Need help with pre-TRT blood-work

Attachment 151140

Before anyone goes off on how I need to read the stickies, I would like to let you know that I DID read them...as well as many other posts on here. But honestly, there isn't a single, simple, thread which outlines which blood tests are mandatory pre-TRT.

Yes there are threads that explain what each test means, such ask the "blood work article" sticky, but no sticky which simply lists the "necessary" pre-TRT bloodwork.
If such sticky or thread does exist then it is buried so deep that it requires a team of librarians to find it.

Considering how important blood work is, it should be among the top stickies...titled clearly.

Anyway...could any of you TRT gurus be kind enough to simply just list the numbers of the tests that are not required pre-TRT?

I've numbered the tests for your convenience so all you have to do is just list the numbers that correspond to tests that one does not have to do pre-TRT...or to find out if that persons needs TRT or not.

Now I would like to point out that I really wouldn't mind doing all the tests on the list above as obviously that would yield more good than harm. I even excitedly took the list to the lab to do them ...that's until they showed me the total price of the tests. Waaaaay over my budget!

So now I would like to know which ones I can safely eliminate from the list.

Thanks a whole bunch in advance!

Very first post in the very first sticky currently at the top of the page titled "finding a trt physician" gives the exact answer to your question.

Quote:

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Originally Posted by The_Crawfish

Very first post in the very first sticky currently at the top of the page titled "finding a trt physician" gives the exact answer to your question.

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Not something you can confidently go with when it starts with "Here are examples only recommended by Dr. John Crisler..."
it sounds like its a plan that only this one doctor recommends.

Need to know...
1) What's the consensus on pre-trt blood work?
2) If it is the list I posted, then what can be eliminated from it?

Quote:

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Originally Posted by x_SANDMAN_x

Not something you can confidently go with when it starts with "Here are examples only recommended by Dr. John Crisler..."
it sounds like its a plan that only this one doctor recommends.

Need to know...
1) What's the consensus on pre-trt blood work?
2) If it is the list I posted, then what can be eliminated from it?

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1) That is the consensus
2) Do what's listed in the thread

I came across a thread on another forum that I found very informative. I don't know if it's ok to name or link here so I won't, but I'll paste the portion that seems to pertain here.

Please Note: I'm just pasting this here and am not the author of the advice (though it's nothing radical and seems to jive with everything else I've ready elsewhere) Hope it helps.


Labs to be done before you start TRT
-LH and FSH
-TT
-FT or bio-T
-E2
-Prolactin - optional in most cases
-DHT [sort of a waist of time and blood if your testosterone levels are low]
-PSA
-DRE: the dreaded digital rectal exam, doc gives you the finger.

Labs to be done when on TRT
-TT
-FT or bio-T
-Implications of injections VS transdermals [and injection frequency]
-E2
-Prolactin [optional and almost never on-going]
-DHT [should be checked, but perhaps not on-going]
-LH/FSH [optional and one last time -do I have cancer?]
-PSA
-DRE: the dreaded digital rectal exam [Your doc does not enjoy this either!]

Labs to never do and timing issues:
-DO NOT test E2 ultra sensitive
-DO NOT do saliva testing for T or E2 and expect any help here
-DO NOT test for free E2
-DO NOT test total estrogens
-DO NOT test PSA within 48 hours after a DRE [digital rectal (prostate) exam] or ejaculation
-DO NOT test prolactin with 48 hours of orgasm, avoid hugging puppies and babies
-DO NOT do lab work when muscles are sore from training or injury as your "liver markers" will show high levels. Those "liver tests" are really not liver specific.
-DO NOT waist time and money on tests that you cannot take any action on. Example, testing IGF-1 for growth hormone status if there is no way you could every pay for GH or actually legally qualify for GH.
-DO NOT routinely test for LH/FSH when on TRT, perhaps once to rule out certain testicular cancers and never again
-DO NOT test for serum DHEA, must test DHEA-S
-DO NOT do saliva testing for T, DHT, DHEA, pregnenolone if taking sublingual/buccal T, pregnenolone OR DHEA OR other steroid. The tests will be wrong and you do not want cross reactivity unknowns
-Testing E2&TT&FT makes also testing SHBG sort of useless.

Labs that are stupid after you start TRT
-LH/FSH

Thyroid labs [basic first line]
-TSH
-T3 no see fT3
-T4 no see fT4
-are you getting enough iodine? probably not!

Ok...a sticky lists blood work that a particular doctor recommends which is:

TotalTestosterone
Bioavailable testosterone (aka Free and Loosely Bound)
Free Testosterone
1 SHBG
DHT (gel users especially pay attention to this)
Estradiol (specify �0„3¡ãsensitive�0„3¡À assay for males)
LH
FSH
Prolactin
Cortisol
Thyroid Panel (complete)
CBC
Comprehensive Metabolic Panel
Lipid Panel
PSA (age dependent)
IGF-1, IGFBP-3 (if HGH therapy is being considered)
Vitamin D

The above is what Craw_fish is recommending.
And below is what Saso1 posted from another similar site to this one.

-LH and FSH
-TT
-FT or bio-T
-E2
-Prolactin - optional in most cases
-DHT [sort of a waist of time and blood if yourtestosterone levelsare low]
-PSA
-DRE: the dreaded digital rectal exam, doc gives you the finger.

Obviously different recommendations. And this is the kind of information that is floating around...very contradicting. Hence confusing.

