T Nation

Lab Work, Blood Testing and Symptoms


This sticky is maintained by KSman. This lead post is the sticky. DO NOT ATTEMPT TO DISCUSS YOUR PROBLEMS HERE! This is for technical reference use. KSman will compile information here and it will be a conservative approach. The next post will be for a broader approach that will be more expensive than most will tolerate and beyond what most insurance will pay for. Keep suggestions and contributions on topic. Some things might be better as PM's to KSman to keep down the clutter.

To understand what the lab work means, what needs to be done, when it needs to be done and what is a waste of time, you need to become an amateur endocrinologist. Or in my case "Endocrinology is my hobby!" This however does give way too much credit to Endocrinologists as most of them really are the amateurs and make some of the worse blunders and have pathological ego problems that keep them from learning what they need to know. I hold most Urologists in the same high esteem. Some of the best TRT docs are not formally medical specialists, but are self taught enthusiasts. But we will save all of that for a [controlled] "Finding a TRT Doc" sticky.

This will be a mix of simple recommendations, explanations and the occasional rant.

Added 01/26/2011

FT is T that is not bound to SHBG or other proteins.

SHBG: http://en.wikipedia.org/wiki/Sex_hormone-binding_globulin
Note that SHBG does not transport and release T, SHBG bound [SHBG-T] is not bioavailable. You will find many incorrect references to the contrary.

SHBG-T is tightly bound. Estrogens bind weakly to SHBG and SHBG can transport estrogens and release the estrogens throughout the body. Note that SHBG occurs in blood, but does not exist in tissues. So all T in tissues is considered FT. Secretions, such as saliva, can be used for hormone lab work and the results are considered FT, thus there is no TT in saliva testing. Many feel that saliva testing is quite useless.

Weakly bound T: T can be bound to other proteins [not SHBG] such as albumin in the blood. Those are weakly bound and the albumin bound T can be release T to tissues and this is considered hormone transport. There are other proteins to which T can be weakly bound. Note that some males loose serum albumin levels as they age. This is thought to also reduce bio-T:TT to some extent. In reality, these guys have low T, and lower albumin is one of the catabolic effects of low T. TRT would be expected to improve albumin levels.

With age, we see E2 and SHBG increase. This tends to increase TT, as FT/bio-T are falling and that can be misleading.

Bio-T is FT plus weakly bound T. Both measures are technically useful. Bio-T and FT are roughly proportional. So you typically do not have any need to do both of these types of labs.

TT is FT + weakly bound + SHBG-T. Note that for a given production rate of T, or a given TRT dose of T, the more SHBG you have, the more TT you will have. In this regard, TT can be the wrong therapeutic target and can be a simplistic and inappropriate concern if one does not understand the larger picture.

From a practical point of view, lab results should be useful. So the results need to be something that others are sufficiently familiar with to interpret. Most here are familiar with FT and not with bio-T. So FT will be better from that point of view.

To put the whole picture together, you also need estradiol numbers. With FT, TT and E2, there is very little need for SHBG lab numbers.

Note that some labs produce high FT ranges and results compared to other labs. FT lab numbers always need the lab ranges for interpretation. In this regard, I expect that bio-T has the same problem and bio-T results will always needs the lab's ranges for interpretation.

In HPTA intact males, LH is released in pulses and diurnal patterns. This leads to changing FT levels. FT has a short half life. When you test FT in these males, the absolute number is not very important as the result is partly a factor of when the lab work was done. With TRT using transdermals, the swings in FT are more extreme and lab timing greatly determines the lab values. With frequently injected T, TT, FT and E2 levels can be very steady and FT lab results thus are more valuable in that case.

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

Labs to be done when on TRT
-FT or bio-T
-Implications of injections VS transdermals [and injection frequency]
-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?]
-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

Thyroid labs [basic first line]
-T3 no see fT3
-T4 no see fT4
-are you getting enough iodine? probably not! http://tnation.T-Nation.com/free_online_forum/sports_training_performance_bodybuilding_trt/ksman_has_a_thryoid_problem
-? stuff that Hardasnails will suggest to me via PM
Thyroid symptoms [hypothyroidism or subclinical] Dry Skin, sparse outer eyebrows [observe others], feel cold easily, low body temperatures, general non-pattern hair loss, enlarged, lumpy, sore or asymmetrical thyroid gland. Many symptoms are the same as low-T.

