LAB TESTING - WHAT is the DIFFERENCE BETWEEN BASIC and COMPREHENSIVE LAB TESTING?

[Lindsay IMT Staff]

Basic Lab Work All You Need to Know



If you're interested in Bio-Identical Hormone Replacement Therapy you may be trying to decide if it is right for you. The first thing everyone needs to do when considering BHRT is get hormone panel blood test but what should you test for? What is important?



Hopefully this thread will clear up the difference between what a comprehensive test and a basic hormone panel.



Men:



· Metabolic Panel



This panel is a measure of your organ function. These results will give you an idea of how well your metabolic system is running.



· (LH) Luteinizing Hormone



The Luteinizing Hormone is a messenger hormone that goes from your pituitary to the leydig cells inside the testes. This hormone dictates how much testosterone you will produce. This test is rather inaccurate in a blood draw and a urinalysis will give you a much better idea of the true levels of this hormone.



· Thyroid Panel T3, T4, Free, Direct and Serum



Hormones can suppress the thyroid over time if you are not taking steps to prevent suppression. This is a great panel to develop a baseline before you embark on hormone therapy, but it is missing one of the most important tests when it comes to the thyroid, which are thyroid antibodies.





· Lipid Panel



This is a measure of your cholesterol and the different types in your body. You will want to know these numbers as well. These can be affected by hormone therapy so you will



· Testosterone Free and Total



This will measure the amount of testosterone in your blood. Keep in mind there is bound testosterone and unbound testosterone. The unbound, or free is a much more direct indicator of what your hormone health is.



· Estradiol



For men? Yes that is right boys, this is a very important number to watch, keeping this hormone in the proper range will ensure less side effects on your hormone program. It plays a role in libido, brain function and joint support. Too much can play hell on your organs and give you cancer.



· Prostate-Specific AG, Serum



This value is a decent indicator of your prostate health. It can indicate cancer or other prostate health issues. Unfortunately recent literature has shown that men over 50 need a more thorough screening for prostate cancer because this test is unreliable.



· IGF-1



This is basically your insulin level. This can give you an idea as to weather or not your pancreas is functioning properly and if your using the insulin it produces. This value does not tell us too much without a comprehensive panel though.





So if this is a basic hormone panel, what else is missing? What else would be important to me to test before starting BHRT?



Here is a list of things that are missing from a basic panel like this.



· FSH

· HA1C

· C-Peptide

· C-Reactive Protein

· Thyroid Antibodies

· Hepatic Panel

· DHEA-S

· Progesterone

· Prolactin

· Ferritin

· SHBG

· Folate

· Cortisol

· Gamma Glutamyl Transpeptidase

· Urinalysis w/ FHS and LH

· Magnesium

· Iron

· Cortisol Salivary Test

· Amino Acid Urinalysis





As you can see many talk about comprehensive testing but most dont actually perform comprehensive testing. Please stay tuned for my next thread explaining the values of a comprehensive test!!!!!!!!



If you would like to schedule your free consultation with one of IMTs specialists just click the link below!




increasemyt.com/services/hormone-replacement/low-t-and-mens-health/low-testosterone-therapy



Lindsay

IMT Staff

 

[halfwit]

Great post! I have to be honest though, your avatar (no disrespect intended) definitely has my attention.

 

[IMT staff]

LOL that is a nice avatar

Welcome to the IMT Team Lindsay!

Tell us a little about yourself:

Stats
how long lifting
fitness comp goals

 

[lowtestosterone.com]

Those are all great labs! How much does it cost for this kind of "comprehensive" testing.

 

[Lindsay IMT Staff]

Hi!
Thanks for the welcome! Im 27, 5'6" 145 lbs and 18% body fat. I LOVE LIFTING!!!! And basically anything that has to do with fitness Right now, a girlfriend and I are prepping for our first bikini competition on june 1st, sooooo I may have to post some videos of us practicing posing *wink wink* or getting our lift on. Stay tuned guys!

 

[THE-DET-OAK]

Can't wait for the videos !!!

 

[IMT staff]

Those are all great labs! How much does it cost for this kind of "comprehensive" testing.

It depends on which one of those test's we are referring too. For a comprehensive panel with us it is about $499. Urinalysis would be separate. With our invoice our patients can get the money spent reimbursed from their insurance company usually. You guys do not offer comprehensive testing?

Its not really about the money though, it would be very important IMHO to get proper testing done to begin with, in order to develop a baseline.

