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Author Topic: Which Labs Should I Get Post-HRT and What Should Be Monitored?  (Read 4214 times)

DuckFan83

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I am due for my follow up labs and Urologist visit next week.  So I am wondering which labs should I request?

 They are already doing 3 tests which I believe are Test, PSA (maybe?) and another one that starts with an H.  Sorry to be so unspecific, but I have the lab slip at home and can update this later.  What I do know is that they didn't originally put down to test E2.  I already am going to ask them about that. 

I don't know what else I need to test though.  SBHG?  I read somewhere that you don't really need to have that tested, but other places say you do.  So do I need to know that number or not?  Also, what does it tell me?

 And then... is there anything else I should have them check for this first follow up?
« Last Edit: June 04, 2014, 04:54:17 pm by PeakT »
pre 2006 - weight = 170
2006ish - 2011: Onset of low T symptoms

07/2009 - Rx Wellbutrin for mild depression
07/2009 - weight = 230
late 2009 - stopped wellbutrin due to ineffectiveness

05/2011 - Total T = 290, no action
05/2011 - weight = 197

07/2012 - Rx Methlyphenidate (Ritalin) for 'Adult ADD'
07/2012 - weight = 219

05/9/2014 - Total T = 242, referred to urologist
05/5/2014 - weight = 245
05/16/2014 - Rx 100mg/week Testosterone Cypionate for hypogonadism

06/05/2014 - weight = 229
06/13/2014 - Total T = 399

12/13/2014 - weight = 210
12/13/2014 - Total T = 740

3/2/2017 - weight = 165
3/2/2017 - Total T = 941 (loving life)

PeakT

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Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #1 on: June 04, 2014, 04:59:05 pm »
Here are the biggees that should be monitored imo post-HRT:

1.  RBCs/Hematocrit/Hemoglobin (or whatever combo your doc thinks is appropriate)
2.  Estradiol
3.  Blood Pressure
4.  PSA.  (There is a new test called PCA-3 that may be a good idea as well.)
5.  Liver/Kidney Function for your physical and this is always a good idea

You also should be pre-screened for clotting disorders and, if you have existing hypertension, aggressively monitored initially.

Now all of the above are just things I have read.  Please go with what your doc says if he has additional tests of course! 
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Peak Testosterone Forum

Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #1 on: June 04, 2014, 04:59:05 pm »


DuckFan83

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Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #2 on: June 04, 2014, 05:21:19 pm »
Here are the biggees that should be monitored imo post-HRT:

1.  RBCs/Hematocrit/Hemoglobin (or whatever combo your doc thinks is appropriate)
2.  Estradiol
3.  Blood Pressure
4.  PSA.  (There is a new test called PCA-3 that may be a good idea as well.)
5.  Liver/Kidney Function for your physical and this is always a good idea

You also should be pre-screened for clotting disorders and, if you have existing hypertension, aggressively monitored initially.

Now all of the above are just things I have read.  Please go with what your doc says if he has additional tests of course!

Hematocrit is the one I couldn't remember!  So he is looking at Testosterone, PSA, and Hematocrit.  I will ask about E2 for sure, because I believe I am experiencing those symptoms.  I'll ask about the liver/kidney.  What do they look at there?  My PCP ran a lot of tests, so I have a baseline for many things. 
pre 2006 - weight = 170
2006ish - 2011: Onset of low T symptoms

07/2009 - Rx Wellbutrin for mild depression
07/2009 - weight = 230
late 2009 - stopped wellbutrin due to ineffectiveness

05/2011 - Total T = 290, no action
05/2011 - weight = 197

07/2012 - Rx Methlyphenidate (Ritalin) for 'Adult ADD'
07/2012 - weight = 219

05/9/2014 - Total T = 242, referred to urologist
05/5/2014 - weight = 245
05/16/2014 - Rx 100mg/week Testosterone Cypionate for hypogonadism

06/05/2014 - weight = 229
06/13/2014 - Total T = 399

12/13/2014 - weight = 210
12/13/2014 - Total T = 740

3/2/2017 - weight = 165
3/2/2017 - Total T = 941 (loving life)

PeakT

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Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #3 on: June 04, 2014, 05:30:08 pm »
Here are the biggees that should be monitored imo post-HRT:

1.  RBCs/Hematocrit/Hemoglobin (or whatever combo your doc thinks is appropriate)
2.  Estradiol
3.  Blood Pressure
4.  PSA.  (There is a new test called PCA-3 that may be a good idea as well.)
5.  Liver/Kidney Function for your physical and this is always a good idea

You also should be pre-screened for clotting disorders and, if you have existing hypertension, aggressively monitored initially.

Now all of the above are just things I have read.  Please go with what your doc says if he has additional tests of course!

Hematocrit is the one I couldn't remember!  So he is looking at Testosterone, PSA, and Hematocrit.  I will ask about E2 for sure, because I believe I am experiencing those symptoms.  I'll ask about the liver/kidney.  What do they look at there?  My PCP ran a lot of tests, so I have a baseline for many things.

