T Nation

Why Draw Blood for Labs on Trough Days?

I’m curious as to why many clinics/docs draw blood for labs on the trough day? Why would they want to know the lab numbers on the day that the patient potentially feels way less than optimal? Also… my current protocol is 100mg every 3.5 days (200 mg/week) self injections. In about 5 weeks, I plan on doing labs. Which day would be recommended for me to have blood drawn? Thanks in advance for any replies.

While I’ve been on twice a week injections for about 6 years, my doctor wants my blood drawn on the morning of my injection, BEFORE injecting. So, if you inject on Monday and Friday, get the blood drawn early Friday morning.

To know the numbers/symptoms where your feeling the worst so they can adjust the protocol to get you feeling optimal all the time.

It’s also good for your doctor to test at trough, because with standard of care keeping levels in range, it makes the doctor look more responsible. Testing at peak and now the doctor has to lower your dosage to keep levels in range, but now your trough levels are going to be lower and you will likely become symptomatic.

An example,

Some random guy is on 150mg weekly and his trough levels are 550, his peak levels are 950 he feels good all the time.

The same man is seeing a different doctor now, this doctor tests at peak instead of trough and sees levels are out of range at 950, he instructs the patient to reduce his dosage and is now symptomatic right before his next scheduled injection.

He tests his trough levels and is at 350 and must look for a new doctor.

I figured blood could be drawn somewhere in the middle of the injection period so an “average” reading might be observed.

That’s like celebrating the triathlon winner half way through the race before he crosses the finish line. The measure of one’s protocol is trough levels, this is the end point, anything above this point is icing on the cake.

Seems more like covering their ass to me.

“I tested and they weren’t over the range”. Well, no shit, but you probably were the day after injecting

And it’s a way to keep everyone’s measurements comparable.

  1. To have a consistent reference point to work from with follow up labs.
  2. CYA as they do not wish to appear to be overdosing.

Re: #1: It would be very interesting to see results of labs drawn every day and compare individual rates of metabolism.

Re:#2: I know a doctor who uses scrotal creams exclusively and he keeps his guys between 1500-2000. So, he’s not worried about overdosing.

Most feel zero difference throughout the week. It isn’t about looking for the day in which the patient will feel the worst. The expectation is they do not experience it at all.

If I felt way less than optimal I would especially want to know my numbers so I could get an idea of what to do. If you really swing over the course of a week or whatever your injection frequency is you probably either need to divide up your dose for more freqent injections or bump you’re dose or both.