Testosterones

Testosterones

It is the primary androgen secreted by interstitial cells of the testes (leydig cell) in men and by adrenal glands and ovaries in women. This is also responsible for the male secondary sex characteristics. The excessive production of this hormone may lead to premature puberty in young males and for women, it may cause excessive facial and body masculinity. It also contributes to the enlargement of external genitalia, accessory organs such as the prostate gland, Voluntary muscle and to the growth of facial, pubic and axillary hair.

The testosterone synthesis begins to increase at onset of puberty and continues to progress during adulthood. And production began to decline at about age of 4o and then totally stop at the peak level of 80.

It is always present is serum as both unbound or free form and bound fractions to albumin. The level of testosterone in the body helps to asses if the patient has hypogonadism, pituitary gonadotropin function, impotency and cryptochidism.
For women it helps to diagnose ovarian tumors, hirsuitism and even irregularities in menstrual periods.

The following guidelines observed during the patient preparation:

The health care provider should able to explain the objectives in performing this Laboratory examination to the patient. They should know well the basic principles of the test and most importantly is to perform the procedure accurately and safely for the benefit of the patient.

Procedure:

Perform a venipucture and collect a serum sample in a 7ml clot-activator tube, If plasma is to be collected use a heparinized tube. Indiacte the patient' age, sex, and history of hormone.

Refence values:

NORMAL

Total Testosterone

Men: 270-1070 ng/dL or 9-38nmol/L (values in elderly men diminish moderately)

Women: 15-70 ng/dL or 0.52-2.4 nmol/L

Pregnant women:3-4 times normal

Postmenopausal women: 8-35 ng/dL or 0.3-1.2nmol/L

Children:2-20 ng/dL or 0.07-0.79nmol/L (depends on age, sex, onset of puberty)

Free testosterone

Men:50-210 pg/mL or 174-729 pmol/L

Women: 1.0-8.5pg/mL or 3.5-29.5 pmol/L

Childern:

Boys: 0.1-3.2 pg/mL or 0.3-11.1pmol/L

Girls:0.1-0.9pg/mL or 0.3-3.1pmol/L

Puberty:

Boys:1.4-156pg/mL or 4.9-541pmol/L

Girls:1.0-5.2pg/mL or 3.5-18.0 pmol/L

Clinical implications:

In males having a decreased total testosterone levels occur in the following condition:

Hypogonadism, Klinefelter's syndrome, Hypopituitarism, Orchidectomy, Hepatic cirrhosis,Down syndrome and delayed puberty

In males have a deceased free testosterone levels occur in hypogonadism and elderly in men.

In males have a increased testosterone levels occur in the following conditions:

Hyperthyrodism, Snydromes of androgen resistance, Adrenal tumors, Precocious puberty and adrenal hyperplasi in boys.

In females have a increased toatl testosterone levels are associated with the following diseases:

Adrenal neoplasms, Ovarian tumor, trophoblastic disease during pregnancy, Idiopathic hirsuitism, Hilar cell tumor.

In females have a increased free testosterone levels are associated with the following conditions:

Female hirsuitism, polycystics ovaries, virilization

Interfering factors:

Avoid hemolysis specimen

Alcoholism in males, drugs such as androgens, steroids may decreases the testosterone levels.

Estrogen theraphy increase testosterone.

References:

Fischbach, Frances, A manual of Laboratory And diagnostic test, 7th edition

Professional gude to Diagnostic tests.

http://images.google.com.ph/imgres?imgurl=http://upload.wikimedia.org/wikipedia/commons/5/5d/Testosterone-from-xtal-3D-balls.png&imgrefurl=http://commons.wikimedia.org/wiki/File:Testosterone-from-xtal-3D-balls.png&usg=__qREvDlXPthw2Rx9uiX54Slfos1Q=&h=828&w=1100&sz=196&hl=tl&start=12&um=1&tbnid=lPrdzsZ6_2VxOM:&tbnh=113&tbnw=150&prev=/images%3Fq%3Dtestosterones%2Bmolecule%26hl%3Dtl%26um%3D1

http://images.google.com.ph/imgres?imgurl=http://www.matteolongobardi.com/general_info/testosterone_clip_clip_image002_0000.gif&imgrefurl=http://www.matteolongobardi.com/general_info/testosterone.htm&usg=__ly3wuR_ANQ2SR2OrehT3u3O-tUc=&h=316&w=365&sz=23&hl=tl&start=6&um=1&tbnid=0Gg6FbBBWDMDDM:&tbnh=105&tbnw=121&prev=/images%3Fq%3Dtestosterones%26ndsp%3D20%26hl%3Dtl%26um%3D1