Rare Case: Low Testosterone - Testicular Cyst?

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A rare clinical case of low testosterone with an unknown cause. This case study is one of the more interesting I’ve seen in my practice: a 38 year old man complaining of low libido, malaise, and concentration problems who’s primary care physician had found his total testosterone in normal range. Additional testing at another clinic showed progressive lowering free testosterone and increasing SHBG, but their TRT protocol did not resolve his symptoms. When he came to see me, I uncovered a possible cause his other doctors had not identified, adjusted his treatment, and now his symptoms have resolved and he feels great. This case shows the importance of an adequate history and physical as well as expert care.

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TABLE OF CONTENTS:

00:59 - CASE HISTORY WITH OTHER PHYSICIANS
- Progressive low libido, malaise, concentration issues
01:17 - Primary care doctor finds T in normal range, does not order free T or SHBG
01:58 - Another clinic finds low free T, high SHBG
02:37 - Initial TRT does not resolve symptoms
02:45 - MY FINDINGS
- History & physical reveals possible cause
03:29 - Additional labs reveal high FSH
03:43 - Why a kidney ultrasound was needed
04:13 - Unknown condition causing progressive declining free T, increasing SHBG
05:13 - TREATMENT & RESULTS
- Lower, more frequent doses of T
06:18 - 1 year later: symptoms resolved, lab results in range
07:24 - TAKEAWAYS
- Importance of an adequate history, physical, & expert care

Stay Strong and Healthy,
Dr. O

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As the Anabolic Doc, since 2003, I’ve provided men who are using or have used anabolic steroids a confidential, ethical and professional medical venue to discuss their use. I do NOT in any way support the use of any performance enhancing drugs - PEDs, anabolic steroid or other medicine for muscle building or body transformation. The “off-label” use of PEDs, as such agents is considered illicit and may lead to adverse health outcomes. Please consult an expert health professional regarding any medical agent and do NOT use any medicine without the explicit advice and supervision of an appropriate medical expert.

This video is for education and information only. This is not medical advice. Only take medications as prescribed by your doctor. Do not take illegal substances. Taking steroids can lead to serious health consequences.


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