Getting first blood test since starting TRT...Do I need to add anything to the test?

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Belmundo

New Member
I'm coming up on day 35 of TRT and have noticed some initial positive changes (brain fog has greatly subsided and libido has increased a bit as well) but I've also noticed that my nipples are sensitive/sore and small pea size lumps behind the nipples have began forming. My E2 was taken by the Roche method and didn't even register in the "normal" range before going on TRT (screenshots below) so I was advised not to take an AI right away. However, with the lumps forming, I'm assuming my E2 is at too high a level.

I informed the lab to give me a sensitive estrogen test this Saturday as it's my next injection day. Looking at the below, is anything else missing that I should have them look at? Any feedback would be greatly appreciated. Thank you!

Screen Shot 2016-12-02 at 7.00.10 PM.jpg
Screen Shot 2016-12-02 at 6.59.15 PM.jpg
 
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CoastWatcher

Moderator
You certainly need to capture a sensitive estradiol test, that's critical. No SHBG was run, that I see - it's important. You needn't test LH and FSH as they are suppressed at this point. Were your thyroid levels checked? TSH, t3, t4, rt3, and antibodies?
 
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Belmundo

New Member
You certainly need to capture a sensitive estradiol test, that's critical. No SHBG was run, that I see - it's important. You needn't test LH and FSH as they are suppressed at this point. We're your thyroid levels checked? TSH, t3, t4, rt3, and antibodies?

None of these were checked initially. Only whats on the blood tests above. So we won't really have a good base level to look back on if one was needed to see the impact TRT has had on these. What do I say specifically about the antibodies so I can ask them to add it?
 
CBC CMP Lipid Panel Testosterone,Free and Total, Prostate-Specific Ag, prolactin Estradiol, Sensitive; TSH; Luteinizing Hormone(LH), S; DHEA-Sulfate; Thyroxine (T4) Free, Direct, S; Vitamin D, 25-Hydroxy; Triiodothyronine,Free,Serum; Sex Horm Binding Glob, Serum;

That's what I got done. Seems pretty detailed.

Get it done day of injection but before injection like you're intending to!

How long have you been on TRT?
 

Belmundo

New Member
CBC CMP Lipid Panel Testosterone,Free and Total, Prostate-Specific Ag, prolactin Estradiol, Sensitive; TSH; Luteinizing Hormone(LH), S; DHEA-Sulfate; Thyroxine (T4) Free, Direct, S; Vitamin D, 25-Hydroxy; Triiodothyronine,Free,Serum; Sex Horm Binding Glob, Serum;

That's what I got done. Seems pretty detailed.

Get it done day of injection but before injection like you're intending to!

How long have you been on TRT?

Thanks for the suggestions! Tomorrow will be 35 days. I was hoping to make it to 6 weeks before the test but the lumps in the nipples have me a little anxious to get blood work done sooner as I'm concerned about my E2 levels.
 
Thanks for the suggestions! Tomorrow will be 35 days. I was hoping to make it to 6 weeks before the test but the lumps in the nipples have me a little anxious to get blood work done sooner as I'm concerned about my E2 levels.

Sometimes the increase in levels can cause nipple sensitivity, but it's usually mild and transient.

I had it right around where you are, and my shirt just kept bothering my nipples, but it only lasted a week. Hopefully that's what it is! Don't panic and change anything in your protocol.
 

Belmundo

New Member
Sometimes the increase in levels can cause nipple sensitivity, but it's usually mild and transient.

I had it right around where you are, and my shirt just kept bothering my nipples, but it only lasted a week. Hopefully that's what it is! Don't panic and change anything in your protocol.

Yeah, I'm not changing the protocol until I get the results of the blood work. I wouldn't mind the sensitivity but the fact that I can feel the little lumps has me worried about any permanent issues.
 

Belmundo

New Member
You certainly need to capture a sensitive estradiol test, that's critical. No SHBG was run, that I see - it's important. You needn't test LH and FSH as they are suppressed at this point. We're your thyroid levels checked? TSH, t3, t4, rt3, and antibodies?

Is rt3 reverse t3?
 
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Belmundo

New Member
What is included in "Thyroid Profile With TSH?"

It says test includes: Free thyroxine index; T3 uptake (THBR); thyroid-stimulating hormone (TSH); thyroxine (T4)

So I've been doing TRT through PrimeBody and I reached out to my rep and asked them if they could add the following:

SHBG (Sex Hormone-binding Globulin), plus a complete thyroid panel (Free T4, Free T3, Reverse T3, TSH, Antibodies TPO & TgAb), DHEA Sulfate and Vitamin D3, 25-Hydroxy

They replied that they'll get me a revised lab request but there will be an additional cost. I'm not trying to kill my wallet and I'm surprised that none of this is invluded or requested by the doctors they work with to be a standard as it seems from many here that this is pertinent information to have. I asked if they could give me a price breakdown before I commit so I guess I'll pick the most crucial reports to have.

Does anyone know of a cheaper out of pocket alternative that includes not only the standard total and free test, and sensitive estrogen but all of the above too?
 

