What should I test at the 6 week mark?

Phil Goodman · Aug 2, 2021

I want to establish a good baseline(or as close to baseline as I can get after 6 weeks in). They only tested four things for my initial visit.
LH = 5.8(1.7-8.6)
FSH = 6.3(1.5-12.4)
Total = 563(264-916)
Free = 10.1(8.7-25.1)

I know a lot of people recommend checking thyroid and I’m open to it if many people feel it’s really needed. Never had symptoms of thyroid issues before though. Always hard to gain or lose weight, can deal with heat with little to no issues and it takes a lot to make me sweat & can also tolerate cold more than most though I occasionally get cold feet and hands(assuming from circulation).

What else should I test? Estradiol I’m sure, maybe DHEA and pregnenelone. I wouldn’t mind looking into cortisol because I have had it flagged high on a test before, but that was a morning after a heavy leg day so I think that may have contributed. Anyway…what do feel needs to be tested to establish a good “close to baseline” measure and also look for other areas I could possibly improve.

madman · Aug 2, 2021

Phil Goodman said:
I want to establish a good baseline(or as close to baseline as I can get after 6 weeks in). They only tested four things for my initial visit.
LH = 5.8(1.7-8.6)
FSH = 6.3(1.5-12.4)
Total = 563(264-916)
Free = 10.1(8.7-25.1)

I know a lot of people recommend checking thyroid and I’m open to it if many people feel it’s really needed. Never had symptoms of thyroid issues before though. Always hard to gain or lose weight, can deal with heat with little to no issues and it takes a lot to make me sweat & can also tolerate cold more than most though I occasionally get cold feet and hands(assuming from circulation).

What else should I test? Estradiol I’m sure, maybe DHEA and pregnenelone. I wouldn’t mind looking into cortisol because I have had it flagged high on a test before, but that was a morning after a heavy leg day so I think that may have contributed. Anyway…what do feel needs to be tested to establish a good “close to baseline” measure and also look for other areas I could possibly improve.

Unfortunately, your FT was tested using an inaccurate assay let alone we have no clue where your SHBG sits.

SHBG will have a significant impact on TT/FT let alone can dictate what injection frequency may suit you best.

Blood work should be done using the most accurate assays.

TT/estradiol/DHT (LC/MS-MS) and FT (Equilibrium Dialysis or Ultrafiltration).

Once blood levels have stabilized (4-6 weeks) get blood work done 6 weeks in as you want to know where said protocol (dose T/injection frequency) has your TT, FT, estradiol, SHBG, DHT.

We want to test at the true trough.

Pre-trt: LH/FSH, TT/FT, SHBG, estradiol, DHT, prolactin, DHEA, Vit D, PSA, lipids, CMP, CBC (includes RBCs/hemoglobin/hematocrit), full thyroid panel, cortisol.

6 weeks on trt you would want to at least test TT, FT, SHBG, estradiol, PSA, CBC (includes RBCs/hemoglobin/hematocrit).

You can add DHT, full thyroid panel, and cortisol as they were not done pre-trt.

Keep in mind that dysfunction thyroid/adrenals can mimic low-t symptoms let alone have a negative effect on the effectiveness of a trt protocol!

madman · Aug 2, 2021

The only way to know where your FT level truly sits is to have it tested using the most accurate assays such as the gold standard Equilibrium Dialysis or Ultrafiltration (next best).

I would not use/rely upon the piss poor inaccurate direct immunoassay for FT!

These are the assays everyone should be using pre-trt let alone when on trt.

Quest Diagnostics

1 Total (LC/MS- No upper Limit) and Free Testosterone by Equilibrium Dialysis