Question

1. Darren is a 46-year-old African American male with a history of HTN and hypertriglyceridemia. Current medications include ezetimibe 10 mg daily, niacin SR 1,000 mg at bedtime and HCTZ/lisinopril 25/20 mg daily. He complains of lack of energy, core weight gain, and a decrease in erections. Labs reveal testosterone 180 ng/dL (193–836 ng/dL) with normal TSH/thyroxine, FSH, LH, and PSA. Is this patient a candidate for testosterone therapy? Why or why not? Which, if any, of his medications are contributing to his symptoms?

Answer 1

The patient is having a lie testosterone count This low count has led to symptoms like lack of energy, weight gain and decreased erection.As one ages this is expected after 45 years. The other cause for this has to be ruled out .Here the drug ezetemibe can cause low testosterone in the patient. So an alternative for this with certain lifestyle changes like reducing weight can be done,medication can be changed and observed .If this does not produce a relief of symptoms then the patient is a candidate for testosterone therapy. Moreover the patient is obese thus therapy can further increase weight and become a risk factor for more cardiovascular issues in the patient .This makes the patient unfit for therapy besides symptoms.