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Thomas E. Finucane, MD

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Hall and colleagues¹ report that 88% of men with "symptomatic androgen deficiency" went untreated. This disease was defined as a serum total testosterone level lower than 300 ng/dL (to convert to nanomoles per liter, multiply by 0.0347) and the presence of symptoms.

The choice of this level is a bit arbitrary (low reference value for total testosterone ranged from 130 to 450 ng/dL in one study),² is presumably based on a mean (SD) value, and is not discussed in the article. In the authors' words, the symptoms are "less specific": low libido and 2 or more of sleep disturbance, depressed mood, lethargy, or diminished physical performance would qualify.

Could it be that the clinicians of 88% of these men are missing an important and treatable disease? Or could it be that the sponsor of the study, GlaxoSmithKline, is encouraging the use of its androgen products for . . . [Full Text of this Article]

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