HRT is supposed to bypass the liver, so you should not see an issue there.  But I believe it's in the endocrinology guidelines, which is why I mention it.  And I have never seen any one have kidney issues from HRT, but testosterone does affect EPO if you've heard of that from Lance Armstrong fame...
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Peak Testosterone Forum

Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #3 on: June 04, 2014, 05:30:08 pm »


bzarfas

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Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #4 on: June 04, 2014, 05:46:56 pm »
Here are the biggees that should be monitored imo post-HRT:

1.  RBCs/Hematocrit/Hemoglobin (or whatever combo your doc thinks is appropriate)
2.  Estradiol
3.  Blood Pressure
4.  PSA.  (There is a new test called PCA-3 that may be a good idea as well.)
5.  Liver/Kidney Function for your physical and this is always a good idea

You also should be pre-screened for clotting disorders and, if you have existing hypertension, aggressively monitored initially.

Now all of the above are just things I have read.  Please go with what your doc says if he has additional tests of course!

Hematocrit is the one I couldn't remember!  So he is looking at Testosterone, PSA, and Hematocrit.  I will ask about E2 for sure, because I believe I am experiencing those symptoms.  I'll ask about the liver/kidney.  What do they look at there?  My PCP ran a lot of tests, so I have a baseline for many things.
I'm assuming you are in the USA?
You can save yourself some money and just done blood to get a free cholesterol test(in some centers) but I've always gotten my hemocrit when I give blood
depending on your insurance, you might find Private labs a cheaper place to get all that blood work  http://www.privatemdlabs.com/


Even if you are having symptoms(depending what you tell him), your doc isnt going to know how to fix you unless you have some blood work to give him

I thought the baseline tests to get were:
CBC
Comp metabolic panel
SHBH
Lipid panel
Total T
IFG-1
Free T
Thyroid
HS-CRP
HS-Estradiol, if this is high or low, I thought then test for SHBH, otherwise testing SHBH isnt that useful?
http://www.peaktestosterone.com/high_shbg

(I thought morgan taylor said the PSA is useless test to get)
http://institutefornaturalhealing.com/2012/03/psa-tests-useless-for-98-percent-of-men/



DuckFan83

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Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #5 on: June 06, 2014, 02:48:39 pm »

I'm assuming you are in the USA?
Yep!  In Oregon (DuckFan = U of Oregon fan/alumni  :) )

You can save yourself some money and just done blood to get a free cholesterol test(in some centers) but I've always gotten my hemocrit when I give blood
depending on your insurance, you might find Private labs a cheaper place to get all that blood work  http://www.privatemdlabs.com/
I'm not sure my insurance company would pay on a lab if it isn't ordered by a doctor.  But I will keep that in mind if he doesn't agree to test what I ask him to.  Although, I think he will.  He is a very laid back doctor and seems willing to listen and help and find solutions with his patients. 

Even if you are having symptoms(depending what you tell him), your doc isnt going to know how to fix you unless you have some blood work to give him

I thought the baseline tests to get were:
CBC
Comp metabolic panel
SHBH
Lipid panel
Total T
IFG-1
Free T
Thyroid
HS-CRP
HS-Estradiol, if this is high or low, I thought then test for SHBH, otherwise testing SHBH isnt that useful?
http://www.peaktestosterone.com/high_shbg

(I thought morgan taylor said the PSA is useless test to get)
http://institutefornaturalhealing.com/2012/03/psa-tests-useless-for-98-percent-of-men/

I did have many of those baseline tests ran by my PCP.  There are only a few I know weren't tested, and I believe that is mostly because my PCP isn't an endo or a uro, I think, so he didn't know any better.  My Urologist didn't take more labs before starting because I had two confirmed low T labs, and he didn't want me to have to pay more money to tell us what we already know.  Being a frugal guy, I liked that opinion. 

And the PSA part... doesn't that have something to do with prostate cancer?  As a uro that works with cancer patients, I can see why he wants to test that.  They also checked my bladder and stuff too, since I was there.   
pre 2006 - weight = 170
2006ish - 2011: Onset of low T symptoms

07/2009 - Rx Wellbutrin for mild depression
07/2009 - weight = 230
late 2009 - stopped wellbutrin due to ineffectiveness

05/2011 - Total T = 290, no action
05/2011 - weight = 197

07/2012 - Rx Methlyphenidate (Ritalin) for 'Adult ADD'
07/2012 - weight = 219

05/9/2014 - Total T = 242, referred to urologist
05/5/2014 - weight = 245
05/16/2014 - Rx 100mg/week Testosterone Cypionate for hypogonadism

06/05/2014 - weight = 229
06/13/2014 - Total T = 399

12/13/2014 - weight = 210
12/13/2014 - Total T = 740

3/2/2017 - weight = 165
3/2/2017 - Total T = 941 (loving life)

PeakT

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Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #6 on: June 06, 2014, 05:10:24 pm »


And the PSA part... doesn't that have something to do with prostate cancer?  As a uro that works with cancer patients, I can see why he wants to test that.  They also checked my bladder and stuff too, since I was there.

