28th August 2020

A 42-year-old male comes to see you with the results of his blood tests

A 42-year-old male comes to see you with the results of his blood tests. He presented 2 weeks ago with reduced libido. He admits that he has been having troubles for about 5 years but has been too embarrassed to seek help sooner. He feels that his reduced libido is due to him having put on weight due to increased stress. He is a heavy smoker and drinks moderate levels of alcohol. He wakes up feeling tired and his partner has told him that he snores a lot. His blood tests are as follows: glucose 4.1mmol/L, serum phosphate 1.6mmol/L, calcium 2.6mmol/L, triglycerides 23mmol/L, IGF-1 482ng/ml.

Normal ranges:

Serum phosphate 0.8-1.5 mmol/L

Calcium 2.2 to 2.6 mmol/L

IGF-1 109‐472 ng/ml

For the patient above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.