What Your Blood Work Actually Means

Welcome to HeydayMD Health Talk. I'm your host, and today we're talking about what your blood work actually means when you are on testosterone therapy.

So, you get your lab results back and it looks like a foreign language.

You see abbreviations... decimal points... reference ranges that span enormous gaps... and arrows pointing up or down.

Your provider will review these with you, but understanding your own numbers puts you in control of your health.

So what does that actually mean?

Let's break down every marker on a standard monitoring panel in plain language.

First up, we have Total Testosterone.

This measures all the testosterone in your blood, both the bound and the free.

The target range on hormone therapy is typically five hundred to eight hundred nanograms per deciliter.

We measure this at the trough... which is just the lowest point in your injection cycle.

Usually, that is the morning before your next dose.

If your trough is above eight hundred, your dose might be too high.

If it is below five hundred, your dose may need an adjustment.

Then there is Free Testosterone.

This is the two to three percent of testosterone that is unbound and biologically active.

This is arguably more important than the total number because it is what your body actually uses.

The target range here is fifteen to twenty-five picograms per milliliter.

Next is Estradiol, or E-two.

This is an estrogen produced from testosterone.

Some estradiol is actually necessary and beneficial for men.

But what happens if it is off balance?

Too much can cause water retention...

Mood changes...

And breast tissue enlargement.

Too little can cause joint pain...

Low libido...

And mood issues.

The target range is typically twenty to forty picograms per milliliter.

We also look at Sex Hormone Binding Globulin, or S-H-B-G.

This protein binds to testosterone and makes it unavailable.

If your S-H-B-G is high, you may need a higher dose or more frequent injections to keep enough free testosterone available.

If it is low, your free testosterone might be higher than your total number suggests.

Now, let's talk about safety markers.

Hematocrit and Hemoglobin measure your red blood cell concentration.

Testosterone stimulates the production of these cells, which can raise your hematocrit.

If your hematocrit goes above fifty-four percent, it makes the blood thicker.

This usually requires an intervention, like a dose reduction or a therapeutic blood donation.

This is actually the most common side effect we monitor.

Then there is P-S-A, which stands for Prostate-Specific Antigen.

This screens for prostate issues.

We establish a baseline before you start therapy.

Any rise of more than one point four nanograms per milliliter from that baseline within a year needs a closer look.

Generally, absolute levels above four point zero should be investigated.

We also track your lipids, like cholesterol and triglycerides.

Hormone therapy can modestly lower your H-D-L, which is the good cholesterol, in some men.

However, it often improves triglycerides and your overall metabolic profile.

For liver health, we look at A-S-T and A-L-T.

While oral products can stress the liver, injectable testosterone cypionate has a very minimal impact.

Finally, we look at your metabolic panel, specifically glucose and A-one-C.

The good news is that testosterone therapy typically improves insulin sensitivity and can lower your fasting glucose over time.

So, what are the red flags?

You should alert your provider immediately if your hematocrit exceeds fifty-four percent...

If your P-S-A rises more than one point four points in a year...

If you develop significant breast tenderness...

If your blood pressure rises significantly...

Or if you experience mood changes that feel disproportionate.

These are not necessarily emergencies, but they do require a prompt evaluation.

Remember, lab reports show reference ranges designed for the general population.

When you are on testosterone therapy, your targets are different and more specific.

The goal is symptom resolution with markers in safe zones... not just passing a general test.

If any of this resonated, check out heydaymd dot com to learn more, or take the free quiz to see where you stand. Thanks for listening to HeydayMD Health Talk. Take care of yourselves, guys.