T Nation

Low T and Lab Work

My current list of problems are: Low T, Low thyroid, High Estrogen, Low libido/ed, depression.

I have current lab orders to check estradiol, testosterone free & total with shbg, and testosterone total. There is 2 different tests listed for total t.

I have seen on this forum references to also checking DHT, DHEA-S,IGF-1,Pregnenolone, Cortisol and GH. I am wondering what the medical justification is for these others as I will need to convince the doctor to add them to the existing lab orders. Any other tests that I need to also consider?

Is there a standard name for the suite of tests for T-levels?

Would I go to my doctor and ask for a Testosterone profile?

What are the most informative tests to get?

Is this stuff in an FAQ or sticky that I’m missing?


Click on: TRT: A Recipe for Success, should answer all your questions.

Get a full blood work up and do a Rhien 24 hour urine. You’ll know exactly where you’re at then.

What doctors order is also controlled by med insurance and HMO type restrictions. And they might not order anything where they would not know what to make of the results.

Some will find it cheaper to order these tests from LEF.org and pay out of pocket. So ones budget and insurance are factors.

And there can be a concern about testing for things that one cannot afford to treat in any case such as IGF-1 and hGH HRT.

Estrogen up: alcohol, grapefruit, smoking, Rx and OTC drugs, ephedra, overweight…

Prolactin levels can cause your problems. One would then expect low dopamine, lack of joy or reward… but these are also part of many types of depression. Cabergoline can increase dopamine and lower prolactin. If that creates a big lift in mood, this really suggests depression that responds to increased dopamine. A trial of cabergoline or trazodone can provide useful observations.

Do not test GH, a waste of money. GH is pulsatile with a short half life. IGF-1 levels are a better indicator of GH status.

TRT can improve thyroid and vice versa.

If a number of these hormones are off, then one needs to look at the possibility of pan-hypopituitarism. Any vision changes or disturbances could be from a growth that is pressing on optic nerve[s] and the pituitary. A brain scan can be useful.

Tests are only tests and do not reflect your individual needs which remain unknown. Do not focus on the technical and ignore other things that are very specific to you such as time lines, illnesses, head or groin injury, fat gain, fat deposit patterns, muscle loss, weakness, energy, initiative, passivity, short temper…

Skin thinner, loss of elasticity?

Mood problems can lead to poor diets. Are you getting EFAs, vitamins, minerals, vitamin-D? Are you getting enough iodine? [Sea salt has no iodine unless the packaging stated that it is iodized.]

Your blood work and CBC: Your liver removes estrogen from your system. Note any elevated numbers that relate to the liver. Do not do any training that leads to sore muscles before labs as the muscles can elevate the markers that are also of interest, but not specific to, the liver. Ditto bruising, sprains etc.

I am getting a IGF-1 test tomorrow, are you saying not to workout tonight?