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Hormonal fluctuations are another key consideration: Rapid weight loss can significantly alter SHBG and free testosterone levels, potentially leading to symptoms of androgen excess or deficiency even when the prescribed testosterone dose remains unchanged

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Evaluation time was short and the sample size was small

Ballas SK, Kesen MR, Goldberg MF, Lutty GA, Dampier C, Osunkwo I, Wang WC, Hoppe C, Hagar W, Darbari DS et al (2012) Beyond the definitions of the phenotypic complications of sickle cell disease: an update on management

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