Transient low testosterone levels after oral hydrocodone may contribute to misdiagnosis of hypogonadism.

CONTEXT Multiple morning testosterone levels are needed to establish the presence of male hypogonadism and to justify its replacement therapy. Any influence on these levels by short-term opioid ingestion has not, however, been reported. CASE DESCRIPTION Serial testosterone levels are reported at 2-hour intervals once weekly for 22 weeks in a man after his ingestion of 0, 5, or 10 mg of hydrocodone. CONCLUSIONS Five milligrams of hydrocodone did not significantly alter postingestion testosterone levels, but 10 mg ingestion lowered them at 2, 4, and 6 hours postingestion.