Adrenal labs
-Cortisol four sample saliva testing [the gold standard]
-Pregnenolone [the foundation of the adrenal hormones and all steroid hormones *]
-DHEA [can't make T without it] no see DHEA-S
-DHEA-S [DHEA Sulphate]

  • Vit-D is multi-step derived from cholesterol directly, not via pregnenolone. Pregnenolone is also direct from cholesterol. Cholesterol is really the root of all steroid hormones. [Because cholesterol can be considered a precursor of testosterone, and testosterone a metabolite of cholesterol under Federal Statute [http://www.justice.gov/dea/pubs/csa/802.htm], cholesterol is technically a schedule III controlled substance and is subject to criminal penalties as an illegal anabolic steroid. Attempts by John McCain and others to explicitly classify DHEA as a schedule III anabolic steroid have nonetheless failed. See http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi?dbname=110_cong_bills&docid=f:s762is.txt.pdf ]

General health labs
-CBC: Complete Blood Counts
-Hematocrit: Part of CBC but needs its own discussion
-Lipids: Fasting Cholesterol and related
-Vit_D25 hormone -yes vitamin D becomes an essential steroid hormone
-Glucose: Fasting levels indicate insulin function
-Liver markers -are they really liver specific? [Hint: not]

Things that you can determine without lab work

Symptoms: Why are you here
-Brain fog, no one knows what that means but everyone knows if they have it!
-Social withdrawal - "I would rather not go out"
-Why do I have boobs? This really is depressing if prolactin is the cause!
-Why do I carry fat like a woman?
-Why am I a moody bitch?
-Can't get it up?
-It is up, now it's gone.
-My penis is numb -your nerves love T too. Things to do with testosterone cream.
-My testes are softer and smaller
-My testes ache 24x7
-My scrotum is up-tight, gives "how are they hanging" a whole new meaning.
-Nocturnal erections -necessary but not sufficient
-"morning wood" -things are working
-Why do really hot looking women and girls now look like art instead of lust?
-I felt great when I started TRT, where did that go? Neural transmitters rule your life.
-My TRT seems ineffective or never was. Things that crash in the night.
-On TRT and still do not feel right, something else is wrong.
-Loss of hair on lower legs, skin below the knees is smooth and shiny.
-Why do I feel cold easily or all of the time?
-Why do really stressful situations leave me feeling physically beat up. Adrenal fatigue.
-Dry skin, brittle hair and nails
-Skin on the back of hand is thin, crinkly. Pinched skin does not recover
-Gum disease, the ugly killer
-Why do I have a chronic cough [when taking a statin drug]
-I have visual field disturbances such as reduced peripheral vision
-My joints have started to ache
-TRT and now leg cramps
-TRT and wife says I am snoring more
-I am not depressed, I just don't care about anything, no joy, no motivation, no reward
-I want sex twice a day and my wife/GF is freaking out. What do do about her.
-We fixed my wife's hormones and I can't keep up with her needs. [Give me her phone number!]
-I want sex twice a day and my wife/GF loves it. Why are you still here?

-pituitary MRI for younger cases of hypothyroidism "what is in there"
-testicular ultrasound exam, detects cancer [please help with other uses]

Serum E2 testing:

E2 is estradiol - in case you were wondering [E1=estrONE, E2=estraDIol, E3=esTRIol]. There are different lab tests to choose from and docs often get this wrong. Some testes have limited reporting ranges and will not report actual values below a certain level and might report <17 pg/ml instead of the actual value. The reason for this is that these tests were developed for work on women's hormones. Women who are fertile have very high levels of estrogen and some tests are appropriate for those levels. Women who are post menopausal have low levels of estrogens and the need tests that are sensitive for those low levels. For post menopausal women with breast cancer, SERM drugs are used to push there already low estrogen levels even lower. Ultra sensitive tests are used to detect these very low levels to determine the effectiveness of the treatment.

