Limited lab testing by endocrinologists

[Forty2]

I've been to 3 endocrinologists and 2 of them only tested me for total testosterone, LH and FSH. The other one also tested SHBG.
Why do you think none of them tested sensitive estradiol, free testosterone, DHEA, progesterone, cortisol or any other hormones? How can they get a full hormonal profile with such limited testing?

 

[Seagal]

$$$ or €€€

 

[NeverSayNeverAgain]

They are getting away from this in general you will have to pay for it yourself upload to chatgpt to analyze it.

Pre- TRT MALE Hormone / Wellness Panel | Discounted Labs

Pre- TRT male hormone and wellness panel lab tests performed before men start testosterone replacement therapy

www.discountedlabs.com

 

[Forty2]

They are getting away from this in general you will have to pay for it yourself upload to chatgpt to analyze it.

Pre- TRT MALE Hormone / Wellness Panel | Discounted Labs

Pre- TRT male hormone and wellness panel lab tests performed before men start testosterone replacement therapy

www.discountedlabs.com

Why are they getting away from this? In my country, only endos can prescribe testosterone and hCG but they won't run any more tests than the ones they have previously referred me for.
I have a GP friend who can run any tests I ask for but he's not allowed prescribe these meds. When I visited the endo with classic symptoms of low estradiol, I handed him my sensitive estradiol lab test results and he immediately put them aside. He was not even interested in glancing at the results!

 

[Seagal]

Why are they getting away from this? In my country, only endos can prescribe testosterone and hCG but they won't run any more tests than the ones they have previously referred me for.
I have a GP friend who can run any tests I ask for but he's not allowed prescribe these meds. When I visited the endo with classic symptoms of low estradiol, I handed him my sensitive estradiol lab test results and he immediately put them aside. He was not even interested in glancing at the results!

Same here. One urologist claimed that only TT matters. That's why this forum is so helpful in obtaining objective state-of-art information as well as anecdotal experience.

 

[anurruti]

When I started 2m ago, I did the same questioning. The GP that oversees the TRT of all of us in UpGuys said:

1) FT is in a "fixed" ratio with TT. Therefore, if one goes up/down, the other one goes up/down proportionally. She did not mention what ratio that is, but apparently is in the ~2%.

2) For the love of my life I could not understand her explanation on why not testing SHGB. She said some docs or 'parctitioners' order it so labs calculate TT, instead of measure it, using the values of Albumin and SHGB.
3) LH and FSH are usually not measured unless there is really something off or bad that requires more info than just a follow up or so.

 

[Cataceous]

...
1) FT is in a "fixed" ratio with TT. Therefore, if one goes up/down, the other one goes up/down proportionally. She did not mention what ratio that is, but apparently is in the ~2%.
...

This is false. The ratio varies and is highly dependent on the SHBG level. For a fixed free testosterone, which occurs at a fixed dose rate, as SHBG goes higher so does total testosterone, and this lowers the ratio of FT to TT.

2) For the love of my life I could not understand her explanation on why not testing SHGB. She said some docs or 'parctitioners' order it so labs calculate TT, instead of measure it, using the values of Albumin and SHGB.

Using measurements of SHBG, albumin and total testosterone you can calculate free testosterone with the Vermeulen equation. This estimation has proven to be reasonably accurate and much better than inexpensive immunoassay-based tests. Calculated free testosterone is also more useful than measured total testosterone in diagnosing hypogonadism.

...
3) LH and FSH are usually not measured unless there is really something off or bad that requires more info than just a follow up or so.

There is little point in measuring these when on TRT because they are usually suppressed to low levels. Prior to TRT these are helpful in determining the type of hypogonadism: Is the problem with the testicles or is it more likely related to the hypothalamus or pituitary?