Things like HA1C and C peptide can tell you a lot about whats going on with your insulin, non-acloholic fatty liver disease and what not. Also without knowing if your suffering from a thyroid dysfunction or some sort of adrenal insufficiency, you could be pouring your money down the drain by not getting that sorted before you get on TRT.

So does it matter what the price is? Its not what you pay, its what you get for what you pay..........

BTW welcome to the board! Please do not hesitate to let us know if you need anything.

Todd

 

[lowtestosterone.com]

We do provide comprehensive testing, however much of the things you have listed above for "comprehensive" would fall far outside of the things needed to complete a comprehensive test for Testosterone Therapy. The term "Comprehensive" is subjective to what it is being tested for.

I think price is a very important aspect, but if you can provide the best price and combine it with the best value, I think you will always have a winner.

 

[IMT staff]

Really? You think things like C Peptide, C reactive Protein, SHBG, FSH, Cortisol, progesterone, prolactin, ferritin and folate fall outside of the realm of testosterone therapy?

Thats news to me..............

 

[IMT staff]

I def was not intending on a discussion with another sponsor in this thread, the idea was to introduce one of our newest staff members

 

[lowtestosterone.com]

Yes and no. Ill touch base on a few you are talking about. SHBG-very easy to calculate just by testing albumin, Free,and total. Dont need to charge the patient for this expensive test when it taks 2 seconds to calculate yourself. This is just one of many examples that i can show you where you dont have to run the test to get the data you want. All this does is cause the client and insurance companies to pay more and increase profits to the clinic. We are trying to make this medicine affordable for everyone. Ill give you another example. Prolactin. You would only need to run this panel on a patient if he had very abnormally low Total T levels. It's just as easy to set a reflex test if they dip below 180 and have it run only if needed. Elevated prolactin levels would indicate a prolactin excreting pituitary tumor. Maybe 1 in 5000 patients. Certainly wouldnt do it on every patient.

The last one I'll get into is the FSH. You can run LH and FSH to test stimulating. but really running LH by itself will give you the data you need and is superior to FSH because it is really the only one truly specific for stimulating leydig cells and Exogenous T production.

So really all im saying is, comprehensive testing is subjective to whom is reading the labs and what the labs are for. Comprehensive is also (in many cases) patient specific and many of the tests you are suggesting to be "comprehensive" are not necessary for TRT. Go read some of the Harvard Protocol by Abraham Morganthaler. He will do a much better job explaining what labs to do and how lab reqs should really be written and customized to the patients needs. This medicine is not black and white and each and every patient should be treated individually.

Mike Brookins

 

[THE-DET-OAK]

Uh oh here we go........

 

[IMT staff]

Yes and no. Ill touch base on a few you are talking about. SHBG-very easy to calculate just by testing albumin, Free,and total. Dont need to charge the patient for this expensive test when it taks 2 seconds to calculate yourself.

What your missing here is your doing a calculation, on a calculated number. Free T is a calculation. So there are too many variations to think you could get a realistic number. Besides your acting like all the patients you get will be be fresh to testosterone replacement therapy (TRT) when many come from other companies that do substandard testing and put them on the big 3.

Your SHBG can tell you more than just what your free T is, as a matter of fact recently it has been shown to have an affect on the activation of the androgen receptor. This number has a large correlation with insulin and diabetes, and many of the men on testosterone replacement therapy (TRT) out there were sold 3mg of adex a week and are now running around with terrible SHBG numbers. I assure you we have done this a few times on men that are new to testosterone replacement therapy (TRT) and that are currently on, and SHBG is a very important number to be calculating off of a calculation.

Ill give you another example. Prolactin. You would only need to run this panel on a patient if he had very abnormally low Total T levels. It's just as easy to set a reflex test if they dip below 180 and have it run only if needed. Elevated prolactin levels would indicate a prolactin excreting pituitary tumor. Maybe 1 in 5000 patients. Certainly wouldnt do it on every patient.

It sounds to me more and more you have little experience with testosterone replacement therapy (TRT) as your response is correct for someone that has never been on therapy before, and honestly I was not suggesting prolactin to check for a tumor . The main reason this number is important is because many men can have a PRL that is not optimal, even if it is in range. Something like a tumor would show levels at 10-50 times what they should be. Leaving your PRL slightly elevated can cause you to lose erections during intercourse, and cause watery semen and poor ejaculations, I wish testosterone replacement therapy (TRT) was as simple as TT, FT and E2 but the fact of the matter it isn't. Many of our patients use a dopamine agonist to increase the sexual performance due to suboptimal PRL number.

On top of this what about all the guys that come to us from propecia? They all have PRL and PGR problems. Like I said, we have done this a few times.

