When it comes to testosterone replacement therapy, it's important to keep track of your treatment status. To ensure that the treatment is working and that you're getting the most out of your hormone treatment, regular checkups are essential. In most cases, we have a target for testosterone levels in mind for treatment. For most men, this is the middle range of normal levels (although this also depends on their particular circumstances).
Generally, we recommend monitoring testosterone levels once a quarter for the first year after starting testosterone replacement. If they remain stable, we may suggest testing once a year. To evaluate total or free endogenous testosterone, we check the presence of CPT codes (84402 and 8440) in any request from inpatients or ambulatory patients. Once the sample arrives, the levels of testosterone bound to SHBG (sex hormone-binding globulin) and free testosterone will be checked.
When hypogonadism is confirmed and treatable causes are ruled out, testosterone replacement therapy can be initiated. We also don't examine testosterone laboratory tests that were performed more than 12 months before the start of testosterone treatment. Table 1 shows the percentage of men who underwent the recommended screening tests before and after starting testosterone replacement. It's important to note that constant monitoring throughout your treatment is the only real way to ensure that it's working properly.
This double measurement is recommended because it's reported that a significant percentage of men with an initial level of testosterone in the slightly hypogonadal range have a normal testosterone level when repeating the measurement. Additionally, testosterone can increase red blood cell production and even cause too many cells in the blood.
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