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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Elevated Testosterone Levels?

I just took my test results and my free testosterone is 4.9 when it said the limit is 4.1 and for the SHBG it is 200 when the maximum limit is 110. What does this mean?Is it that bad ? I have to mention that I had this tests because my endocrinologist said I should for my acne problem.I also took for 4 months Laurina pills and all of my acnee almost disappeared
Wed, 21 Sep 2016
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Endocrinologist,  's  Response
Hello there,

Since you took Laurina pills for acne, I assume that you are a female who is having symptoms related to increased androgen levels (mostly testosterone) in the body.

There are many ways in which testosterone levels can be tested. Most common and practical method is measurement of morning total testosterone. If there is discrepancy between clinical findings and laboratory measurements of total testosterone, free testosterone is measured, which can be supplemented with SHBG measurements. But I rarely get these done in my clinical practice, because these are expensive, labour intensive and variability is high in these tests. Still morning value of total testosterone is the most commonly performed test.

Now since your free testosterone levels are high and you have acne, both clinical and biochemical hyperandrogenemia is evident. There are a variety of causes that can cause such picture. Some common ones are:
1. Hypothyroidism
2. Hyperprolactinemia
3. Cushing's Syndrome
4. Acromegaly
5. Androgen secreting Tumors
6. Variant of Congenital Adrenal Hyperplasia
7. Polycystic Ovarian Disease (PCOD)

A complete history and physical exam followed by relevant investigations is needed to reach to a diagnosis.

Hope it helps......
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What Causes Elevated Testosterone Levels?

Hello there, Since you took Laurina pills for acne, I assume that you are a female who is having symptoms related to increased androgen levels (mostly testosterone) in the body. There are many ways in which testosterone levels can be tested. Most common and practical method is measurement of morning total testosterone. If there is discrepancy between clinical findings and laboratory measurements of total testosterone, free testosterone is measured, which can be supplemented with SHBG measurements. But I rarely get these done in my clinical practice, because these are expensive, labour intensive and variability is high in these tests. Still morning value of total testosterone is the most commonly performed test. Now since your free testosterone levels are high and you have acne, both clinical and biochemical hyperandrogenemia is evident. There are a variety of causes that can cause such picture. Some common ones are: 1. Hypothyroidism 2. Hyperprolactinemia 3. Cushing s Syndrome 4. Acromegaly 5. Androgen secreting Tumors 6. Variant of Congenital Adrenal Hyperplasia 7. Polycystic Ovarian Disease (PCOD) A complete history and physical exam followed by relevant investigations is needed to reach to a diagnosis. Hope it helps......