The last one I'll get into is the FSH. You can run LH and FSH to test stimulating. but really running LH by itself will give you the data you need and is superior to FSH because it is really the only one truly specific for stimulating leydig cells and Exogenous T production.

Honestly a blood draw is about as inaccurate for both these numbers as a test can be. So your telling me you can can diag primary or secondary from a single lab draw on LH? I bet not.

Knowing the total amount throughout the entire day for these 2 hormones is very important. Also FSH is not important? It would be nice to know, in my opinion, if spermatogenesis was active before commencing a testosterone replacement therapy (TRT) program. Not knowing this going in could leave us short information in the future if I decided I wanted to come off TRT.

It sounds to me like your implying that it is possible to look at a 1 time lab draw of LH and confirm primary or secondary? I have seen well over 2,000 blood test's in the medical setting, and I have yet to meet anyone that can guess better than 30% with info like like you suggested, when determining primary or secondary.

So really all im saying is, comprehensive testing is subjective to whom is reading the labs and what the labs are for. Comprehensive is also (in many cases) patient specific and many of the tests you are suggesting to be "comprehensive" are not necessary for TRT. Go read some of the Harvard Protocol by Abraham Morganthaler. He will do a much better job explaining what labs to do and how lab reqs should really be written and customized to the patients needs. This medicine is not black and white and each and every patient should be treated individually.

Mike Brookins

I have read almost all of his work multiple times thank you.

 

[lowtestosterone.com]

LOL Here we go....

 

[IMT staff]

To add to that what about all the PH guys that have problems with PRL and PGR? Some guys did the PH cycle 3-5 years ago and their endocrine system is shot. If they start testosterone replacement therapy (TRT) without figuring that out they will have more side effects than you can imagine.

As per the go read comment: I have more experience dealing with testosterone replacement therapy (TRT) patients than anyone you know, and I can promise you there is a big difference between reading and application.

PS I am not opposed to basic testing for testosterone replacement therapy (TRT), this thread was simply to go over the differences. We are about informing the client, so they know all of their options.

 

[lowtestosterone.com]

Im not trying to get into a pissing contest with you. Im sure you know a few things about TRT. Fine! At least your doing a free T and estradiol which is more than 99% of endocrinologist and Family Practice docs. Just trying to prove my original point about comprehensive testing. You went and selected everything under the sun you could think of for a great age-management massive panel to treat as a standard for everyone. My point is that many of the test you are referring to should only be done on a patient by patient basis and many times are not necessary and very costly to the patient.

Im sorry but just making the statement "I have more experience dealing with testosterone replacement therapy (TRT) patients than anyone you know" sounds absolutely silly and egotistical. The fact is even the worlds best physicians of anti-aging never claim they know it all and will always be students and researchers. I am the same.

By the way. Why dont you list your contact information, A biography on yourself, locations to your clinics, or more importantly the prices for your services on your website? With all of your experience in this market and by knowing more than anyone else I know, I figure you would have a lot more information about yourself and your company listed for us to see.

Michael Brookins

 

[IMT staff]

Im not trying to get into a pissing contest with you. Im sure you know a few things about TRT. Fine! At least your doing a free T and estradiol which is more than 99% of endocrinologist and Family Practice docs. Just trying to prove my original point about comprehensive testing. You went and selected everything under the sun you could think of for a great age-management massive panel to treat as a standard for everyone. My point is that many of the test you are referring to should only be done by a patient by patient basis and many times are not necessary and very costly to the patient.

Im sorry but just making the statement "I have more experience dealing with testosterone replacement therapy (TRT) patients than anyone you know" sounds absolutely silly and egotistically. The fact is even the worlds best physicians of anti-aging never claim they know it all and will always be students and researchers. I am the same.

By the way. Why dont you list your contact information, locations to your clinics, or more importantly the prices for your services on your website? With all of your experience in this market and by knowing more than anyone else I know, I figure you would have a lot more information about yourself and your company listed for us to see.

Michael Brookins

I completely understand, not everyone needs every single test, this should be determined by symptoms. So the comprehensive all inclusive thing is just for show? once you get them on the line then you tell them additional testing, that requires more money spent, may be necessary?

I am sorry that my experience in the field came off as arrogant, but it is the simple truth. I am not claiming to be smarter or better than anyone else, I am simply stating that I have seen a gazillion lab tests of men and women on and prior to BHRT, and have a close relationship with many of them. So that has value to anyone I choose to spend my time with. Experience can not be bought or sold, and few have as much as they claim to have.