For TRT, use the basic LabCorp serum E2 test or Quest Sensitive 4021x. DO NOT USE Quest ULTRASENTIVE! There are some similar issues with other testing labs as well.

DO NOT test for free estradiol
DO NOT test for total estrogens
DO NOT do Saliva testing, simply because very few people know what to do with that data.


Note that many older men, getting fat with low testosterone, can have more estrogen than their post menopausal wives! And old men and women can end up having similar body shapes.

E2 levels are modulated with low doses of aromatase inhibitors such as Arimidex/anastrozole. Optimal level is near serum E2=22pg/ml. Some doctors will prescribe 1mg/day which is a TOTAL disaster unless you are female and have estrogen positive breast cancer. Another idiot doctor mistake.

See this thread concerning problems with Labquest FT testing:
Note that Labquest can also report FT ranges that are about 5 times higher than reality. So you cannot compare Labquest results to Labcorp and others. FT lab results must be reported with lab ranges.

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61 Yrs Old, Had Bloodwork. Looking for Input
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I Do Believe I'm Being Given Bad Advice
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3rd Cycle
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34, Testosterone Level 175
Did I Screw Myself Up?

This is the less conservative approach aka more costly. Might look like cost is no issue to many.

The content here will mostly be whatever board member Hardasnails provides to KSman via PM. Suggest changes to Hardasnails via PM, not to KSman

THS 3 rd generation
TT -total testosterone
cortisol am and free
vitamin D 25 oh
estradiol sensitive assay
B-12/folate serum

place holder status to hold the #2 position in the sticky


Purechance contributed this:

[KSman says: Some of this testing may not be needed, some judgment is needed. Some docs will not do this because of HMO restrictions. Otherwise some insurance may not pay. Note that lab tests can run into a large amount of money if out-of-pocket. Labs that are used for routine followup of HRT treatment may need to be more focused from a cost-benefit point of view.]

Vitamin D deficiency is under-reported. A lot of people would benefit from a Vitamin D supplement.

GET the actual test results from the doctor's office. DO NOT accept "oh, your test results came back fine or within range". You are a paying customer. Make them fax you the results or get a new doctor, or ask for the results to be transferred, then get them from your new doctor.

You are the customer and have a say on what tests are run and your treatment plan. If you have a doctor that won't work with you, find another one.

Doctors surprisingly know very little. You know your body better then they do. Insist on getting your symptoms treated.

Never just accept that "your results are normal." Most doctors don't know what normal is. Get your own results and do your own research. Always insist on seeing your actual results. Get a copy for your records (in case you are like most people here who have to go from doctor to doctor until they can find one who will work with them.)

DO NOT believe the ranges the lab report shows. Do your own research.

Here is some of what I have asked for or doctors have recommended:
* Chemistry Panel (Metabolic panel with lipids)
* Complete Blood Count (CBC)
* Free Testosterone
* Total Testosterone (<500 is not good. 700-1000 is good)
* DHEA-S - Sulfate (low DHEA = increased risk of cardio complications + DHEA converts to T)
* Prostate-Specific Antigen (PSA)
* Estradiol
* Homocysteine
* C-reactive protein (High sensitivity) - (high = cardio risk)
* TSH (Thyroid Stimulating Hormone) - not that important. It is inaccurate and too many doctors use it as the holy grail; T4/T3 numbers are more important.
[KSman says: All of the group above can be had as a male lab panel from lef.org, the price is right, but it is always out-of-pocket and insurance will not cover.]

