Was looking for some advice regarding blood work issues. I’ve recently started a new TRT regimen per a new clinic and wanted some advice on blood work to get to ensure the efficacy and validity of the protocol I’m on. I’m also wanting to look into starting a new thyroid medication and could use help with that as well…
My questions are as follows:
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Given the option should I contact the clinic and have them write the script for blood work or should I go through an internet company? If so can anyone recommend a reliable and cost effective source for blood work online?
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What tests specifically should I be requesting to evaluate my TRT protocol? Taking Test-Cyp, HCG, Anastrazole. I know total test, and free test, Estradiol etc (any specific test for E?) but anything else I need to look into? DHEA, SHBG etc?
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For thyroid panel what all should be included over TSH? Looking to switch from synthroid to Armour…
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I inject on a 3day rotation. Day 1 Test-Cyp, Day 2 AI, Day 3, HCG then repeat. I am assuming I would have blood drawn on the morning of Day 3. Would I have it drawn before or after my HCG injection for a true nadir point or should I have it drawn another day?
Sorry for all the questions, but trying to do this right and not waste the last year or so as I’ve done with incompetent medical care. Thanks in advance for all the help.
Ummm if you are paying a cliinic for their services, why don’t you just ask them these questions?
[quote]VTBalla34 wrote:
Ummm if you are paying a cliinic for their services, why don’t you just ask them these questions?[/quote]
Good question, and here are some answers…
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I actually didn’t pay for their services. I was able to see them for free through a friend who was family friends with the owner after explaining my previous problems with a urologist
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I think we all know that trusting only the opinion of a doctor or clinic in these matters borders lunacy and that many opinions (most certainly including yours) are valued just as much as not more than theirs
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Arming yourself with as much knowledge as possible is never a bad thing and there may be tests available to help determine efficacy a clinic might decide to overlook or not be aware of
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Having not paid for the initial visit doesn’t mean I will be absolved for life of their fees if I continue to use their services. I don’t mind paying more than the cost of a traditional doctor if need be for quality care, but at the same time I don’t want to throw money away on something I can do on my own regarding preventative medicine and taking care of myself in the best possible means necessary. Especially if there is a chance just simply visiting them for a blood draw might not cover everything.
I hope that explains my logic sufficiently and I hope you can help as you’ve done in the past. Take care!
Fair enough… I just found it surprising that you were going to one of those clinics, and hadn’t asked them that. Would be easier to see what they suggested and then tweak that as necessary as opposed to coming up with your own plan from scratch. But I understand your situation (pretty cool of them to do that btw).
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If they will write the script and insurance will pay for it, have them do the script for bloodwork. Otherwise you will have to pay out of pocket for one of the anonymous bloodwork sites.
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If you already have your protocol set, do not have other issues (cortisol/thyroid), and have ruled out that you are taking adequate T dose and don’t have underlying pituitary issues (LH/FSH=0) then you could get by with the following:
-TT
-Free T (or bioavailable)
-E2
-DHT
-PSA
-SHBG (debatable since there isn’t much you can do directly to influence this)
-CMP
-CBC
-Lipids
- I had already typed #2 before reading this, so in addition:
-TSH
-Free T3
-Free T4
-Total T3/T4 (not a requirement but good to have)
-Reverse T3
-Cortisol
-Thyroid antibodies (unless you have already had these checked to rule out auto-immune disorders and Hashi’s)
- Weird protocol (easier to to just do them all in one day) but the morning of your HCG shot, before the shot, would be best time.
[quote]VTBalla34 wrote:
Fair enough… I just found it surprising that you were going to one of those clinics, and hadn’t asked them that. Would be easier to see what they suggested and then tweak that as necessary as opposed to coming up with your own plan from scratch. But I understand your situation (pretty cool of them to do that btw).
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If they will write the script and insurance will pay for it, have them do the script for bloodwork. Otherwise you will have to pay out of pocket for one of the anonymous bloodwork sites.