The reason we do not list the contact information of our physicians is simple, we have a national network of MD's that perform exams and sometimes lab draws in house. This does not mean IMT has 200 offices. They are not our offices, they are the doctors, and that physician may have other patients that are not connected with us.

IMT contact info is on the site.

We will not put prices on our website, we do not sell price. It is my opinion that anyone selling price is hiding something, not the other way around. let me give you an analogy and maybe it will help:

toyota dealership advertises $99 a month camry. What happens when you get there? it is a beer can special with crank windows and plastic rims. No one actually buys that car. They always upgrade to something that will actually fit their needs.

So what is the point of offering that? It just pisses people off once they realize what they are getting for their money. So we do not put prices on our website, cause there is no way to know what that price will actually be or what the client will need or be interested in. As a matter of fact, our patients on a standard optimization program pay $180 a month but very few stick with only this program. It is up to the client on what he or she would like to work on.

It is not IMT's intention to brand ourselves and be the "cenegenics" so to speak. We would rather work with physicians that are already practicing through our proprietary EHR/EMR software. We care about our reputation with our clients, not the "glam" so to speak. So trying to get our name out there to so many people is not one of our priorities. We actually have many different websites that cater to different demographics.

Now that I have hopefully answered all of your questions, let me ask you a couple please:

What is your average dosage for the patient on the 199 program? what are target TT levels?

If one patient takes 80mg a week with Human Chorionic Gonadotropin (HCG) and an Aromatase inhibitor (AI), and another is primary so he does not need HCG, why does he have to pay the same as the guy who gets all 3?

Have you ever had a friend that bought the same type of car as you and then found out later he paid more than you? How do you think that made him feel?

Todd

 

[IMT staff]

also it dawned on me that you may be inquiring about why we do not have prices on our website implying that we hide our pricing:

IMT does not accept a penny from one of our potential clients until the following has happened:

All new patient forms have been uploaded by our medical team to our private HIPAA compliant medical portal. Once this has taken place the medical team will request any and all pertinent previous medical information.

Then our medical team, administrator and physician licensed in the client's state will review the file and give a recommendation on what the next step would be.

Then one of our consultants will contact the client and go over the recommendation and discuss how much the cost will be. Wether this is more testing or what not.

This is a 100% free no obligation free pre approval process. We work for our clients a ton before we even ask them for a penny.

I am really surprised this thread turned into a Q and A. This was suppose to be an informative thread about lab diagnostics. Many threads lately have came across in the forum about lab testing and IMT wanted to take the time to discuss what the values were in an easy to understand manner.

Thank You for your interest but we can not exchange anymore because it is a distraction to the board.

 

[lowtestosterone.com]

You are entitled to your opinion, but I think many people would disagree with you that a price on the sticker is a LOT better for business and it makes the client feel more comfortable. The price on our site is the price on our site. We provide treatment to those with the highest level of need all the way down to those who need a bit less and we do it all for the same price (as advertised on the site). The interesting thing we did with our business model was we took the cost it would take to treat those with less needs and priced it at that price, so that those who need more can feel confident that they are getting more than a fair deal.

To answer your question about dosing, that will be left up to the clients doctor to help you with and is really no business of yours or even mine for that matter.

Our prices are adjusted so that if you are getting treatment with just one medication, your price is still better than most. If you get all medication, then our clients can tell their friends and family how good of a deal they got and they can continue to enjoy the most affordable care.

Your next answer is: Again, we price the vehicles at all the same price and IF you require a compact car, you get it for one price. However, if you need a truck to get you through your day, we also offer that vehicle at the same price.

You keep making a few good points, but you are making them for me: For example, earlier you said "Its not what you pay, its what you get for what you pay.........."

That seems to be what people say who are car salesmen or a guy trying to tell me why paying an astronomical price for something is justified. It is my opinion that people like to get the most for their money and try to find the best place to shop. It has to do with several issues:

The Right Product
A Great Price
Excellent Customer Service
Convenience
Added Value

Why wouldn't you offer all of that AND STILL PUT A PRICE ON THE WINDOW? I dont want to spend half a day with someone while they tell me how great their product is and then get told the price after a huge song and dance production. Just give me the price!

If you are confident in your product, offer it to people for NO OBLIGATION, List Your Prices, Offer Outstanding Perks, and throw in some airfare just to be cute.

 

[lowtestosterone.com]

Thank You for your interest but we can not exchange anymore because it is a distraction to the board.

I think that would be a great idea because people dont want to know about the sponsors of the site. I hope you have not taken offense to these posts as that has not been my intention. But, I did want to give my .02 on what a "comprehensive" lab test is.