CoastWatcher

Moderator
It says test includes: Free thyroxine index; T3 uptake (THBR); thyroid-stimulating hormone (TSH); thyroxine (T4)

So I've been doing TRT through PrimeBody and I reached out to my rep and asked them if they could add the following:

SHBG (Sex Hormone-binding Globulin), plus a complete thyroid panel (Free T4, Free T3, Reverse T3, TSH, Antibodies TPO & TgAb), DHEA Sulfate and Vitamin D3, 25-Hydroxy

They replied that they'll get me a revised lab request but there will be an additional cost. I'm not trying to kill my wallet and I'm surprised that none of this is invluded or requested by the doctors they work with to be a standard as it seems from many here that this is pertinent information to have. I asked if they could give me a price breakdown before I commit so I guess I'll pick the most crucial reports to have.

Does anyone know of a cheaper out of pocket alternative that includes not only the standard total and free test, and sensitive estrogen but all of the above too?


They are charging you for a lab order??? Go to discountedlabs.com and price it there.
 
It says test includes: Free thyroxine index; T3 uptake (THBR); thyroid-stimulating hormone (TSH); thyroxine (T4)

So I've been doing TRT through PrimeBody and I reached out to my rep and asked them if they could add the following:

SHBG (Sex Hormone-binding Globulin), plus a complete thyroid panel (Free T4, Free T3, Reverse T3, TSH, Antibodies TPO & TgAb), DHEA Sulfate and Vitamin D3, 25-Hydroxy

They replied that they'll get me a revised lab request but there will be an additional cost. I'm not trying to kill my wallet and I'm surprised that none of this is invluded or requested by the doctors they work with to be a standard as it seems from many here that this is pertinent information to have. I asked if they could give me a price breakdown before I commit so I guess I'll pick the most crucial reports to have.

Does anyone know of a cheaper out of pocket alternative that includes not only the standard total and free test, and sensitive estrogen but all of the above too?

Are they charging you because you don't have insurance that covers these tests?

Or are they charging you for writing a prescription so you can run it through your insurance? If so I don't know why they'd charge per test so it must be the first one.
 

Belmundo

New Member
They are charging you for a lab order??? Go to discountedlabs.com and price it there.

Are they charging you because you don't have insurance that covers these tests?

Or are they charging you for writing a prescription so you can run it through your insurance? If so I don't know why they'd charge per test so it must be the first one.

The results I posted above are the standard tests they run for their blood work, I think. I asked them for the upcoming 6 week test to do a sensitive estradiol test instead of the Roche. They sent me the lab request which was fine but I thought I should ask the forum in case I was missing anything on the labs. I sent another email asking them to add the additional tests and they replied "I will send you another requ with the additional labs you requested. And total price of the additional labs."

I don't have insurance so I'm not sure how they price things if you have insurance or don't but when I first got blood work prior to joining, it was like $66 to get the test done which was setup through LabCorp. Not sure if this upcoming test is covered by the monthly fee I'm currently paying and I'll just have to pay for the added stuff or if it will be $66 + the cost of the added tests. From her email it sounds like I'll be charged extra for the things I've requested regardless. Does anyone know if this is the norm with them?
 
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Belmundo

New Member
What would be the most important test to get done with this updated blood work if I had to choose? SHBG?

My nipples are really sore and the lumps are getting more pronounced. I'm worried that I'm doing irreversible damage here. If my estrogen is high which it has to be based on these symptoms, would the .25mg 1x a week of anastrozole reverse this or would I need to increase the dosage?
 

CoastWatcher

Moderator
What would be the most important test to get done with this updated blood work if I had to choose? SHBG?

My nipples are really sore and the lumps are getting more pronounced. I'm worried that I'm doing irreversible damage here. If my estrogen is high which it has to be based on these symptoms, would the .25mg 1x a week of anastrozole reverse this or would I need to increase the dosage?

Given your concerns, the sensitive estradiol test is what will set your mind at ease in regard to your nipple discomfort. Have you priced tests at Discountedlabs.com? Many of us use them on a regular basis to self-monitor our progress.

I'm concerned you aren't receiving the care you deserve and are paying a premium for it.
 

Belmundo

New Member
Given your concerns, the sensitive estradiol test is what will set your mind at ease in regard to your nipple discomfort. Have you priced tests at Discountedlabs.com? Many of us use them on a regular basis to self-monitor our progress.

I'm concerned you aren't receiving the care you deserve and are paying a premium for it.

Yeah, PrimeBody is adding the sensitive estradiol (I have the LabCorp request for it in hand) but in regards to the other tests I requested SHBG (Sex Hormone-binding Globulin), plus a complete thyroid panel (Free T4, Free T3, Reverse T3, TSH, Antibodies TPO & TgAb), DHEA Sulfate and Vitamin D3, 25-Hydroxy

What's the most important tests to add to this, if any? Pricing it out on discountedlabs (Test, Thyroid, Sensitive E, SHBG) is going to be like $250. SHBG is just $62 + 5% off coupon you get for first time orders.
 

Belmundo

New Member
I was going to get the blood test this saturday but I held off after reading everyone's comments as I thought I might need to add the others and wanted to get it all done in 1 shot. I'm 100% getting the bloodwork done on Tuesday as that's when my next T+HCG injection is. It's odd that PrimeBody doesn't have those tests as part of their blood work analysis because it seems like they play a role in determining the proper dosage for Test, HCG, and AI.
 

CoastWatcher

Moderator
I was going to get the blood test this saturday but I held off after reading everyone's comments as I thought I might need to add the others and wanted to get it all done in 1 shot. I'm 100% getting the bloodwork done on Tuesday as that's when my next T+HCG injection is. It's odd that PrimeBody doesn't have those tests as part of their blood work analysis because it seems like they play a role in determining the proper dosage for Test, HCG, and AI.

I'm surprised at that as well.
 
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