SHM Converge Scientific Abstract ePoster Gallery-Recurring Hypoglycemia in a Patient on Exogenous Testosterone Therapy: A Case Study

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This case describes a 44-year-old paraplegic man with a chronic Foley catheter and multiple medical comorbidities who was admitted for an ESBL urinary tract infection. His hospital course was complicated by persistent, unexplained hypoglycemia and marked thrombocytosis, which were ultimately suspected to be related to exogenous testosterone use.<br /><br />During hospitalization, his blood glucose repeatedly fell below 70 mg/dL, with lows of 62 mg/dL, despite adequate oral intake and no evidence of calorie deficit. Platelet counts remained very elevated, ranging from 600,000 to over 1,000,000/μL. Workup did not support adrenal insufficiency or insulinoma: C-peptide and cortisol levels were normal on repeated testing. The patient reported use of testosterone supplements and an injection before admission, but the exact regimen and start date were unclear, and no one could confirm his baseline laboratory values or prior testosterone use.<br /><br />Unlike many prior reports linking testosterone therapy to polycythemia, this patient remained anemic throughout admission, with hemoglobin values of 8.0–12.1 g/dL and hematocrit of 24.5–36.7%. The authors note that his persistent anemia may have reflected prior blood loss or possible iron deficiency. His case highlights uncertainty about the safety of testosterone supplementation, especially in metabolically healthy patients without known hypogonadism, prediabetes, or diabetes.<br /><br />The report emphasizes that testosterone therapy and over-the-counter testosterone-boosting supplements remain controversial. While they may improve insulin sensitivity and body composition, they can also carry risks such as venous thromboembolism, sleep apnea, and weight gain. This case adds to limited evidence suggesting exogenous testosterone may contribute to hypoglycemia, underscoring the need for careful monitoring and further research in non-diabetic patients.

Asset Subtitle

Javier Prieto

Meta Tag

Author List Javier Prieto, Jhon A. Orozco Arismendy, Lakshmi Puvvula, Zayan Musa

Category Clinical Vignettes

Concept Hypoglycemia

Concept Exogenous Testosterone

Concept ESBL UTI

Concept Thrombocytosis

Concept Adverse Effect

Distinguished Non-Finalist

Presenter Organization UC Riverside School of Medicine

Presenting Author Javier Prieto

Track Adult

Keywords

testosterone

hypoglycemia

thrombocytosis

exogenous testosterone

urinary tract infection

ESBL

Foley catheter

anemia

insulin sensitivity

non-diabetic

Hypoglycemia

Exogenous Testosterone

ESBL UTI

Thrombocytosis

Adverse Effect