Testosterone Replacement Therapy

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A recent New England Journal of Medicine article focuses on a case vignette about a 61 year old gentleman (Martin) who complains of low energy, low libido and a decreased ability to play sports.  Martin´s physical is unremarkable with the only noteworthy fact is that he is obese.  His blood results shows normal hematocrit, normal fasting glucose and normal thyroid function.  His prostate specific antigen (PSA) is 3.5 which is stable comparing it to a level taken a year ago.  What is noteworthy, is a testosterone level of 275 ng/deciliter (normal range is 300-1200 ng/deciliter).

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