A 27-Year-Old Man Comes to the Physician with Fatigue, Erectile

A 27-year-old man comes to the physician with fatigue, erectile dysfunction, and muscle weakness.  He says, "I am losing my muscles despite working out every day in the gym."  He has no past medical history.  He had taken over-the-counter supplements to improve his endurance but now cannot afford them as he was recently laid off from his job.  He requests a prescription to improve his fatigue and sex drive.  He has no headaches, peripheral vision loss, weight gain, decrease in facial hair growth, or joint pain.
His vital signs are normal, and BMI is 26 kg/m².  He is a well-built, muscular man with minimal gynecomastia. The testes are small and soft.  The remainder of the physical examination is normal.
Initial laboratory results show normal chemistry profile and hematocrit of 52%.
Which of the following laboratory abnormalities would most likely be present on further evaluation?

A) High prolactin levels
B) High TSH levels
C) Increased transferrin saturation
D) Increased insulin-like growth factor 1 levels
E) Low luteinizing hormone

Correct Answer:

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