Which tests to get?

[scm007]

I've been feeling sluggish, mentally lethargic, low sex drive, decreasing muscle mass, etc. I desperately need to get my hormones checked, but I am not sure which tests to get?

Is Total Test, Free Test, and Estradiol sufficient to begin with?

Should I add DHT, DHEA, and PSA, or will the results of my first test influence whether or not to test these?

[wharton]

I've been feeling sluggish, mentally lethargic, low sex drive, decreasing muscle mass, etc. I desperately need to get my hormones checked, but I am not sure which tests to get?

Is Total Test, Free Test, and Estradiol sufficient to begin with?

Should I add DHT, DHEA, and PSA, or will the results of my first test influence whether or not to test these?

What?

[Vettester]

If it were me, and I was unsure ... I'd run a complete lab panel
Lipid profile
CBC w/Diff
Complete Met Panel
Thyroid
Hormones
PSA

Any major changes going on with life or lifestyle? Would enjoy your story if you find time.

Good luck!

[madmax1974]

just go and tell your doctor how you feel and that you want your test levels checked and he or she knows what to do, well at least thats what i did with my
doc, then when the results came back i was sent to an Endo. and he placed me on hrt.

[jfg4]

I agree with vetteman08. Full blood work up by doctor should do the trick. He/she will guide you in the right direction

[JHeisman1]

If you wanna save money and order highest yield tests only, then I would check:
-Estrogen [estradiol or total] [make sure its not all converted by aromatase]
-Total Testosterone [a must]
-Free Testosterone [a must, should be about 3% of the total in healthy physiologic men]
-Prolactin [to rule out prolactinoma which high prolactin suppresses gonadotropins (FSH/LH) and results in low testosterone in men, no ovulation in women]
-TSH/T4 [rule out thyroid disease as Thyroid Releasing Hormone causes high Prolactin]
-Progesterone [low in women causes low testosterone -dont know why & I've never read anything about low progesterone causing testosterone changes in men. ALSO, High increases the clearance of testosterone in both men/women].

These will find the cause in the vast majority of people as any of the listed tests can cause your symptoms. If your testosterone is indeed low, then the next most cost efficient tests are: GnRH, FSH, LH to see if you are making gonadotropins. If any or all of these are low, then it is low testosterone from the brain [hypothalamus makes GnRH and Pituitary makes FSH/LH in response to GnRH], which is termed Secondary hypogonadotropic hypogonadism.

IMHO, you do not need to check DHEA [adrenal source of testosterone, only checked in females as that is the primary source of their testosterone but an insignificant source in men], PSA [unless looking for prostate cancer], DHT [never been shown to promote erectile function, only Testosterone has], or even cortisol initially [but the cortisol should be checked if the above tests are normal]. Someone mentioned lipid panel, which hyperlipidemia can cause endothelial dysfunction and plaque formation in the penis [resulting in erectile dysfunction, but the sex drive is usually fine] which is compounded in smokers. I dont think I would check it initially, but if the first battery of tests are negative, I would. Same goes for CBC.

Good Luck...

[flatscat]

If you wanna save money and order highest yield tests only, then I would check:
-Estrogen [estradiol or total] [make sure its not all converted by aromatase]
-Total Testosterone [a must]
-Free Testosterone [a must, should be about 3% of the total in healthy physiologic men]
-Prolactin [to rule out prolactinoma which high prolactin suppresses gonadotropins (FSH/LH) and results in low testosterone in men, no ovulation in women]
-TSH/T4 [rule out thyroid disease as Thyroid Releasing Hormone causes high Prolactin]
-Progesterone [low in women causes low testosterone -dont know why & I've never read anything about low progesterone causing testosterone changes in men. ALSO, High increases the clearance of testosterone in both men/women].

These will find the cause in the vast majority of people as any of the listed tests can cause your symptoms. If your testosterone is indeed low, then the next most cost efficient tests are: GnRH, FSH, LH to see if you are making gonadotropins. If any or all of these are low, then it is low testosterone from the brain [hypothalamus makes GnRH and Pituitary makes FSH/LH in response to GnRH], which is termed Secondary hypogonadotropic hypogonadism.

IMHO, you do not need to check DHEA [adrenal source of testosterone, only checked in females as that is the primary source of their testosterone but an insignificant source in men], PSA [unless looking for prostate cancer], DHT [never been shown to promote erectile function, only Testosterone has], or even cortisol initially [but the cortisol should be checked if the above tests are normal]. Someone mentioned lipid panel, which hyperlipidemia can cause endothelial dysfunction and plaque formation in the penis [resulting in erectile dysfunction, but the sex drive is usually fine] which is compounded in smokers. I dont think I would check it initially, but if the first battery of tests are negative, I would. Same goes for CBC.

Good Luck...

If any or all of total, FSH, LH and GNRH are low, you say you have to be secondary? What would show primary then?

[Brian McClay]

x2 with Mad Max

[JHeisman1]

If any or all of total, FSH, LH and GNRH are low, you say you have to be secondary? What would show primary then?

Primary hypogonadotropic hypogonadism just means the testes are not making Testosterone [implying leydig dysfunction]. Secondary hypogonadotropic hypogonadism is from the hormones in the brain [GnRH in the hypothalamus and FSH/LH in the pituitary] being off which secondarily prevents the testicles from producing testosterone.

Example; If you have low testosterone and take HCG , you should make testosterone in the testes. If you do not, then the testicles are not working correctly and you have primary hypogonadotropic hypogonadism [leydig cell dysfunction or could be HCG insensitivity as you can de-sensitize the testes to LH or HCG if you take too high of HCG or for too long].

Hope this helps...