What Blood Tests Do I Need To Start Testosterone Replacement Therapy?

December 12, 2018

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What blood work is required for beginning testosterone therapy for men who think they have low T?


NovaGenix in Jupiter, Florida can help get your labwork done to begin TRT in Palm Beach County.

For men wishing to start testosterone replacement therapy, it’s important to make sure that you get the right blood tests to determine if TRT is something that would be beneficial to them. It’s important for men to properly monitor their hormone levels by performing the right labs and blood work to ensure that their hormone levels are balanced and optimized so that they can begin to feel their best and get the most health benefits from treatment. Lab results a physical exam and an ADAM Test (Androgen Deficiency in Aging Males) (Click HERE to take the ADAM test online)  https://novagenix.org/how-to-test-for-low-t





At a minimum, to start testosterone replacement therapy, the following panels listed should be performed, but are by no means the only tests that could or will be performed by your provider. More thorough panels are great in the sense that more information is always a good thing regarding your health, however the more comprehensive the blood tests are, the more expensive they can be, so ask ahead of time how much labs will cost to start TRT through the clinic as some business charge more for labs than others.




At a minimum to start Low T therapy, we would start with Total Testosterone. Most men who start TRT want to see their levels rise above 500 ng/dl. This is the area where patients really see the improvements while on Low t therapy. Typical total testosterone ranges in men vary from around 250 to 1100 and certainly age and lifestyle choices will place groups within various sub-sections on this scale. For example, an active 22-year-old male will have a higher average testosterone value than a sedentary 60-year-old male averaged out across the population. All research and literature point to the benefits of TRT on an individual’s health with having their hormones levels with the upper quartile of the standard ranges.


Free testosterone is also extremely important as it measures the amount of bioavailable testosterone in the body. Many patients come in with their serum or total testosterone levels seemingly normal, however, their free testosterone tells a different story. Many patients may have testosterone being tied up or bound by Albium or sex hormone binding globulin, (SHBG). Despite the testes producing a significant quantity of testosterone, there is very little left to be used for the individual which will lead them to feel the symptoms of male hypogonadism, so we need both values of Free and Total Testosterone to diagnose and treat men.



Estradiol is another important test for men thinking about starting HRT. We often find that healthcare practitioners who are not as knowledgeable in HRT as they should/could be, will neglect to run this test. The reality is a male’s estrogen levels are extremely important in how they feel. You want your estrogen levels to be neither too high, nor too low. Knowing your estradiol levels will allow a practitioner to prescribe the appropriate estrogen blocker and help determine the amount of aromatization of testosterone into estrogen. Determining your baseline and seeing how much it changes while on TRT is important in making sure that the patient feels better while on treatment. When estrogen levels are too low, a person may become fatigued and if estrogen levels are too high, they may develop unwanted symptoms like gynecomastia and/or have mood swings, low libido, muscle loss, ED and more. Knowing your levels will help the physician in adjusting medications properly and allowance for successful treatment.


PSA or prostate specific antigen is an important test for starting TRT. Is the first step in determining whether or not there’s potential enlargement/cancer of the prostate. The American Urological Association has come out with the definitive report that states testosterone therapy does not cause prostate cancer, however, in some patients there could be some enlargement which is not advisable for someone with prostate cancer. By assessing the PSA, a skilled physician can evaluate the lab results and determine the risk factor. If the PSA is over 4.0, it’s recommended to follow up with the urologist and possibly get an ultrasound to evaluate the possible risk of prostate cancer or tumors.



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Blood Work Request Form

This subsequent lab panel is necessary for males undergoing Testosterone Replacement Therapy (TRT) through NovaGenix Health and Wellness. It allows physicians to assess the patient's response to prescribed medications, covering sex hormone levels, thyroid function, adrenal health, hematocrit, and liver and kidney function. The panel includes tests such as:

  • Complete Blood Count
  • Comprehensive Metabolic Panel
  • Testosterone (Free and Total)
  • Estradiol Sensitive
  • Thyroid Stimulating Hormone
  • Prostate Specific Antigen

Each test serves a specific purpose in monitoring overall health and treatment effectiveness. When required, Dr Mackey may require LH and FSH (Luteinizing hormone, follicle stimulating hormone) SHBG (Sex hormone binding globulin) or any other tests which may be important for your health and optimizing your hormones.

The Comprehensive Hormone and Wellness Panel for Women offers a foundational assessment of sex hormones, thyroid function, adrenal health, metabolic activity, and overall well-being. This panel serves as a diagnostic tool for identifying testosterone and estrogen deficiencies, assessing health risks, and detecting potential thyroid issues before considering hormone replacement therapy. Additionally, it includes insights into hematocrit (red blood cell volume), as well as liver and kidney function. The panel encompasses various tests such as:

  • Complete Blood Count (CBC)
  • Complete Metabolic Panel
  • Testosterone (free and total)
  • Estradiol
  • Thyroid Stimulating Hormone (TSH)
  • Progesterone

When indicated, Dr. Mackey may require additional tests such as Follicle Stimulating Hormone (FSH), and IGF-1 and Cortisol.

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