An Unusual Case of Elevated Testosterone: When Testosterone by Dialysis Saves the Day

This case reviews an uncommon clinical scenario in which a markedly elevated total testosterone was detected in the setting of a complaint of hair loss in a male. Clinically, the patient had no other manifestations of elevated testosterone and did not have any notable supplement use that would explain such aberrant values. Due to concerns for potential malignancy, imaging was pursued that failed to show a source. Given the discordance in his lab values and his workup, a testosterone by dialysis was pursued that returned with reassuringly normal range testosterone levels, highlighting the impact of varied testosterone-protein binding affinity among humans and the ongoing value of equilibrium dialysis as a laboratory technique.