Q. Why are my total and free testosterone levels so high?

Answered by
Dr. Shaikh Sadaf
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 15, 2017 and last reviewed on: Jun 28, 2019

Hello doctor,

I am a 36 year old male. I suddenly developed sexual dysfunction, I have reduced interest, arousal, plateau, and orgasm. The triggering event seems to be the discontinuation of 150 mg Bupropion because of adverse effects. I switched to 20 mg Citalopram, and over the course of six months, I reduced Citalopram to less than 1.5 mg. However, the sexual dysfunction has remained unchanged. I previously took Citalopram in doses ranging from 10 to 20 mg, depending on the external stress, for six years, and this did not cause significant sexual side effects, except delayed orgasm. While on Bupropion, my semen production stopped, but there were no marked changes in sexual desire, arousal, or behavior. The Citalopram and Bupropion had been prescribed for anxiety and depression, which have been well controlled for many years. Six months after the onset of the sexual dysfunction, a testosterone test revealed total testosterone in the 400s and free testosterone beyond the laboratory's ability to measure it (highly elevated >100). I do not use androgen supplements and illegal or recreational drug. There is no history of alcohol addiction or nicotine use. There is no neurological history, history of an endocrine disease, or surgery. I currently take Fexofenadine, antihistamines, and steroid nasal sprays.

#

Hello,

Welcome to icliniq.com.

  • I just read your query and from the history you gave and the levels of testosterone you mentioned, it is very high level of serum testosterone.
  • There are usually some males who normally have high testosterone levels without any major underlying disease. I will discuss that later on.
  • Regarding the reduced interest, arousal, plateau, and orgasm they are called as erectile dysfunction altogether. In this case, you were initially taking Bupropion, which is not known to cause sexual dysfunction, in fact in rare cases it does cause an increased libido.
  • Albeit the anxiety and depression, which you had right from the start, definitely, contribute towards developing erectile dysfunction and are known to be a major cause for it.
  • Citalopram is known to cause ejaculation disorder in 6 % of cases, impotence in 3 %, and decreased libido in 2 % of patients, so it might be another reason for erectile dysfunction.
  • The cause for raised testosterone, both total and free could be one of the following in your case.
  1. Antidepressants or antianxiety medications are known to cause increased testosterone levels.
  2. Adrenal tumors, these are glands located just above the kidneys and they sometimes cause an increased testosterone secretion. So, I would suggest you have an MRI of the adrenals done to make sure they are not enlarged.
  3. Prolonged use of steroid nasal sprays also contributes to making increased testosterone in the long run.
  • I would suggest you do the following.
  1. Some blood tests such as serum prolactin, FSH (follicle stimulating hormone), prostate specific antigen, and liver function test.
  2. MRI of adrenals.
  3. Ultrasound of the pelvis, to rule out any testicular causes.

Do get back to me after you have done these. Hope my advice is of some benefit to you.

Revert with more information to an endocrinologist online --> https://www.icliniq.com/ask-a-doctor-online/endocrinologist



Was this answer helpful?

 | 


Related Questions:
Postpartum Depression

History of bipolar disorder ... Family history of depression or other psychological disorders ...   Read full

Generalized Anxiety Disorder(GAD)

that worsens with life stressors with the occurrence of negative life events ... stress of GAD ...   Read full

Can anxiety and stress cause frequent urination?

I use to get those episodes every few months when I had stress but since I got the fear it might never go away I get it almost daily now ... Can anxiety cause polyuria like this clear urine when I am stressed ...   Read full

 

This is a sponsored Ad. icliniq or icliniq doctors do not endorse the content in the Ad.

Also Read Answers From:

ideaComprehensive Medical Second Opinion.Submit your Case

Also Read


Sporting Events During the Pandemic
If you are into any sporting event and plan a trip to an outdoor or indoor stadium, or you are an organizer or an athlet...  Read more»
Can viral fever lead to Parkinson's disease?
Hello doctor,I had a viral fever six years back. I had a very high temperature of 105, bad cough, also hallucinations. I...  Read more»
Parkinson's Disease: Historical Aspects and Current Treatment Approaches
This article discusses the historical aspects of Parkinsonism and, the evidence based approaches currently available for...  Read more»

Ask your health query to a doctor online?

Ask an Endocrinologist Now

* guaranteed answer within 4 hours.

Disclaimer: No content published on this website is intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek advice from your physician or other qualified healthcare providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.