LOW TESTOSTERONE EXPERT DOCTORS IN MIAMI
EVERYTHING YOU MUST BE TESTING FOR IN ORDER TO KNOW IF YOU TRULY HAVE LOW T AND OTHER HORMONAL IMBALANCES
TESTING FOR LOW TESTOSTERONE & WHAT TO KNOW
We are going to cover almost all you need to know about Low T in this article. Before we break down the reasons behind getting legitimate blood work, let’s start with the three things that define aging and how they relate to the following information.
The three things that define aging are memory, vision, and physical movement. Hormone replacement therapy and low T treatment is hands down the best way to maintain the proper optimal function of these aging factors. Our Miami low T doctors agree that this is the most essential tool you can use to age gracefully.
However, hormone or testosterone replacement therapy should never be considered without a complete understanding of how all the body’s hormones interact with each other. If one hormone is altered or deficient in your body, it will affect the actions of all of the other hormones and cause a “cascade effect.” The hormonal response of an individual is as unique as their fingerprints, and how one responds to therapy is related to the condition of one’s health, genetic profile, stress level, nutritional supplementation, aging, detoxification, lifestyle, and what you eat.
UNDERSTANDING LOW TESTOSTERONE & TRT TREATMENT
Nevertheless, we hope that you could agree that one size does not fit all, and why it’s so crucial that we customize each treatment for each patient with a proper blood work analysis. So, before starting you on a hormonal replacement treatment or if you are already on therapy, and your Miami doctor is not ordering all of the following tests panels found below, we would ask you to think twice or at least consider his overall expertise in the field of regenerative and functional medicine.
We promise that once you read what each of these hormones’ jobs plays in your body, you will understand why blood work like this is absolutely invaluable to your well-being. Once you’ve gone through the material, you will no longer have any doubts about its importance. We want to prove to you that this by far the most comprehensive blood test you can order (for Low T and hormone replacement therapy). In addition, we want you to see how we are sincerely watching out for our patient’s best interests. As we know, most of us are on a busy schedule. Thus, we made the information as simple, accurate, and easy as possible for you to read and understand.
WHAT IS A HORMONE
A hormone is a chemical the body produces to control and regulate the activity within your cells and organs. Hormones play a critical part in every bodily function. This includes bone density, digestion, metabolism, reproduction, sex drive, and mood. Think of them as “messenger molecules” that give your cells and organs instructions. For example, insulin is a hormone that causes cells to absorb glucose. Glucagon helps burn the sugar out of the fat cell. The luteinizing hormone helps produce more natural testosterone and sperm count. The point is your hormones are designed to work together, and not testing for all of them would be irresponsible of your low T doctor in Miami. Let your common sense decide if these panels are of any importance for your TRT therapy or low T treatment.
WHAT A COMPLETE HORMONE BLOOD TEST LOOKS LIKE
Total Testosterone
This test measures testosterone that is bound to protein carriers in the blood like albumin and sex-hormone binding globulin, also known as SHBG. It is not a good marker indicator to identify if the patient is truly suffering from all the symptoms of low T, but we check for it to give us a broad understanding of the patient’s specific hormone deficiency.
Free Testosterone
This test measures the testosterone that is not attached to protein carriers like SHBG and albumin and is free to be utilized by our body. This panel is really what provides the benefits of testosterone and the patient’s overall vitality and health. See total testosterone as the money you have in the bank and free testosterone as the money you have in your pocket for immediate purchasing power. Which one do you think you need more on a daily basis? The one you have for purchasing whatever you want at the moment or the one sitting in the bank? Money in the bank is worthless if you can’t use it as needed.
IGF-1
This test measures Insulin-like growth factor 1 (IGF-1), also called somatomedin C. IGF-1 controls the reproduction and development of every cellular function in the human body, making it invaluable for our health as we age. It is known as the “fountain of youth” or “master” hormone. Low levels of IGF-1 cause symptoms like saggy skin, poor muscle tonality, decreased bone density, fatigue, poor memory, diminished quality of sleep, reduced exercise tolerance, increase in body fat, especially around the midsection, and poor wound healing.
