case study

Details: A 43-year-old African American male has a history of hypertension, hypertriglyceridemia, and avitaminosis D. Current medications include ezetimibe 10 mg daily, niacin SR 1,000 mg at bedtime, hydrochlorothiazide (HCTZ)/lisinopril 25/20 mg daily, and vitamin D3 over the counter 5,000 units twice a day. He had a previous testosterone level drawn at another facility that he
reports as being low. He endorses a feeling of fogginess, lack of energy, core weight gain, decrease in erections, and decrease in semen consistency. Labs reveal testosterone 180 ng/dL (193–836 ng/dL), and thyroid-stimulating hormone/thyroxine, vitamin D, follicle-stimulating hormone/luteinizing hormone, and prostate-specific antigen within normal levels.

A. Is this patient a good candidate for testosterone therapy? Why or why not?

B. What are his risk factors for having erectile dysfunction?

C. What information is required to make a final decision on the testosterone replacement?

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