased SHBG

Summary

INTRODUCTION

Testosterone is a male sex hormone that is produced by the Leydig cells in testicles and is responsible for male physical characteristics. A 46-year-man was recommended by the general physician for laboratory testing of total testosterone level, as he complained of erectile dysfunction for 3 months. The physician ordered ultrasonography (USG) of the abdomen and pelvis when the laboratory result of total testosterone was very high (Table 1). On reviewing patient clinical history, no other significant problem was identified, except for a weight loss of 7 kg during the last 8 months. He regularly consumes alcohol and is an occasional smoker. The thyroid function test was done and he was found to have an undetectable TSH level (Table 1)

Result

Findings

CONCLUSION