What labs are needed before starting TRT?

Full answer

TRT is anchored to a baseline biomarker panel rather than a symptom intake. The standardized oMeds panel for hormone optimization covers four pillars. Hormones: total testosterone, free testosterone (or calculated free T with SHBG and albumin), SHBG, estradiol (sensitive assay), LH, FSH, prolactin, and thyroid (TSH, with fT3/fT4 and reverse T3 where indicated). CBC: hematocrit, hemoglobin, RBC, and platelets — read at baseline and monitored throughout TRT for erythrocytosis. CMP: ALT/AST, bilirubin, creatinine, eGFR, fasting glucose, electrolytes. Lipids: total cholesterol, LDL, HDL, triglycerides, with ApoB added where cardiovascular risk stratification matters. PSA is included where age and history indicate. The panel is required at baseline, repeated at the first recalibration window (typically 8–12 weeks), and read on the ongoing recalibration cadence — not retired after initiation.

Educational. Not a substitute for individualized provider review.