Thyroid Disorders: An Update
The “Updates in Thyroidology” issue of the Endocrinology and Metabolism Clinics of North America reflects the progress in clinical management of patients with thyroid disorders in the past decade. The guest editors are Dr Megan Haymart and Dr Maria Papaleontiou from University of Michigan in Ann Arb or, Michigan, both endocrinologists with extensive clinical and research experience in this field. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - April 22, 2022 Category: Endocrinology Authors: Adriana G. Ioachimescu Tags: Foreword Source Type: research

Accurate Measurement and Harmonized Reference Ranges for Total and Free Testosterone Levels
Diagnosing testosterone deficiency requires accurate and precise measurement of total testosterone levels by an accurate method, such as liquid chromatography –tandem mass spectrometry in a laboratory certified by an accuracy-based program (eg, Centers for Disease Control and Prevention’s Hormone Standardization (HoST) Program), and, if needed, free testosterone level. Free testosterone level should ideally be measured by equilibrium dialysis method. Testosterone levels should be measured in 2 or more fasting samples obtained in the morning. Harmonized reference ranges for total testosterone can be applied to laborator...
Source: Endocrinology and Metabolism Clinics of North America - February 23, 2022 Category: Endocrinology Authors: Ravi Jasuja, Karol M. Pencina, Liming Peng, Shalender Bhasin Source Type: research

The Effects of Testosterone Treatment on Cardiovascular Health
Current evidence suggests that testosterone therapy has numerous benefits and risks on cardiovascular health. Examples of this include published data that support improvements in insulin sensitivity and body composition which may reduce the risk of diabetes. On the other hand, testosterone therapy may offset such benefits by mild impairments in lipid parameters. Consequently, controversy on the effects of testosterone therapy on cardiovascular health remains. Studies are underway to clarify this important question for the benefit of men with hypogonadism. (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 23, 2022 Category: Endocrinology Authors: Channa N. Jayasena, Carmen Lok Tung Ho, Shalender Bhasin Source Type: research

Testicular Dysfunction Among Cancer Survivors
In parallel with increased survival rates, quality of life (QoL) has become of growing importance in the management of young cancer survivors. Several surveys have indicated that in those subjects, the issue of reproductive function is considered as one of the main QoL aspects. In this article, we summarize the current evidence, as well as gaps of knowledge and research needs, regarding the impact of cancer and cancer treatment on testicular function —including fertility and androgen production. Also, pre and posttherapy clinical management of reproductive issues in male cancer survivors, are given. (Source: Endocrinolog...
Source: Endocrinology and Metabolism Clinics of North America - February 23, 2022 Category: Endocrinology Authors: Angel Elenkov, Aleksander Giwercman Source Type: research

Hypogonadism
ENDOCRINOLOGY AND METABOLISM CLINICS OF NORTH AMERICA (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 23, 2022 Category: Endocrinology Authors: Shalender Bhasin, Channa N. Jayasena Source Type: research

Copyright
Elsevier (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 23, 2022 Category: Endocrinology Source Type: research

Contributors
ADRIANA G. IOACHIMESCU, MD, PhD (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 23, 2022 Category: Endocrinology Source Type: research

Contents
Adriana G. Ioachimescu (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 23, 2022 Category: Endocrinology Source Type: research

Forthcoming Issues
Updates in Thyroidology (Source: Endocrinology and Metabolism Clinics of North America)
Source: Endocrinology and Metabolism Clinics of North America - February 23, 2022 Category: Endocrinology Source Type: research

Diagnosis and Evaluation of Hypogonadism
A systematic approach to diagnose hypogonadism initially establishes the presence of symptoms/signs of testosterone deficiency, considers other potential causes of manifestations, and excludes conditions that transiently suppress testosterone. Hypogonadism is confirmed by measuring fasting serum total testosterone in the morning on at least 2 separate days, or free testosterone by equilibrium dialysis or calculated free testosterone in men with conditions that alter sex hormone –binding globulin or serum total testosterone near lower limit of normal. To guide management, further evaluation is performed to identify the sp...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Alvin M. Matsumoto Source Type: research

The Benefits and Risks of Testosterone Treatment in Older Hypogonadal Men
As men age, their serum testosterone concentrations decrease —the total testosterone very little but the free testosterone more. Testosterone treatment of older men whose serum testosterone concentrations are unequivocally low to bring their testosterone levels to normal for young men improves their sexual function, walking, mood, bone mineral density, and hemoglobin, but does not improve their sense of vitality or cognitive function. This treatment has also been suspected of increasing the risk of prostate cancer, benign prostatic hyperplasia, and heart disease, but these possible risks have neither been confirmed nor r...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Peter J. Snyder Source Type: research

Testosterone, Diabetes Risk, and Diabetes Prevention in Men
Middle-aged and older men with lower testosterone concentrations are more likely to have or to develop metabolic syndrome and type 2 diabetes. Central adiposity is a risk factor for metabolic syndrome and diabetes and predisposes to lower testosterone concentrations. Conversely, testosterone treatment reduces fat mass and insulin resistance. In a randomized controlled trial of 1007 men with either impaired glucose tolerance or newly diagnosed type 2 diabetes, 2  years of testosterone treatment on a background of lifestyle intervention reduced the risk of type 2 diabetes by 40%; this demonstrates the potential utility for ...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Bu B. Yeap, Gary A. Wittert Source Type: research

Testosterone Replacement Therapy in Hypogonadal Men
All approved testosterone replacement methods, when used according to recommendations, can restore normal serum testosterone concentrations, and relieve symptoms in most hypogonadal men. Selection of the method depends on the patient's preference with advice from the physician. Dose adjustment is possible with most delivery methods but may not be necessary in all hypogonadal men. The use of hepatotoxic androgens must be avoided. Testosterone treatment induces reversible suppression of spermatogenesis; if fertility is desired in the near future, human chronic gonadotropin, selective estrogen receptor modulator, estrogen ant...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Christina Wang, Ronald S. Swerdloff Source Type: research

Body Image Disorders and Anabolic Steroid Withdrawal Hypogonadism in Men
Hypogonadism commonly occurs during withdrawal from anabolic-androgenic steroid (AAS) use, particularly when users have been taking AAS for prolonged periods. Mounting evidence now suggests that AAS-induced hypogonadism may persist for months or even years after last AAS use, and in some cases may be partially or completely irreversible. Treatment with human chorionic gonadotropin and clomiphene may help to restore hypothalamic-pituitary-testicular axis function, and these substances are widely used illicitly by AAS users at the end of a course of AAS as so-called postcycle therapy. Many endocrinologists still have only li...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Harrison G. Pope, Gen Kanayama Source Type: research

Optimized Use of the Electronic Health Record and Other Clinical Resources to Enhance the Management of Hypogonadal Men
Electronic health records (EHRs) have enabled electronic documentation of a tremendous amount of clinical data. EHRs have the potential to improve communication between patients and their providers, facilitate quality improvement and outcomes research, and reduce medical errors. Conversely, EHRs have also increased clinician burnout, information clutter, and depersonalization of the interactions between patients and their providers. Increasing clinician input into EHR design, providing access to technical help, streamlining of workflow, and the use of custom templates that have fewer requirements for evaluation and managem...
Source: Endocrinology and Metabolism Clinics of North America - February 8, 2022 Category: Endocrinology Authors: Anna Goldman, Martin Kathrins Source Type: research