The initial biochemical test should be total testosterone level measured in serum samples taken in the morning; determinations of bioavailable testosterone or free testosterone should be restricted to patients with equivocally low total testosterone levels (strong recommendation; high-quality evidence).
Low free T4 (thyroid hormone) level without high TSH would indicate the pituitary does not make enough TSH ; Low testosterone with normal or low LH or FSH shows that the pituitary is not making enough LH and FSH ; Low IGF-1 or poor response of GH to stimulation test show that the pituitary is not making enough GH.
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high testosterone vs low testosterone face