Whoever is giving you the HRT should be monitoring PSA regularly imo.  PSA is not the greatest test in the world, since inflammation, prostatitis and BPH (and probably genetic)s can raise it very significantly.  But one thing is pretty certain:  if your PSA rises significantly, then your prostate is probably "stressed."  So you need to get it checked out is the bottom line, because it could also be prostate cancer. 

At least that is what I have and that is still the mainstream opinion from all I have seen.

Example:  my HRT clinic monitored my PSA every three months and saw it go through the roof one reading.  They immediately took me off of HRT and sent me to a urologist.  Of course, no one likes to be taken off of HRT, but it was the right thing to do in case it was prostate cancer.  (I had a biopsy and they only found inflammation.)

THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

PeakT

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Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #7 on: June 06, 2014, 05:17:44 pm »
and he didn't want me to have to pay more money to tell us what we already know.  Being a frugal guy, I liked that opinion. 


Kudos to you for watching your dollars and cents.  But don't go too far with it.  I don't want to be dramatic - or maybe I do actually - but not monitoring HRT can get you killed.  Hematocrit is very important:  you can end with a stroke from this.  We just had a guy on the forum who was having trouble breathing and other issues.  He found this was high, donated blood and all was well. 

None of this is a lot of money.  As Einstein (reportedly) said, "Make things as simple as possible, but no simpler."
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

DuckFan83

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Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #8 on: June 06, 2014, 06:04:44 pm »
and he didn't want me to have to pay more money to tell us what we already know.  Being a frugal guy, I liked that opinion. 


Kudos to you for watching your dollars and cents.  But don't go too far with it.  I don't want to be dramatic - or maybe I do actually - but not monitoring HRT can get you killed.  Hematocrit is very important:  you can end with a stroke from this.  We just had a guy on the forum who was having trouble breathing and other issues.  He found this was high, donated blood and all was well. 

None of this is a lot of money.  As Einstein (reportedly) said, "Make things as simple as possible, but no simpler."

I completely agree with you.  The only thing not tested for initially (from the list you previously posted) was E2.  There were a few things that bzarfas mentioned that I can't detect on my chart, but I have pretty good lab results from just before TRT, and then also labs from 2011 and 2008 (or 09).
pre 2006 - weight = 170
2006ish - 2011: Onset of low T symptoms

07/2009 - Rx Wellbutrin for mild depression
07/2009 - weight = 230
late 2009 - stopped wellbutrin due to ineffectiveness

05/2011 - Total T = 290, no action
05/2011 - weight = 197

07/2012 - Rx Methlyphenidate (Ritalin) for 'Adult ADD'
07/2012 - weight = 219

05/9/2014 - Total T = 242, referred to urologist
05/5/2014 - weight = 245
05/16/2014 - Rx 100mg/week Testosterone Cypionate for hypogonadism

06/05/2014 - weight = 229
06/13/2014 - Total T = 399

12/13/2014 - weight = 210
12/13/2014 - Total T = 740

3/2/2017 - weight = 165
3/2/2017 - Total T = 941 (loving life)

PeakT

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Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #9 on: June 06, 2014, 07:24:23 pm »
and he didn't want me to have to pay more money to tell us what we already know.  Being a frugal guy, I liked that opinion. 


Kudos to you for watching your dollars and cents.  But don't go too far with it.  I don't want to be dramatic - or maybe I do actually - but not monitoring HRT can get you killed.  Hematocrit is very important:  you can end with a stroke from this.  We just had a guy on the forum who was having trouble breathing and other issues.  He found this was high, donated blood and all was well. 

None of this is a lot of money.  As Einstein (reportedly) said, "Make things as simple as possible, but no simpler."

I completely agree with you.  The only thing not tested for initially (from the list you previously posted) was E2.  There were a few things that bzarfas mentioned that I can't detect on my chart, but I have pretty good lab results from just before TRT, and then also labs from 2011 and 2008 (or 09).

Gotcha.  Well, just one more thing, eh?  I had my estradiol monitored very regularly at the clinic.  Now I'll probably have to do it on my own.
THE MOST COMPREHENSIVE BOOK ON TRT/TESTOSTERONE:
https://www.amazon.com/Natural-Versus-Testosterone-Therapy-Myer/dp/1523210532/ref=sr_1_1?ie=UTF8&qid=1499116128&sr=8-1&keywords=natural+versus+testosterone+therapy
And check out my New Peak Testosterone Program: http://www.peaktestosterone.com/peak_testosterone_program
If you are on medications or have a medical condition, always check with your doctor first before making any lifestyle changes or taking new supplements.  And low testosterone is a medical condition.

Peak Testosterone Forum

Re: Which Labs Should I Get Post-HRT and What Should Be Monitored?
« Reply #9 on: June 06, 2014, 07:24:23 pm »