  • Total T4
  • Free T4
  • Total T3
  • Free T3
  • Reverse T3 (excess T4 converts to RT3. High RT3 blocks free T3 - so your TSH and T3 numbers could look great, but are blocked by RT3 and you feel like @$#!)
  • Thyroglobulin Antibodies
  • Thyroid Peroxidase

  • Cortisol (low cortisol = low overall cellular functions)

  • LH (low LH = pituitary disfunction causing hypogonadism - need MRI to check for pituitary tumor)
  • FSH (same as above)
  • DHT (Dihydrotestosterone)
  • SHBG
  • IGF-1 (Insulin-Like Growth Factor) (indicator of Human Growth Hormone <200 = not great)
  • Prolactin
  • Progesterone
  • Pregnenolone (precursor of Cortisol, DHEA, and Progesterone + Preg resolves brain fog and improved memory)
  • Vitamin D, 25-OH Total (should be 70-100 I think - almost everyone is deficient)
  • Vitamin D, 25-OH D3

  • Ferritin (critical for cellular function - low ferritin = low transport capability of hormones, etc.)

  • Iron, Total Binding Capacity
  • Iron, Binding Capacity
  • Magnesium, RBC (is important for cellular energy (ATP) production)



Although some of the symptoms you listed above have implied causes that are inferrible to a majority of your readers, it would be beneficial if you could give the possible relationship between the suspected pathologies which may result in these symptoms.

i.e. Can't get it up. (possibly low or high E2)



Here is another consolidated comprehensive list posted by JanSz on another forum.

1 Metabolic Panel (14), Comprehensive
2 CBC w/ diff/PLT
3 VAP TM Cholesterol Test
4 Selenium, Whole Blood
5 Copper, serum
6 Zinc
7 Magnesium, serum
8 Magnesium, RBC
9 Potassium, RBC
10 C-Reactive Protein (CRP), Highly Sensitive, CSF
11 Fibrinogen
12 Homocysteine, cardio
13 Lipoprotein (A) Lp(A)
14 Iron and Iron Binding Capacity
15 Iron, Total
16 Ferritin
17 Transferrin
18 Folate, RBC & Hematocrit
19 Hemoglobin A1c
20 Hemoglobin, Plasma
21 VITAMIN A, E, B3, B12
22 Vitamin D, 25Hydroxy
23 T3, Total
24 T4, Total
25 T3, Free
26 T4, Free
27 T3, Reverse
28 Ultrasensitive TSH
29 Thyroid Peroxidase and Thyroglobulin Antibodies
30 Thyroglobulin
31 Thyroxine binding globulin
32 T3 Uptake
33 Prealbumin/Transthyretin
34 Insulin, serum
35 IGF Binding protein3
36 IGF-1
37 DHEA Sulfate
38 Aldosterone
39 Renin Activity, Plasma
40 ACTH, Plasma
41 Cortisol Binding Globulin (Transcortin)
42 7:30AM/12PM/3:30PMCortisol, Free and Total
43 Prolactin
44 Progesterone
45 Pregnenolone
46 Androstenedione
47 Estradiol, sensitive 140244 (370)
48 Estrone, Serum
49 Total Testosterone
51 Albumin
52 Dihydrotestosterone
53 3aAndrostanediol Glucuronide
54 Ceruloplasmin
55 Coenzyme Q10

244.9 257.2 780.79
250.00 272.4 788.41
250.01 601.9 253.3
255.4 780.4 255.8


I'm finding this to be very overwhelming.
Is it possible to make a 'TRT for Dummies', and if this is it, then to make a 'TRT for Retards'? Maybe have the abbreviations/terms explained, or with an explanation if you browse your curser over the term?

If I read this correctly, there are six (6) necessary labs to be done before TRT:
1. LH and FSH
2. TT
3. FT or bio-T
4. E2
5. PSA
6. DRE

And, there are seven (7) necessary for after you have started TRT
1. TT (again)
2. FT (again)
3. Implications of injections VS transdermals (that's a lab?)
4. E2 (again)
5. DHT
6. PSA (again)
7. DRE (again)

If I MUST test for DHEA-S, why isn't that in the 'Labs to be done before' or 'Labs to be done after' lists?


Does that mean that thyroid labs and adrenal labs are 'stupid to do after you start TRT'?

