How do I install the Icsm Treat Anemia With Tt skill?

Run npx skillmds@latest add dromlakhani/icsm-treat-anemia-with-tt in your terminal (requires Node.js), paste this page's agent-chat prompt into Claude, Cursor, or any MCP-connected agent, or download the SKILL.md file and copy it into your agent's skills directory.

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Is Icsm Treat Anemia With Tt free to use?

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Who published Icsm Treat Anemia With Tt?

dromlakhani (@dromlakhani) published this skill. Their other Agent Skills are listed on their SkillMD profile.

Icsm Treat Anemia With Tt by dromlakhani

Name: Icsm Treat Anemia With Tt
Rating: 4.2 (5 reviews)
Author: dromlakhani

Icsm Treat Anemia With Tt

Testosterone therapy is more effective than placebo at correcting anemia in middle-aged and older men with confirmed hypogonadism. Consider this approach when evaluating a hypogonadal man with anemia and questioning whether testosterone will improve hemoglobin or if testosterone therapy should be used for anemia.

dromlakhani Updated Sep 8, 2026 10 repo stars

File contents

Treat anemia with testosterone therapy in hypogonadal men

STEP 1 — Gather Information

Collect morning total testosterone (fasting, 07:00–11:00) on two occasions, hemoglobin, hypogonadal symptoms (low libido, fatigue, erectile dysfunction), iron studies, vitamin B12/folate, renal/liver function, baseline hematocrit, and prostate assessment (PSA, DRE) if testosterone therapy is contemplated.

STEP 2 — Rule In / Rule Out

Is the man hypogonadal (total testosterone <12 nmol/L on two occasions plus symptoms) AND anemic (hemoglobin <12.7 g/dL) with no identifiable non‑hypogonadal cause? If yes, proceed; if no, investigate alternative anemia etiologies or refrain from using testosterone therapy for anemia.

STEP 3 — Classify or Stratify

Assess contraindications: hematocrit ≥54%, active prostate cancer, desire for fertility, untreated severe sleep apnea, or high thrombotic risk. If any contraindication is present, do not initiate testosterone therapy; otherwise classify the patient as a candidate for therapy.

STEP 4 — Decide

Initiate testosterone therapy (gel, injection, or other formulation) targeting the mid‑normal total testosterone range; re‑evaluate hemoglobin and hematocrit at 3 months; expect a hemoglobin rise of ≥1 g/dL and resolution of anemia (hemoglobin ≥12.7 g/dL) in responders.

Clinical Guardrails / Mimics / Pitfalls

Do not use testosterone therapy in eugonadal men or solely for anemia without hypogonadism; monitor hematocrit to avoid polycythemia (>54%) and hold or reduce dose if exceeded; avoid in men seeking fertility (use gonadotropins instead); do not ignore prostate cancer screening (PSA/DRE per guidelines); anemia due to iron deficiency, B12 deficiency, or chronic disease will not respond to testosterone therapy alone.

Concrete Clinical Example

A 62‑year‑old man presents with fatigue, low libido, and hemoglobin 11.8 g/dL. Morning total testosterone is 9.5 nmol/L (confirmed on repeat) and hematocrit is 49%. Iron studies are normal. He is started on testosterone gel 50 mg daily. At 3‑month follow‑up, hemoglobin is 13.2 g/dL and hematocrit 52%, confirming anemia resolution.

Source: Male hypogonadism: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024), International Society for Sexual Medicine, 2025, https://doi.org/10.1093/sxmrev/qeaf036

---name: icsm-treat-anemia-with-ttdescription: Testosterone therapy is more effective than placebo at correcting anemia in middle-aged and older men with confirmed hypogonadism. Consider this approach when evaluating a hypogonadal man with anemia and questioning whether testosterone will improve hemoglobin or if testosterone therapy should be used for anemia.---# Treat anemia with testosterone therapy in hypogonadal men## STEP 1 — Gather InformationCollect morning total testosterone (fasting, 07:00–11:00) on two occasions, hemoglobin, hypogonadal symptoms (low libido, fatigue, erectile dysfunction), iron studies, vitamin B12/folate, renal/liver function, baseline hematocrit, and prostate assessment (PSA, DRE) if testosterone therapy is contemplated.## STEP 2 — Rule In / Rule OutIs the man hypogonadal (total testosterone <12 nmol/L on two occasions plus symptoms) AND anemic (hemoglobin <12.7 g/dL) with no identifiable non‑hypogonadal cause? If yes, proceed; if no, investigate alternative anemia etiologies or refrain from using testosterone therapy for anemia.## STEP 3 — Classify or StratifyAssess contraindications: hematocrit ≥54%, active prostate cancer, desire for fertility, untreated severe sleep apnea, or high thrombotic risk. If any contraindication is present, do not initiate testosterone therapy; otherwise classify the patient as a candidate for therapy.## STEP 4 — DecideInitiate testosterone therapy (gel, injection, or other formulation) targeting the mid‑normal total testosterone range; re‑evaluate hemoglobin and hematocrit at 3 months; expect a hemoglobin rise of ≥1 g/dL and resolution of anemia (hemoglobin ≥12.7 g/dL) in responders.## Clinical Guardrails / Mimics / PitfallsDo not use testosterone therapy in eugonadal men or solely for anemia without hypogonadism; monitor hematocrit to avoid polycythemia (>54%) and hold or reduce dose if exceeded; avoid in men seeking fertility (use gonadotropins instead); do not ignore prostate cancer screening (PSA/DRE per guidelines); anemia due to iron deficiency, B12 deficiency, or chronic disease will not respond to testosterone therapy alone.## Concrete Clinical ExampleA 62‑year‑old man presents with fatigue, low libido, and hemoglobin 11.8 g/dL. Morning total testosterone is 9.5 nmol/L (confirmed on repeat) and hematocrit is 49%. Iron studies are normal. He is started on testosterone gel 50 mg daily. At 3‑month follow‑up, hemoglobin is 13.2 g/dL and hematocrit 52%, confirming anemia resolution.**Source:** Male hypogonadism: recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024), International Society for Sexual Medicine, 2025, https://doi.org/10.1093/sxmrev/qeaf036

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