What blood tests?

[Janosch]

I have been on Cypionate (75mg twice a week) and Anastrazole (0.25mg twice a week) for six months. I am going to do a lab follow up to see where I am at as I have made no progress in the ED/libido department. I am thinking to test: Total T; Free T; Sensitive Estradiol; SHBG; Prolactin; DHT; TSH; Free T3; Free T4. Are there other tests you would recommend for me? Thanks for any feedback you might have!

 

[ratbag]

Yes to add to that list:
RT3
TPO
TGAb
DHEA
Progesterone
Ferritin
morning cortisol serum (if this is low you should follow up with 4 x dirurnal cortisol saliva labs)

 

[Vince Carter]

Ferritin
Iron, Serum

Also have you ever had SHBG pulled and what's your history if so? I would recommend another test if your SHBG is <20.

 

[Janosch]

Ferritin
Iron, Serum

Also have you ever had SHBG pulled and what's your history if so? I would recommend another test if your SHBG is <20.

Thanks Vince. My last E2 was 49.41 (not sensitive) and my last SHBG was 22.05 (I am 6'7" and 276lb.)

 

[Janosch]

Yes to add to that list:
RT3
TPO
TGAb
DHEA
Progesterone
Ferritin
morning cortisol serum (if this is low you should follow up with 4 x dirurnal cortisol saliva labs)

Thanks ragbag. What is TGAb and why DHEA and Progesterone?

 

[ratbag]

TPO and TGAb are your thyroid antibodies. Since Low T symptoms are very similar to Low Thyroid it's practically standard protocol to verify that your thyroid is good. FYI, thyroid is as equally difficult as determining Low T. The average MD ignores thyroid or claims your normal when in fact your not. DHEA and progesterone numbers tell us what your HPTA axis is doing.

 

[Janosch]

TPO and TGAb are your thyroid antibodies. Since Low T symptoms are very similar to Low Thyroid it's practically standard protocol to verify that your thyroid is good. FYI, thyroid is as equally difficult as determining Low T. The average MD ignores thyroid or claims your normal when in fact your not. DHEA and progesterone numbers tell us what your HPTA axis is doing.

That is very helpful. Thanks! In my readings, I stumbled over Pregnenolone, which supposedly is a precursor to cortisol, dehydroepiandrosterone (DHEA), aldosterone, testosterone, estrogens, and progesterone. Is that something you are familiar with and that could be helpful to test for? (it is expensive to test).

 

[ratbag]

If your progesterone and DHEA are low yes it would be wise to test further HPTA axis hormones... like cortisol, aldosterone etc. Conversely if they are normal then no need to do further labs.

 

[Janosch]

If your progesterone and DHEA are low yes it would be wise to test further HPTA axis hormones... like cortisol, aldosterone etc. Conversely if they are normal then no need to do further labs.

Excellent; thanks again!

 

[Vince Carter]

Since your SHBG is 22 I suggest you include "Estradiol, Free"...run that with the other LC/MS/MS test, assuming it's affordable for you.

The pregnenolone test is expensive, much more so than Progesterone, and the Preg test isn't very good or reliable so they say so folks run Progesterone. I don't believe in DHEA-S testing, Preg, or Progesterone but they can be nice to see, if affordable for you.