Testosterone testing has increased dramatically in the United States over the last decade, but this increase has largely been among men with normal levels, according to a study published in the March issue of the Journal of Clinical Endocrinology & Metabolism (JCEM). This surge may be due to increased marketing efforts by supplement makers and wider recognition of naturally declining testosterone levels in older men, particularly in those who are obese or with chronic disease. However, these tests may be of limited clinical value, and there are calls for technological improvements on the part of laboratories to improve the reliability of biochemical diagnosis of hypogonadism. While testosterone treatment is recognized for men with diagnosed hypogonadism, controversy exists over the necessity and safety of treating men who may have decreasing testosterone levels without meeting diagnostic criteria for hypogonadism. Diagnosis is confounded by a lack of agreement over the range defining testosterone deficiency, particularly at the lower normal range (200 to 350 ng/dL). Testosterone assay reference ranges have frequently been determined in populations of healthy, younger men, which may not be applicable to older men experiencing natural age-related declines. Furthermore, interpretation of results is complicated by assay variation between testing facilities. In […]