New Endo What New Tests

bodyofageekgod

New member
So I'm going to seeing a new Endo. My old endo was a complete dick/idot. My primary care doc referred me to Dr William Bremner at the University of Washington Medical Center. He is a published expert in the HPT axis and male hormones. I'm hoping he knows his stuff. If he doesn't work out I'm calling Chip.

My last T test was on 7/13 and was 280 (up from 206 after a month of HCG 500IU 3xWeek). I'm still on HCG 500IU 3xWeek and seen some improvements but not a lot.

I want to get some new labs before my visit with him, my primary doc will order whatever I want.

I've asked for:
• Total Testosterone
• Free Testosterone
• Total T3
• Estradiol
• SHBG
• LH
• FSH

What else would you recommend?
 
Blood Test Recommendations

Hi, this'll be my first post here. I'm not a doctor, just on testosterone replacement therapy (TRT) and interested in my blood tests. So, take it for what it's worth (I'm using LabCorp naming conventions below, other labs might have different names in a few cases).

These would just be your basic blood tests, the kind of generic stuff you'd likely get at an annual physical if they ran blood:

-Lipid Cholesterol Profile
-Complete Blood Count w/ Differential
-Comprehensive Metabolic Panel

Buried in those three general categories of tests are some different cholesterol tests (Total, HDL, LDL, etc), hemoglobin, hematocrit and red blood cell count and liver values among others. Good to have a baseline read for tracking purposes; testosterone replacement therapy (TRT) definitely influences my RBC, hematocrit, hemoglobin and cholesterol scores.

Then, the obvious hormones or hormone-related items:

-Testosterone Serum (Total T)
-Free Testosterone
-Estradiol, Sensitive (I'd go for sensitive as you'll get a better read at the lower end of the range, which could be useful if you're on an Aromatase inhibitor (AI) down the road and could also be helpful in assessing cause of various current symptoms)
-Luteinizing Hormone(LH)
-Follicle-Stimulating Hormone (FSH)
-Sex Hormone binding Globulin, Serum (SHBG) -- (With SHBG, Total T and Albumin, which you would've gotten in the general blood tests above, some calculations to get Bioavailable T and Free T can be done, if you want to do that for the fun of it)

The LH, FSH and SHBG will help track down the cause of Total T/Free T deficiency.

As you mentioned T3, if you want to go down the thyroid measurement path:

-Thyroxine-Stimulating Hormone (TSH)
-Triiodothyronine, Free, Serum (Free T3)
-T4, Free (Direct)
-Reverse T3 (controversial in some circles but the test isn't going to hurt you)

Some others to consider:

-Hemoglobin A1c (measures what's going on with blood sugar over last 6 to 12 weeks)
-Cardiac C-Reactive Protein Test, High Sensitivity
-Insulin Growth Factor (IGF-1) -- (TRT definitely causes mine to go up vs baseline)
-Insulin, Fasting
-Magnesium (one could go for lots of nutrient testing; magnesium just happens to be an important one that many people are deficient in that doesn't get much attention by most doctors)
-Vitamin D, 25 Hydroxy (lots of people are low on this one, although the winter time might reveal a low score more readily than summer if you get/got summer sun exposure)
-Prostate-Specific Antigen (PSA) -- (Most docs would probably want this test before you start TRT)
-Dehydroepiandrosterone Sulfate (DHEA)
-Pregnenolone -- (this is a very upstream hormone, so if this is low it would be no shock that other hormonal items are low)
-Dihydrotestosterone (DHT) -- (I think it's good to have a baseline on this one. If you were to end up on a T gel, increased conversion of T to DHT is considered more likely)

The final one would not be a blood test but a saliva test for Cortisol. Salivary Cortisol would ideally be diurnal, measuring at least 4 times over the course of one day (morning, noon, afternoon and late night).

That's my long list for blood. It should be helpful diagnostically and could be valuable or interesting, as a pre-TRT baseline, if you get on testosterone replacement therapy (TRT) later.

Now, extend your arm. :vampire:
 
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