If they're important, should they be in the 'labs to be done when you start' list or 'labs to be done when you're on TRT' list?

Are the General health labs important, and if so, should they be in 'labs to be done before' or 'labs to be done after' list?

I'm sorry if this post makes me sound like a jackass or like I'm being picky, but I really just don't understand.


You do not test LH or FSH when on TRT as you will be shutdown and they will be close to zero. That is in the stickies.

Yes, general labs are important, and basic, too basic to make take up space here.

I did state "-LH/FSH [optional and one last time -do I have cancer?]" If FSH stays high with HPTA shutdown, you probably have a FSH producing testicular cancer.

Some say to test for thyroid and adrenal issues because if they are low, when you increase metabolism with TRT, you will find the next weak links, aka hitting the wall. The rest of answer it self evident. This issue is discussed many times in posts.

Was not saying when to test DHEA-S. You can do that any time you want and DHEA is also part of adrenal function. If DHEA is low, take some and test later to see if you need more or less. I did not state that you MUST test DHEA, only that if you do, test for DHEA-S, not DHEA. DHEA tests are quite useless for reasons that I will not explain now as I have stated the reasons many times elsewhere.

You two need to learn to learn and read between the lines. Asking to explain everything that you do not know it a bit much.

This sticky is not a TRT guide.

Use Google, there is a lot to learn. If I explained ever little thing the message would be lost. No one else has these issues. Please do not mess up this sticky with more questions like this, and this is not a place for a discussion about this.

Don't ask me to explain all that I know about pathologies. This sticky is an attempt to create list of thing that you should consider and understand. And there are hints for you to follow. You need to study to understand.

Read other stickies and posts and search the web. If you cannot contribute to the knowledge here, do not post here in this sticky.


Can't the DRE be done by blood work now?


the only blood test is for PSA - prostate specific antigen, but that doesn't always tell you if your prostate is enlarged or growing (due to BPH)- therefore a DRE is still required and considered best practice.


Damnit...I was really hoping that wasn't the case.


Do you guys pay for these tests out of your own pockets?


Yes and no...I don't but would if I had to


Some guys get all needed tests via insurance, some get some and some get none.


Why is it important to check Vit. B12 and Ferritin levels? Also, what number do you want for prolactin and why is that important?


Prolactin can be a powerful HPTA inhibitor. We some times see high range, which causes problems and some times very high. Pituitary adinomas do happen and are small cancers. These can increase prolactin and/or decrease gonadotrophins - lowering T. Prolactin can contribute to gynomastia. Older men have an expected age related decrease in gonadotrophins [LH & FSH] and a decrease of testicular production of T when properly stimulated by gonadotrophins.

When younger men loose T levels, prolactin is something that should be tested. If not mid range, a pituitary MRI can be performed to see if there is an imageable adinoma. If an adinoma is larger, it will press on one or more of the optic nerves that pass beside the pituitary gland. If that happens, there can be a loss of peripheral vision... and worse if ignored.

We mostly see normal prolactin test results in the 6-9 range.

If young men loose T levels and estrogens and/or prolactin do not see to be causative agents, then one can check for one of a few [rare] genetic defects. Klienfelter's syndrome is odd because one might appear to be normal, then things go wrong at age 19-22. This is rare and some young men have such problems without any technical mechanism been found. I term these as "brittle HPTAs". Some of these events are precipitated by misadventure with steroids.

Prohomones and DECA seem to be the worst. 5-alpha reductase inhibitors, hair loss drugs, can break HPTAs, sometimes with a few doses. Those affected might perhaps have suffered the same fate later and the drugs simply precipitated the preexisting problem. But we will never know such details.

Libido, energy and mood are all a measure of ones sense of well-being - a state of health. Many are B12 deficient. This happens naturally as we age. But use of drugs, especially antacids and proton pump inhibitors can lower ones ability to absorb B12 from food or supplements via the gut. Other digestive conditions are associated with low B12 levels. B12 is important for proper function of the nerves and brain.

