First of all, let me say I don’t have much of a clue on this topic. Don’t be afraid to dumb it down…
I requested a blood panel for my first followup after starting TRT based on TCs advice:
"…make sure you get tests done in exactly the way specified below. (For instance, if you don’t ask for a " sensitive assay " estradiol test for males, they’re going to measure your estradiol the same as if you were a ballerina from the Bolshoi ballet suffering from menstruation problems.)
Ask for this lab work:
- Testosterone, total
- Testosterone, bioavailable
- Testosterone, free
- Estradiol (sensitive assay)
- Steroid Hormone Binding Globulin
- Follicle Stimulating Hormone (FSH)
- Luteinizing Hormone (LH)
- Dihydrotestosterone (DHT)
- Complete Blood Count (CBC)
- Prostate Specific Antigen (PSA)
- Blood Chemistry Panel
- Metabolic Panel
These tests will give a fairly good baseline reading of where you stand so that when you have follow-up blood testing done three to six months later, you can see…"
I get this back from the VA doc:
"Thank you for your message. Based on evidence based medicine, the recommendation for TRT monitoring is a history & physical examination, a total testosterone level, hematocrit, Prostate Specific Antigen, Bone density scan and a digital rectal exam, all of which I will happy to order and perform.
Please send me any scientific evidence backing you justification for the following labs:
• Testosterone, bioavailable
• Testosterone, free
• Estradiol (sensitive assay for males)
• Steroid Hormone Binding Globulin
• Follicle Stimulating Hormone (FSH)
• Luteinizing Hormone (LH)
• Dihydrotestosterone (DHT)
Additionally, what is the difference between a blood chemistry panel and metabolic panel?"
I think he’s being a smart ass with the last one. Is he pointing out the fact that I don’t know what I’m talking about? I looked it up- the blood panel does not include protein and liver tests. So what? The reason I asked for all these test is the first time a diff doc allowed some of these and a nurse took it upon herself to not include the FSH or LH or both because I’m male!
Since this is not a baseline test, are some of these not needed now?
How do I respond to the doc? I have a full plate right now and don’t have the time or know-how to get that info, and again, I think he’s messing with me. What’s he gonna do with just total T?