-
If you already have your protocol set, do not have other issues (cortisol/thyroid), and have ruled out that you are taking adequate T dose and don’t have underlying pituitary issues (LH/FSH=0) then you could get by with the following:
-TT
-Free T (or bioavailable)
-E2
-DHT
-PSA
-SHBG (debatable since there isn’t much you can do directly to influence this)
-CMP
-CBC
-Lipids
- I had already typed #2 before reading this, so in addition:
-TSH
-Free T3
-Free T4
-Total T3/T4 (not a requirement but good to have)
-Reverse T3
-Cortisol
-Thyroid antibodies (unless you have already had these checked to rule out auto-immune disorders and Hashi’s)
- Weird protocol (easier to to just do them all in one day) but the morning of your HCG shot, before the shot, would be best time.[/quote]
Thanks for your help as always. As far as asking the clinic goes, I definitely do plan on getting their input, but as with my previous experiences with my primary and an idiot urologist the lack of knowledge most “professionals” seem to possess coupled with their apparent hatred for thoroughness leaves a lot to be desired with the standard plan most places dish out. But like you mentioned it never hurts to ask and I might be surprised.
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Will do. My insurance isn’t the greatest, but it will do. In case it becomes easier to do it through a site do you have any suggestions?
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Seems like a solid list. I have a physical scheduled with my primary and he covers a lot of that regarding CBC, Lipids, PSA, etc, so asking for TT, Free T, E2, DHT, and SHBG would be a good start to evaluate the protocol?
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Very comprehensive and more than I’ve had from my primary who’s writing me prescriptions. Thanks for that!
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As far as the protocol goes that’s more or less the way I set up as a convenience for myself with my schedule. Originally suggested was 200mg test on Friday, 0.5mg Anastrazole on Sat and Wed, and 250 IU HCG on Wed and Thursday. My protocol seemed to make sense for me to split the T into smaller doses and still spread the other compounds out.
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www.privatemdlabs.com
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My mistake. I didn’t actually mean “do them all in one day” as in, only one day of the week. But something like Monday-Thursday split where you take half of everything (T, AI, HCG) one day and the other half the other day. Or MWF if you have the time. Personally I inject and take my aromasin on Mon-Thurs and am not on HCG. Aromasin has a slightly longer active life than AI so dosing twice a week is fine for me. Adex may require 3x/week.
Regardless, if it works for you, go for it.
[quote]VTBalla34 wrote:
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www.privatemdlabs.com
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My mistake. I didn’t actually mean “do them all in one day” as in, only one day of the week. But something like Monday-Thursday split where you take half of everything (T, AI, HCG) one day and the other half the other day. Or MWF if you have the time. Personally I inject and take my aromasin on Mon-Thurs and am not on HCG. Aromasin has a slightly longer active life than AI so dosing twice a week is fine for me. Adex may require 3x/week.
Regardless, if it works for you, go for it.[/quote]
Thanks for the link… Will look into that as well as check with my clinic and see what makes more sense…
As far as the protocol, I figured you meant all 3 on one day, still doing twice a week. I could definitely consolidate and do all one day if you think it would be beneficial. E3D rotation works better just for my schedule but I could easily combine and do all 3 same day E3D. I just thought for some reason spreading them out was the right thing to do haha. Go figure!
[quote]VTBalla34 wrote:
- www.privatemdlabs.com
[/quote]
Checked out the website and it looks great, thanks. Are there any specific packages that are one stop shop or is piecing everything out the best way to go? I noticed several packages, but the names run together and I didn’t know if you personally had a a goto or a favorite.
Also I have an upcoming well visit/physical scheduled with my primary including blood work. Would it be somewhat correct to assume that some of the blood work mentioned would be covered in standard yearly physicals such as PSA, CMP, CBC, Lipids etc?
If so could I get by with TT, Free T, E2 for now with possible SHBG since it’s debatable like you said? Also I’m not very educated with what DHT is for…
Thanks for the education!
The best package I’ve found on mdlabs is actually the female hormone panel. That is a shitty name for it, but it is irrelevant because when you check out it knows that you are a male and they do the tests correctly based on that when you get your blood done. Check it out and see if it works for you and try to align it to the recommended tests in the stickeys. Not a perfect solution but pretty good, at least for starting out.
Yes to your question about those being covered in a yearly physical, for the most part. PSA is dependent on age I think and not sure if it is routine or not.