Clinical conditions affecting testosterone-binding proteins (sex hormone binding globulin and albumin) result in falsely elevated/low total testosterone values, and the measurement of free testosterone is recommended in such scenarios (Table 2).20,21 Guidelines do not recommend universal screening for hypogonadism;20,21 however, physicians should remain more vigilant with patients at risk of hypogonadism (e.g. patients with HIV, pituitary disease or on chronic opioid therapy). This evidence concerns the gene SHBG and hypogonadism.