Sex Hormone Binding Globulin (SHBG)
This test measures the amount of testosterone that your body’s tissues can utilize. SHBG binds tightly to two sex hormones found in men like dihydrotestosterone (DHT), and testosterone. A high SHBG level means that less free testosterone is available to the tissues than is indicated by the total testosterone test. A low SHBG means that more of the total testosterone is bioavailable and not bound to SHBG. The level of SHBG in your blood changes because of factors such as sex and age. It can also change because of obesity, liver disease, alcohol consumption, and hyperthyroidism.
Cortisol
One of the most important reasons for performing a cortisol test has to do with its effect on increasing SHBG, which we already mentioned above, how horrible it’s for your testosterone. Cortisol increases your body fat and decreases your ability to lose weight. Other problems associated with chronically elevated cortisol levels include reduced libido, suppressed immunity, hypertension, high blood sugar (hyperglycemia), insulin resistance, carbohydrate cravings, metabolic syndrome, type 2 diabetes, and fat deposits on the face, neck, and belly.
Dihydrotestosterone (DHT)
It is a sex hormone created from testosterone in the body and plays a major role in the development of body hair, muscle growth, fat loss, and a deep voice in men. DHT is critical to the development and health of the penis and prostate gland in men. When levels of testosterone are increased, more testosterone is converted to dihydrotestosterone, and DHT increases as a result of that.
DHEA Sulfate (stands for dehydroepiandrosterone)
This test is used to check how well your adrenal glands are working. DHEA is a hormone made by your adrenal glands and to a lesser degree by the testes. In men, DHEA serves as the steroidogenic metabolic intermediate in the formation of the sex hormones from progesterone to testosterone and estrogen. Optimizing DHEA facilitates the conversion of more free testosterone, lowers inflammation, improves libido, bone density, muscle mass, protects against depression, cognitive decline, and mood swings, and aids in weight loss.
Progesterone
This hormone has long been known as a “female hormone,” since it plays a significant role in ovulation, fertility, and pregnancy. But for men, progesterone helps to counteract the effects of estrogen in the male body which causes weight gain and gynecomastia, also known as “man boobs”. Not only is progesterone found in males, but men rely on the so-called “female hormone” to preserve masculinity. The fact is, progesterone is a precursor to testosterone “the male sex hormone” and is beneficial to your libido, sleep, hair follicle health, and fertility.
Estradiol
Estrogen in men plays a major role. As men age, testosterone levels decrease while estrogen levels increase. In the medical field, we call this “male andropause”. Testosterone treatment can cause aromatization which is a natural process by which the body converts testosterone into estrogen through the aromatize enzyme conversion inside your fat cells. Having too much estrogen can cause hair loss, nipple sensitivity, or gynecomastia. Now, this only happens when testosterone injections are prescribed with an old school protocol “once a week injections”, but when you are with a true testosterone expert physician we prevent this build-up from happening by dividing your testosterone injections into 2-3 shots per week. Therefore, you avoid any risk of experiencing any form of hair loss or gynecomastia. Now, having low estrogen is also not good because it will kill your libido, make you more susceptible to osteoporosis, causes brain fog, shunts fat burning, and reduce human growth hormone production. This happens when an untrained doctor prescribes an aromatize inhibitor like Arimidex along with your testosterone therapy, which is toxic for your system and should never be used. Arimidex is a breast cancer medication for women and is something uninformed doctors use as an easy fix to bad prescribing habits.
FSH & LH
FSH & LH stands for follicle-stimulating hormone & luteinizing hormone. These hormones measure the testosterone feedback between the brain and the testicles and enable the testes to accomplish two primary jobs, the natural production of sperm and testosterone. We examine this to check for primary or secondary hypogonadism which identifies if there is an over-or-under production of these natural hormones that produce testosterone and sperm count. FSH acts on the Sertoli cells in the testes to stimulate androgen binding protein. LH acts on the Leydig cells in the testes to stimulates the production of testosterone and when androgen binding protein and testosterone join together, sperm is produced. This is another important panel to check for along with your hormonal blood test, especially if you are considering testosterone treatment.
PSA
Conditions that could lead to an elevated PSA level in men are prostate cancer, benign prostate enlargement or also known as BPH, and a prostate infection or also known as prostatitis. This is a mandatory test to check for because if you have an elevated PSA serum, depending on the condition identified, can rule out if you are a good candidate for testosterone replacement therapy. Scary to think that some doctors don’t require this test panel on their blood work prior to prescribing testosterone replacement therapy.
