Talk:Testosterone (medication)

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Commercial synthesis

I am aware of the split, move and revamp of these 2 articles, so I will not edit this one yet. This article needs a small section on the pharmaceutical synthesis. Cheers, BatteryIncluded (talk) 18:34, 13 November 2016 (UTC)[reply]

Thanks for your interest and support. You don't need to wait to edit either of these articles. The only major change that might happen in the next couple of days is to remove the disambiguation from one of the two articles. I was also thinking of adding a synthesis section, but it is difficult to know exactly what types of syntheses are currently being used industrially. For example, the Pfizer process starts from 4-androstenedione, but they have kept as a trade secret their proprietary intermediate:
  • Kovats B, Ball. "A Green Manufacturing Route to Testosterone". Pharmaceutical Technology. 33 (9).
Also testosterone may be prepared by microbial fermentation of cholesterol or phytosterol:
  • Liu WH, Lo CK (1997). "Production of testosterone from cholesterol using a single-step microbial transformation of Mycobacterium sp". Journal of Industrial Microbiology & Biotechnology. 19 (4): 269–72. doi:10.1038/sj/jim/7000243. PMID 9439002.
  • Lo CK, Pan CP, Liu WH (2002). "Production of testosterone from phytosterol using a single-step microbial transformation by a mutant of Mycobacterium sp". Journal of Industrial Microbiology & Biotechnology. 28 (5): 280–3. doi:10.1038/sj/jim/7000243. PMID 11986932.
  • Donova MV, Egorova OV (2012). "Microbial steroid transformations: current state and prospects". Applied Microbiology and Biotechnology. 94 (6): 1423–47. doi:10.1007/s00253-012-4078-0. PMID 22562163.
Not at all sure if any of these are used industrially. Cheers. Boghog (talk) 19:04, 13 November 2016 (UTC)[reply]

Moved here

This article is about the medication not about diagnosing the condition. The first part is in the wrong article.

Second part appears to be spam by a conflicted editor.

Doc James (talk · contribs · email) 00:15, 2 February 2018 (UTC)[reply]

Main Lab Tests

To determine patient's testosterone levels, physicians request a blood test [1]. This blood test will measure the total testosterone level. It may also measure free testosterone and SHBG [2] levels. Any test that measures all three values provides more information than the total testosterone level test alone. The test requires a blood sample to be taken from a vein. The best time for the blood sample to be taken is between 7 a.m. and 10 a.m [3] because testosterone levels fluctuate throughout a day [4]. The second sample is often needed to confirm the result to be lower than expected.

Additional Tests for Low Testosterone

Additional tests for LH (luteinizing hormone) levels, FSH (follicle stimulating hormone) levels, prolactin levels, and a full thyroid panel help to understand the reason for low testosterone level [5]. Low testosterone level can be caused by testicular failure (primary hypogonadism) and by a problem in the hypothalamus (secondary hypogonadism) [6]. LH and FSH are important to test for because they are the two hormones that are responsible [7] for telling the testes to produce testosterone. When testosterone levels are low, the hypothalamus (a small gland of the brain) releases GnRH (gonadotropin releasing hormone). Then, GnRH stimulates the pituitary gland (another small gland in the brain) to release LH and FSH, which tell the testes to produce testosterone [8]. Normal LH levels for adult men are between 1.8 and 8.6 mIU/mL or IU/L [9]. Normal FSH levels for adult men are between 1.5 and 12.4 mIU/mL or IU/L [10]. Prolactin level is important to test for because high levels of prolactin suppress the secretion of GnRH and in turn LH and FSH [11]. Thus high levels of prolactin suppress normal testosterone production. In addition to lower testosterone, elevated prolactin level leads to erectile dysfunction, decreased libido, and impotence; in some men, high prolactin levels and low testosterone levels may cause breast enlargement and tenderness. However, this is less common [12]. A full thyroid panel [13] (includes TSH (thyroid-stimulating hormone, free T4 (thyroxine), free T3 or total T3 (triiodothyronine)) is important because hypothyroidism (underproduction of the thyroid gland) suppresses the secretion of LH. Thus hypothyroidism, like high levels of prolactin, also suppresses normal testosterone production. [14]

