Haemochromatosis

Type 2 diabetes mellitus, primary hypogonadism and deranged liver function tests, a combination that raises the possibility of haemochromatosis. Genetic testing for the common mutation in the HFE gene is increasingly available, but initial screening with measurement of serum transferrin saturation will identify most cases. Although central obesity per se may be associated with hepatic steatosis and borderline low/normal testosterone levels, the gonadotrophins are usually within the normal range, reflecting the fact that these subjects typically have normal free testosterone levels. However, measurements of total testosterone may be borderline low due to a reduction in circulating sex hormone-binding globulin levels.