Hormone Panel for Men on TRT- Upstream & Downstream

This hormone panel for men on testosterone replacement therapy (TRT) contains upstream and downstream hormones to testosterone.  TRT has been shown to decrease upstream hormones like pregnenolone and progesterone, and slightly decrease DHEA. Downstream hormone metabolites like ultrasensitive estradiol and DHT are also included.  Lastly, prolactin is added since high prolactin can decrease sexual function.  No LH and FSH were included since TRT shuts them down.

Several of the hormone tests (estradiol, testosterone, pregnenolone, progesterone, & DHT) included in this panel are done using liquid chromatography/mass spectrometry since they are more precise at high and low values and have no interences.

You can add an IGF-1 test and 17-OH-progesterone test to your cart for an even more complete picture.

• DHEA-S Test

Dehydroepiandrosterone (DHEA) is a hormone produced by the adrenal gland. It is also made in the brain. DHEA leads to the production of androgens and estrogens (male and female sex hormones). DHEA levels in the body begin to decrease after age 30. Lower DHEA levels are found in people with hormonal disorders, HIV/AIDS, Alzheimer's disease, heart disease, depression, diabetes, inflammation, immune disorders, and osteoporosis. Corticosteroids, birth control taken by mouth, and agents that treat psychiatric disorders may reduce DHEA levels.  Do you need to take a DHEA supplement?

• Estradiol Test (Ultra-Sensitive) Test (LC/MS)

Estradiol is the predominant sex hormone present in females and is also found at lower levels in men. It represents the major estrogen in humans. Estradiol not only impacts reproductive and sexual functioning, but also affects other systems including bone health, heart health, nerves and metabolism. Estradiol, also known as E2, is the most active of all three estrogens commonly measured in a clinical setting. For women, it is important to compare the relationship between estradiol and progesterone in evaluating menopausal symptoms such as hot flashes, mood disorders, and aging skin. In both men and women, low levels of estradiol are associated with osteoporosis. More information: Estradiol in Men: Top Ten Things You Should Know

• Progesterone Test

Progesterone is a female hormone important for the regulation of ovulation and menstruation. It is also present in men in smaller concentrations. This test is performed using the immunoassay technology. Progesterone is used to cause menstrual periods in women who have not yet reached menopause but are not having periods due to a lack of progesterone in the body. This hormone is also used to prevent overgrowth in the lining of the uterus in postmenopausal women who are receiving estrogen hormone replacement therapy. Progesterone replacement may also be used for other purposes. TRT may lower progesterone in men.  Progesterone may have a calming effect in men, so some researchers speculate that decreasing progesterone levels in men may affect mood, sleep quality and anxiety.

• Pregnenolone Test- Sensitive (LC/MS)

Pregnenolone is the mother of all hormones. It is known as a neurosteroid with brain health benefits.  As most hormones, it decreases with age. Aside from the natural decrease in pregnenolone that occurs as you age, research shows that higher doses of Testosterone Replacement Therapy (TRT) cause pregnenolone levels to drop even further. 

This pregnenolone lab test uses liquid chromatography, so it is accurate for the measurement of pregnenolone. Pregnenolone is known as the mother hormone. All other steroids including testosterone and estrogen are derived from this important hormone. For this reason, optimal blood levels of pregnenolone are critical for a healthy hormone balance.

However, pregnenolone does more. It is important for proper brain development, cognition, memory, and mood. These dramatic effects on the brain are why pregnenolone is known as a neuro-active steroid.

Fasting is not required. Pregnenolone supplementation should be taken approximately 2 hours before the blood draw. More on the role of pregenolone in men.

• Total Testosterone, LC/MS

• Free Testosterone by Equilibrium Ultrafiltration

This panel includes total testosterone measured by the most accurate method for women (liquid chromatography/mass spectrometry), free testosterone percent by equilibrium ultrafiltration, and free testosterone calculated from percent free T. Food may temporily low testosterone blood levels in men not on TRT.

• Dihydrotestosterone (DHT) (LC/MS)

DHT is synthesized from testosterone in the prostate gland, testes, hair follicles, and adrenal glands by 5-alpha reductase. Dihydrotestosterone exerts its action similar to testosterone, which binds to and activates androgen receptors. Dihydrotestosterone is responsible for the formation of male primary sex characteristics and most male secondary sex characteristics during puberty, such as muscular growth, facial and body hair growth, and deepening of the voice.

Excess DHT has been associated with hair loss, prostate volume increase, and acne in men with a genetic predisposition to those issues. Blocking or decreasing DHT to low levels may cause sexual dysfunction. Please read DHT: Friend or Enemy of Men?

• Prolactin Test

Prolactin is secreted by the pituitary gland to induce milk production. It also has many other functions on immune response, myelin coating on nerves, heart muscle protection, and enhances LH receptors on testicular Leydig cells so that testosterone can be produced. 

Prolactin levels peak during REM sleep, and in the early morning. Levels can rise after exercise, meals, sexual intercourse, minor surgical procedures, or following epileptic seizures. 

High prolactin can decrease testosterone and cause sexual dysfunction. Higher levels of prolactin have been associated with tumors involving the lungs, the pituitary gland, and the kidneys. Prolactin is sometimes used by doctors to evaluate sexual dysfunction of unknown cause in both men and women.

Drugs, supplements and certain diseases like pituitary adenomas may disrupt normal prolactin blood levels. These include hypothyroidism, antiepileptics, antidepressants, estrogen, opiates, diuretics, certain growth hormone releasing peptides and arginine. More on the role of prolactin in men.