Starting Testosterone Replacement Therapy: What Lab Tests Do You Need?

Testosterone replacement therapy (TRT) can be a powerful tool for men looking to boost their testosterone levels. TRT has been associated with improved energy, libido, and overall quality of life. But before you consider TRT, it’s important to understand the tests that are used to measure your testosterone levels and help you decide if TRT is right for you.

Total & Free Testosterone

Total Testosterone measures the amount of protein-bound testosterone in your body. This is the most common testosterone test guys are familiar with. Most ranges vary from 300-1200 ng/dL. This test is usually done in the morning when testosterone levels are at their highest. It’s important to note that this test won’t tell you how much unbound (free) testosterone is available to your body.

Free Testosterone measures the amount of unbound testosterone in your blood. If your Total T is low, it’s likely that your Free T is also low. However, if you’re already on TRT, it’s possible that your Free Testosterone may be high. Excess Free Testosterone can be converted further into estrogen that may cause another whole list of problems in the male body.

Sex Hormone Binding Globulin

Sex hormone binding globulin (SHBG) is a protein that binds to both testosterone and estrogen in the bloodstream, making them inactive. Too little SHBG means that your Free Testosterone may be high. High levels of SHBG can cause lower free testosterone. 

LH & FSH

Luteinizing hormone (LH) and follicle stimulating hormone (FSH) are produced by the pituitary gland. These two hormones work together to regulate the production of sex hormones in both men and women. If either one of these hormones is low or elevated, it may indicate a problem with your pituitary gland. Testing LH/FSH along with other hormone tests can provide more insight into potential causes for Low T symptoms.

Prostate Specific Antigen

Prostate-specific antigen (PSA) is produced by the prostate gland. High levels can be an indication of prostate enlargement, or potentially cancer. This should be checked at least 2 times a year when on TRT.

Other lab tests that may be ordered include complete blood count (CBC), comprehensive metabolic panel (CMP), thyroid stimulating hormone (TSH), Free T4, and cholesterol levels.

Before starting any type of hormone therapy, it’s important to understand what lab tests are needed to get an accurate assessment of your current health status and evaluate if TRT would be beneficial for you. In addition to total testosterone, free testosterone, LH/FSH, and SHBG measurements should all be taken into account when assessing whether or not TRT would be appropriate for you as an individual patient’s needs vary from patient to patient. 

If you have questions about these lab tests or want more information about how they can help diagnose potential underlying causes for low T symptoms then don’t hesitate to ask! We can provide personalized recommendations based on your unique situation so don’t hesitate to reach out today!

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