Ferritin is important for oxygen transport. If too high one has hemochromatisis and that alone can lower T levels. If low, that can interfere with your thyroid function. Discussion of details of thyroid function are way to complex to address here. Others have posted useful links to such information. Low ferritin can also identify anemia, however that will show up with low hematocrit and other CBC, complete blood count abnormalities. Most men have more than enough iron intake and levels are often higher, not low.

However, if there are diseases of the gut that lead to blood loss, levels can be low. We sometimes see that. But one in that state typically is painfully aware of that condition already, but perhaps not aware of the need to increase iron intake to compensate. Low T can lead to thin blood, low hematocrit and other markers. TRT can reverse this problem in many cases and one of the "indications" for prescribing testosterone and [rarely] some other anabolic steroids is anemia.

If one is on TRT and feels great, there is not much reason to test ferritin if hematocrit and other CBC markers are good. If one has some thyroid issues, testing ferritin can be useful, if only to rule that out as a cause. Note that TRT can, not rare, take hematocrit too high which can lead to some serious problems. In these cases, one donates blood or reduces/eliminates T dose.

If you are not familiar with any of the terms that I use, you can read up on Wikipedia. Suggest that you google ['term' wiki] and go from there.



I know that SHBG binds to testosterone and renders it unavailable, so you obviously want this to be on the lower side--but how low? Is there an optimal range that we're seeing? Or does it primarily depend on the individual?


From my point of view, there is not much to be gained getting concerned with something that you cannot directly manipulate. For most, E2 determines SHBG levels. So one can focus on management of E2 levels and SHBG will then be whatever it wants to be. As we age, we can also expect to see SHBG increase. Not known if that is truly a process on its own, or a result of men typically getting overweight with increasing E2 and falling T.

We also know that increased T levels will lower SHBG. I read that to be increased FT or bio-T. I do not expect that SHBG-T will have any effect lowering SHBG.

TRT T dosing should be focused on youthful levels of FT or bio-T, so dosing can increase over time if needed to maintain FT levels if SHBG keeps increasing.

We can focus on E2 management and youthful FT levels and not bother testing SHBG. Lower/optimal levels of E2 will allow more FT to dock with T receptors.

A reminder: T is not delivered to your cells by SHBG. SHBG-T will not release T. Yes, SHBG can transport and release estrogens, but they are not tightly bound. What people read about SHBG and estrogens very often misleads people to thing wrongly about SHBG-T. Albumin weakly binds T and transports T to the cells in your body.


so what have you found through your research or through conversations with your doctor(s) to be the ideal ranges for all of these blood tests?

Can you please post what you have found to be the ideal or optimal range?

Here is what I have put together. The more '?' the more uncertain I am.

Profile/Panel/Test Unit Normal Range
Cortisol ug/dL 3.1 - 22.4 (15 - 20 ideal for 8am blood draw)
Cortisol, Free mcg/dL 0.07 - 0.93 (.75 or more ideal??)
ACTH, Plasma pg/mL
Plasma Renin Activity ng/mL/h 0.25 - 5.82 (3.0 or more ideal)
Aldosterone ng/dL < 28 (14 - 28 ideal?)
Total Testosterone ng/dL 241 - 1000 (600 - 1000 ideal??)
Estradiol pg/mL 10 - 54 (22 ideal?)
IGF-1 (Insulin-Like Growth Factor) ng/mL 115 - 307 (200 or more ideal???)
Homocysteine, Cardo umol/L <11.4 (<6.3 ideal)

TSH ulU/mL 0.50 - 2.00 (<1.5 ideal?)
Thyroxine (T4) ug/dL (8.0 - 12.0 ideal?)
Thyroxine (T4) Free ug/dL 0.8 - 1.8 (1.1 - 1.7 ideal)
Triiodothyronine (T3) Free pg/mL 2.3 - 4.2 (3.3 - 3.9 ideal?)

