Question: I am 66 years old and have the sweats. Any tests you might suggest for me? I have low testosterone, and we are addressing it with injections every two weeks.
Dr. Hibberd's Answer:
Bouts of sweating should not be regarded as a primary hormone (testosterone deficiency) driven event. Men do not usually have sweats or hot flashes so commonly seen in women around the time of menopause.
These episodes require investigation for other causes.
Silent infection (such as TB) commonly present as sweats, and night sweats are often seen in malignancy as well as immune deficiency states. While there are hormonal causes for excessive sweating that may relate to undiagnosed diabetes, thyroid disease, and other hormone excess and deficiency states, testosterone deficiency is not the first on my list. Dietary factors, toxins, and low grade exposures to environmental chemicals should be considered as well as any occupational risk factors or exposures you may have.
If your doctor is unable to evaluate the cause of your sweating, request or obtain another physician who will. Recommendations will depend upon your presentation history and physical findings as well as any co-existing symptoms (such as fever, etc.), so a suggested work-up testing is hardly relevant.
Most prudent physicians would start with an H and P,add some general studies such as CBC (blood count), CMP (chemistry), ESR (sed rate), TSH (thyroid ultrasensitive TSH), urinalysis, and a CXR (chest X-ray, PA and lat), and an EKG, then target further evaluation upon these findings.
You are correct to wonder what the cause of this is. Insist on appropriate evaluation, investigation, and referral until the cause is found. Listening to your body will generate more useful information than reliance on any annual physical examination alone.
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