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Testosterone Assays.

Brendan King¹, Caleb Natale¹, Wayne J G Hellstrom¹

¹Department of Urology, Tulane University School of Medicine, #8642 1430 Tulane Avenue, New Orleans, LA 70112, USA.

The Urologic Clinics of North America

|October 29, 2022

Summary

Accurate testosterone measurement faces challenges like standardization issues and high costs. Total testosterone is most accessible, while free and bioavailable forms offer insights for borderline cases, using mass spectrometry and equilibrium dialysis as gold standards.

Keywords:

Free testosterone Hypogonadism Testosterone assays Total testosterone

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Area of Science:

Endocrinology
Clinical Chemistry
Laboratory Medicine

Background:

Accurate testosterone measurement is crucial for diagnosing various conditions.
Current methods face challenges including standardization, variable reference ranges, and equipment costs.

Purpose of the Study:

To review the challenges and gold standards in testosterone measurement.
To highlight the utility of different testosterone assays in clinical practice.

Main Methods:

Review of current literature on testosterone measurement techniques.
Discussion of gold standard methods: mass spectrometry for total testosterone and equilibrium dialysis for free testosterone.

Main Results:

Total testosterone assays are widely accessible but require standardization.
Free and bioavailable testosterone measurements can be valuable for borderline cases.
Gold standard methods provide high accuracy but are often costly or complex.

Conclusions:

Addressing standardization and cost are key for improving testosterone testing.
Appropriate selection of testosterone assays, considering patient context, is essential for accurate diagnosis and management.