WBC X10^3/uL 3.8 - 10.1 (4.0 - 5.5 ideal)
RBC X10^6/uL 4.4 - 5.8 (4.7 - 5.2 male ideal)
Platelets X10^3/uL 130 - 400 (230 - 400 ideal)
Neutrophils % 37 - 73 (50 - 60% ideal)
Lymphs % 20 - 55 (30 - 45% ideal)
Monocytes % 2.5 - 10.0 (3 - 8% ideal)
EOS% % 0.0 - 5.0 (0 - 3% ideal)
BASOS% % 0 - 2 (0 - 1% ideal)
Hemoglobin g/dL 13.8 - 17.2 (14 - 15 male ideal)
Hematocrit % 41 - 50 (42 - 48% ideal male)
MCV fL 81 - 99 (87 - 92 ideal)
MCH pg 27 - 33 (28 - 32 ideal)
RDW % 12.1 - 15.2 (13% is ideal)

Glucose mg/dL 70 - 105 (93 - 100 ideal?)
BUN (Urea Nitrogen) mg/dL 7 - 25 (12 - 20 ideal)
Creatine, Serum mg/dL 0.7 - 1.3 (0.8 - 1.1 ideal)
Sodium, Serum mmol/L 135 - 146 (142 - 144 ideal)
Potassium, Serum mmol/L 3.5 - 5.3 (4.0 - 4.5 ideal)
Chloride, Serum mmol/L 98 - 110 (101 - 103 ideal)
CO2 mEq/l 21 - 31 (24 - 28 ideal)
CALCIUM mg/dL 8.6 - 10.3 (9.5 - 10.2 ideal)
Total Protein Serum g/dL 6.0 - 8.3 (7.2 - 8.0 ideal)
ALBUMIN g/dl 3.6 - 5.1 (4.5 - 5.0 ideal)
GLOBULIN g/dl 2.10 - 4.20 (2.3 - 2.8 ideal)
ALB/GLOB 1.0 - 2.1 (1.7 - 2.2 ideal)
AST/SGOT U/L 10 - 39 (20 - 30 ideal)
ALT/SGPT U/L 7 - 52 (20 - 30 ideal)
Anion Gap 7 - 16 (10 - 12 ideal)

Cholesterol, Total mg/dL 100 - 200 (185 - 200 ideal?)
Triglycerides mg/dL 0 - 149 (< 60 ideal or 70 - 100? Differing opinions)
HDL mg/dL 39 or more (60 or more OR 55 - 75 ideal?)
LDL Calculated mg/dL 0 - 99 (< 60 ideal)
Lipoprotien(a) nmol/L <75 (0 is ideal)

VITAMIN B12 pg/mL 200 - 1100 (700 or more ideal)
Vitamin D, 25-OH Total ng/mL 32 - 100 (70 - 90 ideal)
Ferritin ng/mL 20 - 345 (100 or more ideal for male, but <200)
% Saturation calc 20 - 50 (35 - 45% ideal)
Magnesium, RBC ng/dL 4.0 - 6.4 (higher is better?)
Fibrinogen Activity, Clauss mg/dL 175 - 425 (< 331 Ideal?)
Phosphorus (3.8 - 4.2 ideal)


Ideal TT is problematic as the amount that is SHBT-T can vary. FT or bio-T is a much better metric. Consider an old guy with TT-1000 and a young normal virile male with TT=1000; not the same situation at all.

You do not show FT, edit that in[?]. The problem with FT is that some lab ranges can be 4 or 5 times larger than others. So we cannot simply pass out numbers, but must qualify anything that we say. We cannot discuss FT without SHBG, but that fits into the following category.

Please add prolactin [Most do well in the 7-9 range], CRP, PSA.

If you state that there is an ideal range for something that can be manipulated, such as TT, FT, E2, vit-D25; there is a real value to that as a therapeutic goal. Ideal ranges for things that we cannot directly alter is perhaps a less practical thing.


I came across this link today on STTM. You may have gathered your info from here as well, but a valuable resource nonetheless:

I came across this link on STTM this afternoon and thought it would be a great resource for some of us on here to reference.

KSMAN: I can't PM you, but if you read this and concur, I think it would be a good item to put into the stickies (if not already). Perhaps the