Testosterone Lab Tests in the United States

People who have low testosterone issues should do testing periodically to monitor the testosterone level, and share lab tests result with a doctor to correct their treatment.[15] Testosterone tests may include testing for the total amount of testosterone in the blood, amount of free or bioavailable testosterone[16] and the most suitable test should be chosen by a doctor. If doctor orders a test for a patient, the testing can be performed in a hospital, clinic laboratory. In some states, due to federal and states limitations by law, the patient cannot order lab tests without a requisition from a doctor and doctor should order, receive and provide a patient with test results and their interpretation.[17] In most of the states, patients can order lab tests by themselves without a doctor requisition in one of the lab stores affiliated with labs (so-called "Direct Access Testing" or "DAT"[18]). There are two main medical laboratories in the U.S. that perform most of the DAT: Quest Diagnostics and LabCorp.[19] Direct Access testing is the way to bypass visits to a doctor for the requisition and receiving the test results. Most of DAT stores do not accept insurance plans, so It also works for uninsured people. Testosterone test cost for uninsured people varies from $70 to $150 in the U.S.[20] Insured people need to check co-pay or/and co-insurance details of their medical insurance plan: Quest Insurance Providers, LabCorp Insurance Providers. Even for patients with health insurance plan, it may be cheaper to pay for lab testing completely out of pocket (by cash).[21]

References

  1. ^ "Low Testosterone: How to Talk to Your Doctor". WebMD. Retrieved 1 February 2018.
  2. ^ "Sex Hormone Binding Globulin (SHBG)". American Association for Clinical Chemistry. Retrieved 1 February 2018.
  3. ^ "Testing your testosterone: It's tricky". Harward Medical School. Retrieved 1 February 2018.
  4. ^ "Testosterone Test". VirtualMedicalCentre. Retrieved 1 February 2018.
  5. ^ "Testosterone replacement therapy: role of pituitary and thyroid in diagnosis and treatment". US National Library of Medicine, NIH. Retrieved 1 February 2018.
  6. ^ "Male hypogonadism". MAYO Clinic. Retrieved 1 February 2018.
  7. ^ "Gonadotropins: Luteinizing and Follicle Stimulating Hormones". Colorado State University. Retrieved 1 February 2018.
  8. ^ "Learn about GnRH deficiency / Kallmann syndrome". GNRH Network. Retrieved 1 February 2018.
  9. ^ "Luteinizing Hormone (LH), Serum". MAYO Clinic. Retrieved 1 February 2018.
  10. ^ "Follicle-stimulating hormone (FSH) blood test". Owensboro Health, ADAM. Retrieved 1 February 2018.
  11. ^ "Prolactin". Wikipedia. Retrieved 1 February 2018.
  12. ^ "Prolactinoma". UR Medicine. Retrieved 1 February 2018.
  13. ^ "Thyroid Panel". American Association for Clinical Chemistry. Retrieved 1 February 2018.
  14. ^ "Your Thyroid and Low Testosterone — What's the Connection?". Testosterone Centers of Texas. Retrieved 1 February 2018.
  15. ^ "Signs You Shouldn't Take Testosterone Therapy". EveryDay Health. Retrieved 1 February 2018.
  16. ^ "Testosterone, Total, Bioavailable, and Free, Serum". MAYO Clinic. Retrieved 1 February 2018.
  17. ^ "Releasing Clinical Laboratory Test Results: Report on Survey of State Laws" (PDF). HealthIT. August 2009. Retrieved 1 February 2018.
  18. ^ "Direct Access Testing (DAT) and the Clinical Laboratory Improvement Amendments(CLIA) Regulations" (PDF). CMS. Retrieved 1 February 2018.
  19. ^ "Lab stocks Quest, LabCorp shine as testing outlook brightens". Reuters. 31 May 2016. Retrieved 1 February 2018.
  20. ^ "Testosterone Tests Cost". Retrieved 1 February 2018.
  21. ^ "Even if you have health insurance, you may want to pay cash". 10 June 2016. Retrieved 1 February 2018.

Move discussion in progress

There is a move discussion in progress on Talk:Lithium (medication) which affects this page. Please participate on that page and not in this talk page section. Thank you. —RMCD bot 23:15, 28 January 2019 (UTC)[reply]

Gender Dysphoria Treatment

It's unclear in the lead whether Testosterone is used to ease the "mismatch" of gender caused by Gender dysphoria or if it's used to treat gender dysphoria by gender transitioning procedures. Should this be clarified and how? JazzClam (talk) 16:13, 3 March 2021 (UTC)[reply]

"Testivan" listed at Redirects for discussion

A discussion is taking place to address the redirect Testivan. The discussion will occur at Wikipedia:Redirects for discussion/Log/2021 August 17#Testivan until a consensus is reached, and readers of this page are welcome to contribute to the discussion. signed, Rosguill talk 17:46, 17 August 2021 (UTC)[reply]

Conflicting information for prostate cancer

Under the subsection prostate cancer it clearly states that the link to it causing prostate cancer is unknown and is backed by a reference, then just below in effects on the body and brain it goes on to list development of prostate cancer as one Ramahamalincoln (talk) 21:45, 27 January 2023 (UTC)[reply]

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