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Hypogonadism is a medical condition where the body's sex glands produce insufficient sex hormones. It is caused by testicular or ovarian failure (primary hypogonadism) or by pituitary gland dysfunction affecting luteinizing hormone (LH) and follicle-stimulating hormone (FSH) production (secondary hypogonadism). The Testosterone, Free, Bioavailable and Total test is the most important test for diagnosis because it comprehensively measures all forms of testosterone.
Hypogonadism is caused by either direct failure of the sex glands (primary hypogonadism) or problems with the pituitary gland or hypothalamus that control hormone production (secondary hypogonadism). Primary hypogonadism results from testicular damage due to injury, infection, chemotherapy, radiation, genetic conditions like Klinefelter syndrome, or autoimmune disorders. Secondary hypogonadism occurs when the pituitary gland fails to produce adequate luteinizing hormone (LH) and follicle-stimulating hormone (FSH), which can be caused by pituitary tumors, medications (especially opioids and steroids), obesity, aging, or chronic illnesses like type 2 diabetes.
The Testosterone, Free, Bioavailable and Total test is the most important test for hypogonadism because it provides a complete picture of all testosterone forms in your body, using the highly accurate LC/MS/MS methodology. This comprehensive panel distinguishes between free testosterone (the active form available to tissues), bioavailable testosterone (loosely bound and readily usable), and total testosterone (the complete amount in your blood). For complete diagnosis, your healthcare provider may also order Follicle-Stimulating Hormone (FSH) and Luteinizing Hormone (LH) tests to determine whether the problem originates in the sex glands themselves or in the pituitary gland that controls them. In some cases, Estradiol testing is also recommended since testosterone converts to estradiol, and abnormal ratios can indicate hormonal imbalances.
You should get tested if you experience persistent symptoms like reduced sex drive, erectile dysfunction, chronic fatigue, difficulty building muscle despite exercise, unexplained weight gain, mood changes including depression or irritability, or decreased energy levels. Men over 40 should consider testing if they notice declining physical performance, reduced morning erections, or loss of body hair. Testing is also important if you have risk factors such as obesity, type 2 diabetes, chronic opioid use, previous testicular injury or infection, cancer treatment history, or a family history of hormone disorders. Early detection allows for timely hormone replacement therapy that can significantly improve quality of life and prevent long-term complications like osteoporosis and cardiovascular problems.
What this means
Your testosterone level is slightly below the optimal range. While not severely low, this may contribute to occasional fatigue, reduced motivation, difficulty building muscle, or lower sex drive. Many men in this range benefit from lifestyle modifications to naturally boost their levels.
Recommended actions
Increase resistance training and compound exercises like squats and deadlifts
Prioritize 7-8 hours of quality sleep per night and manage stress levels
Include zinc and magnesium-rich foods like shellfish, beef, pumpkin seeds, and spinach
Consider retesting in 3-6 months after implementing lifestyle changes
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