Like I said earlier, don't mind doing the complete blood work...if it didn't cost so damm much.

Mind you, I am not in the States. So that list of blood work that I posted at the top is going to cost me $2142!

Therefore, I would like to take out from that list as many blood tests as I "safely" can. Meaning, which blood tests are not necessary when it comes to TRT? Which ones have no connecting with/are not effected by TRT?

Quote:

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Originally Posted by Saso1

I came across a thread on another forum that I found very informative. I don't know if it's ok to name or link here so I won't, but I'll paste the portion that seems to pertain here.

Please Note: I'm just pasting this here and am not the author of the advice (though it's nothing radical and seems to jive with everything else I've ready elsewhere) Hope it helps.


Labs to be done before you start TRT
-LH and FSH
-TT
-FT or bio-T
-E2
-Prolactin - optional in most cases
-DHT [sort of a waist of time and blood if your testosterone levels are low]
-PSA
-DRE: the dreaded digital rectal exam, doc gives you the finger.

Labs to be done when on TRT
-TT
-FT or bio-T
-Implications of injections VS transdermals [and injection frequency]
-E2
-Prolactin [optional and almost never on-going]
-DHT [should be checked, but perhaps not on-going]
-LH/FSH [optional and one last time -do I have cancer?]
-PSA
-DRE: the dreaded digital rectal exam [Your doc does not enjoy this either!]

Labs to never do and timing issues:
-DO NOT test E2 ultra sensitive
-DO NOT do saliva testing for T or E2 and expect any help here
-DO NOT test for free E2
-DO NOT test total estrogens
-DO NOT test PSA within 48 hours after a DRE [digital rectal (prostate) exam] or ejaculation
-DO NOT test prolactin with 48 hours of orgasm, avoid hugging puppies and babies
-DO NOT do lab work when muscles are sore from training or injury as your "liver markers" will show high levels. Those "liver tests" are really not liver specific.
-DO NOT waist time and money on tests that you cannot take any action on. Example, testing IGF-1 for growth hormone status if there is no way you could every pay for GH or actually legally qualify for GH.
-DO NOT routinely test for LH/FSH when on TRT, perhaps once to rule out certain testicular cancers and never again
-DO NOT test for serum DHEA, must test DHEA-S
-DO NOT do saliva testing for T, DHT, DHEA, pregnenolone if taking sublingual/buccal T, pregnenolone OR DHEA OR other steroid. The tests will be wrong and you do not want cross reactivity unknowns
-Testing E2&TT&FT makes also testing SHBG sort of useless.

Labs that are stupid after you start TRT
-LH/FSH

Thyroid labs [basic first line]
-TSH
-T3 no see fT3
-T4 no see fT4
-are you getting enough iodine? probably not!

---

I disagree on IGF-1 testing. Peptides took me from 100-150 ish to 320 in 7-8 months.

Hey Jasondd1, I'm not really too familiar with IGF and what the consensus is on the peptides. What was your experience and what peptides/supplements did you take? How does the increase in IGF affect you?

Quote:

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Originally Posted by Saso1

Hey Jasondd1, I'm not really too familiar with IGF and what the consensus is on the peptides. What was your experience and what peptides/supplements did you take? How does the increase in IGF affect you?

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I started with cjc1295 no dac 100 mcg 3 times a day and Ipamorelin 100 mcg 3 times a day and that raised me to like 207 in 5 months or so. Then went 100 mcg cjc1295 4 times a day and ipam 150-175 mcg 4 times a day and in 1 month raised it from 207 to 320. I maintain my original weight but I keep getting leaner and leaner and bigger and bigger. Strength up as well No sides other than worsening my hemotocratit. I read before trying to expect increase of 30-40% not the 200% i got

Sandman do you know for a fact that you need TRT based on prior BW or are you basing this on how you feel?
And Dr. Crisler is one of the best in the business so yes, you can have all the confidence you need in that list.

Quote:

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Originally Posted by kelkel

Sandman do you know for a fact that you need TRT based on prior BW or are you basing this on how you feel?
And Dr. Crisler is one of the best in the business so yes, you can have all the confidence you need in that list.

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Thanks for replying Kelkel and goddam your avatar is so distracting!

I'm considering TRT based on a) how I feel b) my inability to gain muscle no matter how well I diet and workout c) my low free t levels.

I have never done a complete bw similar to the one I posted at the start of this thread. The only bw I've ever done is total testosterone a few years ago. That came back 387. E2, also a few years ago, which was 13.7. And more recently free testosterone, which is a depressing 26.90 pg/ml. Reference range: 34.51 - 107.78 pg/ml.

So basically, now I am considering TRT. As is usually the protocol before starting TRT, I am going to do bloodwork. However, a bloodwork like the one I posted above is just too expensive here. Therefore, I am here to ask...which of the tests on the list I posted above can safely be eliminated in order to save cost? Meaning, which tests are not necessary as pre-trt tests?

To get on TrT my Dr looked at 6 tests

Total Test
LH
FSH
E2
PRO
PRL

Period.

He did not need to look past that due to LH FSH and TT showed primary hypogonadal.

Which other bloods am I glad I did on my own before TrT?

RBC
WBC
HDL
LDL
TG
VLDL
CK
HCT
HCY
TBIL
DBIL

When you go on TrT you will see changes in these and need to be monitored minimally. There are more that are really good to have but those I am so happy I did get.

Good luck on your journey. It can be a pain but the rewards can be awesome.