From the Guidelines
The ADAM blood test is not a valid or recognized medical test for detecting androgen decline in the aging male, and instead, the diagnosis of testosterone deficiency should be made based on a combination of low total testosterone levels and the presence of symptoms and/or signs, as recommended by the American Urological Association guideline 1.
The diagnosis of testosterone deficiency requires a total testosterone level below 300 ng/dL, measured on two separate occasions in an early morning fashion, and the presence of symptoms such as reduced energy, reduced endurance, diminished work and/or physical performance, fatigue, and changes in erectile function, as well as signs such as gynecomastia, testicular evaluation, and prostate size and morphology 1.
Key points to consider in the diagnosis of testosterone deficiency include:
- Measuring total testosterone in patients with a history of unexplained anemia, bone density loss, diabetes, exposure to chemotherapy, exposure to testicular radiation, HIV/AIDS, chronic narcotic use, male infertility, pituitary dysfunction, and chronic corticosteroid use, even in the absence of symptoms or signs associated with testosterone deficiency 1.
- Using validated questionnaires is not currently recommended to either define which patients are candidates for testosterone therapy or monitor symptom response in patients on testosterone therapy 1.
- A targeted physical exam should be conducted to examine patients for signs associated with low testosterone, including evaluation of general body habitus, virilization status, body mass index or waist circumference, gynecomastia, testicular evaluation, and prostate size and morphology 1.
In clinical practice, it is essential to prioritize the diagnosis of testosterone deficiency based on a combination of low total testosterone levels and the presence of symptoms and/or signs, rather than relying on a single test or screening tool, to ensure accurate diagnosis and effective management of patients with testosterone deficiency 1.
From the Research
ADAM Blood Test
The ADAM (Androgen Decline in the Aging Male) blood test is not mentioned in the provided studies.
Relevant Information
- The studies provided focus on testicular cancer, tumour markers, and their role in diagnosis and follow-up 2, 3, 4, 5, 6.
- Tumour markers such as alpha-fetoprotein (AFP), human chorionic gonadotropin (hCG), and lactate dehydrogenase (LDH) are discussed in the context of testicular cancer 2, 3, 4, 5, 6.
- The diagnostic performance of these tumour markers is evaluated in various studies, with results indicating limitations in their accuracy for detecting relapse 4, 5.
Key Findings
- hPLAP is the most frequently elevated serum marker in testicular cancer 2.
- A combination of hPLAP, AFP, and hCG provides better results than single markers for therapy monitoring 2.
- The positive predictive value (PPV) of tumour markers is limited, with βHCG having the highest PPV and LDH having the lowest 4.
- False-positive marker elevations are common, and many patients do not have marker elevations despite a relapse 4.
Tumour Markers
- Alpha-fetoprotein (AFP) is a tumour marker used in the diagnosis and follow-up of testicular cancer 2, 3, 4, 5, 6.
- Human chorionic gonadotropin (hCG) is another tumour marker used in the diagnosis and follow-up of testicular cancer 2, 3, 4, 5, 6.
- Lactate dehydrogenase (LDH) is a tumour marker used in the diagnosis and follow-up of testicular cancer, although its diagnostic performance appears to be poorer than AFP and hCG 4, 5.