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Hot Flushes in a 76-Year-Old Man

Kent R. Kreider, MD
JAMA. 1986;255(24):3364. doi:10.1001/jama.1986.03370240034022.
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To the Editor.—  In the QUESTIONS AND ANSWERS section of The Journal,1 there was a question concerning flushing in a 76-year-old man. The two replies failed to mention a low testosterone level as a cause of flushing.

Report of a Case.—  In November 1976, I saw a 48-year-old man who had sweating and hot flushes. He was afebrile and had a positive tuberculin test result but a normal chest roentgenogram, and he was treated with isoniazid for a year. Because his flushes continued, in December 1977 a serum testosterone value was obtained, which was 40 μg/dL (normal range, 400 to 1,000 μg/dL). He also had a low luteinizing hormone level, 3.5 mIU/mL (normal range, 4 to 22 mIU/mL), a normal prolactin value, and a normal cortisol level. Thyroid function study values were low; the free thyroxine index was 13 (normal range, 18 to 46). A computed tomographic scan of


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