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FAA CACI Low Testosterone (Hypogonadism) Worksheet

Pilots treated for low testosterone or hypogonadism can be certified in the AME's office through this Conditions AMEs Can Issue (CACI) checklist. The AME reviews a progress note from the urologist, endocrinologist or treating physician dated within 90 days of the exam, or the FAA's Low T Status Summary, and confirms stability, no phlebotomy, no VTE, a hematocrit of 54% or less and an accepted medication.

Who completes it

The AME completes the checklist and records the Block 60 outcome. The urologist, endocrinologist or treating physician supplies either a current, detailed Clinical Progress Note or a completed Low Testosterone (Low T) Hypogonadism Status Summary.

Submitting and payment

How to submit it
When every criterion is met, the AME notes 'CACI qualified Hypogonadism' in Block 60 of FAA Form 8500-8 and the documents do not need to go to the FAA. Otherwise the AME defers and submits the supporting documents.

Good to know

  • A complete blood count within the last 90 days must show a hematocrit of 54% or less, and the pilot must not need phlebotomy or have had a PE or DVT.
  • Accepted medications include anastrozole, clomiphene citrate, HCG, Testopel, oral or injectable testosterone and tamoxifen. Enclomiphene citrate is not acceptable.
  • Clomiphene requires a 14-day initial ground trial and AME confirmation of no visual side effects; HCG requires a 7-day initial ground trial.
  • The regimen must be stable with no changes recommended and no side effects that would interfere with flight duties. Mild skin irritation and acne are acceptable.

Get the official form

Download the current version from the source each time; forms change without notice.

CACI – Low Testosterone (Low T) Hypogonadism Worksheet

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Frequently asked questions

What hematocrit does the FAA allow for the Low T CACI?

54% or less, on a complete blood count performed within the last 90 days. The worksheet also requires that the pilot not need phlebotomy and have no history of a venous thromboembolic event such as a PE or DVT. The clinician's note or status summary should report the recent hematocrit.

Is enclomiphene acceptable for the FAA Low T CACI?

No. The worksheet states enclomiphene citrate is not acceptable. Accepted options are anastrozole, clomiphene citrate (after a 14-day ground trial with no visual side effects), HCG (after a 7-day ground trial), Testopel, oral or injectable testosterone and tamoxifen, alone or in combination.

Can the Low T Status Summary replace the progress note?

Yes. The worksheet accepts either a current, detailed Clinical Progress Note or a completed Low Testosterone (Low T) Hypogonadism Status Summary from the urologist, endocrinologist or treating physician. The pilot brings it, with a copy of the recent CBC, to the AME exam.