By T. Hugh Jones
Testosterone has a major impact on significant organ platforms and tissues, together with mind, metabolism, cardiovascular in addition to musculoskeletal and immune platforms. masking many medical components, this publication will pay specific recognition to the analysis and administration of hypogonadism, discussing present guidance, biochemical evaluation, new ideas in testosterone substitute remedy and long term tracking of taken care of males. moreover the function of testosterone deficiency in getting older, weight problems, muscle functionality and frailty and erectile disorder is covered.Recent proof for the function of testosterone within the pathogenesis of persistent illnesses equivalent to diabetes, heart problems and osteoporosis is suggested. New advancements within the power therapy of those scientific stipulations also are. offered. essentially of curiosity to endocrinologists, urologists, andrologists and sexologists, the variety of issues lined is additionally appropriate to basic care physicians, gerontologists, diabetologists and cardiologists.
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Additional info for Advances in the Management of Testosterone Deficiency (Frontiers of Hormone Research Vol 37)
Few laboratories are registered with an appropriate licensing authority (in the UK: The Environment Agency) in order to use radioactivity as an endpoint in immunoassays. 22 Diver Standard, well-authenticated immunoassay techniques are used on these automated platforms. Detailed methodologies are comprehensively described in previous reports [1, 3] with sample volumes ranging from 15 to 200 l and incubation times varying from 15 min to 2 h. Most platforms incorporate solid phase separation of bound and free moieties using antibody-coated magnetic particles, beads or wells with chemiluminescent, enzyme-linked or immunofluometric endpoints to quantify the testosterone concentration.
Recent reviews of treatment modalities may be recommended [1, 2]. Free unesterified testosterone is absorbed well from the gut but is effectively metabolized and inactivated in the liver before it reaches the target organs. Pharmacological changes of the testosterone molecule in the 17␣ position render the molecule orally effective. Alkylated derivatives of testosterone including methyltestosterone and fluoxymesterone are administered orally or sublingually. They are metabolized by the liver, like natural testosterone, but more slowly, and, like testosterone, interact directly with androgen receptors.
Nevertheless a very large body of opinion would now advocate the use of bioavailable testosterone as the best marker of androgen status [see 14 for references]. This index may be measured, usually by the ammonium sulphate precipitation method of Tremblay and Dube , or derived from measuring total testosterone and SHBG and applying an algorithm in a computer program. Numerous formulae, both simple and more complex, have been derived for calculation of either free or bioavailable testosterone.