The panel
Total and free testosterone, SHBG, estradiol by sensitive assay, LH and FSH, hematocrit, PSA where indicated, lipids including ApoB, fasting insulin, and a thyroid panel. A low total with a normal free is a different conversation than a low free.
Why we do not chase a number
Symptoms, labs and risk together. A man at 450 with fatigue, poor sleep and a fasting insulin of 18 needs his sleep and his insulin fixed before his testosterone. Often the testosterone follows.
Estradiol
Estradiol is protective for bone, brain and vessels in men. Crushing it with an aromatase inhibitor to hit a forum number is how joints and libido get worse. We treat the ratio, and we rarely need an inhibitor.
Delivery
The form is chosen with the clinician, around lifestyle, labs and follow-through. Hematocrit is checked at follow-up, and the plan changes if it climbs.
Women
Testosterone matters for women too, as one part of rhythmic bioidentical replacement. That work is led here by Elaine Marquez Mortensen, ND.
Educational. Not medical advice. Treatment decisions are made by a licensed clinician with the patient. Nothing here describes a product as approved by any regulator.