WHAT A COMPLETE THYROID TEST LOOKS LIKE
Whether there are high, average, or low levels of thyroid hormone (hyperthyroidism, Hashimoto’s, euthyroid, hypothyroidism), most patients complain of hypothyroidism-like symptoms than any other type of thyroid problems. Hypothyroidism is commonly under-diagnosed and under-treated because conventional physicians believe that these patients are healthy as long as their hormone levels (specifically thyroid-stimulating hormone “TSH”) are just within the so-called “conventional” boundaries of laboratory reference ranges.
Our hormone or testosterone expert physicians think otherwise because they don’t want patient’s levels to just be “within the reference ranges”; they want their hormone levels to be optimal. It is merely impossible to make an accurate diagnosis or prognosis on a patient just obtaining TSH values. To have a solid overview of a patient’s thyroid function, the physician must test for thyroid-stimulating hormone “TSH”, Free T3, Free T4, thyroid peroxidase, and thyroid antibodies (optional reverse T3). They are all interrelated and provide a definitive look at what is actually going on with the patient current thyroid health status.
TSH
This test is performed to determine the underlying cause of abnormal thyroid hormone levels to screen for an under-active or over-active thyroid gland. By measuring the level of TSH in the blood, we can determine how well the thyroid is working.
Free T3
A free triiodothyronine (free T3) test is used to assess thyroid function. T3 is the active form of thyroid hormone in that it influences many body processes, in particular the regulation of your metabolism.
Free T4
A free thyroxine (free T4) test is used to help evaluate thyroid function and diagnose thyroid diseases, including hyperthyroidism and hypothyroidism, usually after discovering that the thyroid-stimulating hormone (TSH) level is abnormal and it also gives us a complete understanding of what is going on with your thyroid.
Thyroid Antibodies (TPO)
This test is for autoimmune thyroid disease; it can be detected in Graves disease or Hashimoto thyroiditis. In autoimmune disorders, your immune system makes antibodies that mistakenly attack normal tissue.
Thyroid Peroxidase AB
Thyroid peroxidase is a test that measures the level of an antibody that is directed against thyroid peroxidase (TPO). Autoantibodies to thyroid peroxidase (TPO) are produced within the body. The presence of TPO in the blood reflects a prior attack on the thyroid tissue by the body’s immune system, often caused by chronic stress.
WHAT VITAMINS & MINERALS NEED TO BE TESTED FOR TESTOSTERONE THERAPY
Most people underestimate the power of vitamins and minerals. What you need to understand about micronutrients is that they lubricate all the biochemical wheels of life. And without them, you would die! Nutrients can become biological response modifiers, as they change and adapt to how the body is currently working and feels. When you are deficient in them, the body slows down in every shape and form.
One of the unanticipated consequences of nutritional deficiencies is weight gain and disease susceptibility. To name a few examples, deficiencies of key nutrients like B vitamins and magnesium causes the following fatigue which impedes caloric expenditure, a low level of CoQ10 slows the mitochondrial activity, inadequacy of vitamin D is associated with obesity, insulin resistance worsens in the absence of sufficient Omega 3 fatty acids, magnesium, and chromium
This is just to name a few, but we hope you get the point by now. You can order a micronutrient deficiency test right to your home. Read more about it on our Micronutrient Deficiency Test page. Here are the vitamins and minerals we look for.
Vitamin B12
This vitamin test is essential to identify the normal formation of red blood cells and the health of your nerve tissues. B12 acts as a co-factor to produce energy and dopamine, (a neurotransmitter), plays a major role in reward-motivated behavior. In addition, it helps produce cellular energy, DNA/RNA, maintain healthy vision, and many other health benefits. Undetected and untreated, vitamin B12 deficiency can lead to permanent nerve and brain damage. Homocysteine levels tend to be elevated in vitamin B12 deficiency patients. Never supplement with cyanocobalamin B12 because too much of it can suffocate your brain. The most active co-active enzyme form of B12 is methylcobalamin and is the only form you should be taking.
Vitamin D, 25-Hydroxy
Vitamin D is a nutrient essential for maintaining healthy teeth, bones, and neuromuscular function as we age. Vitamin D has over 1,000 physiological responses in your biochemistry. Optimizing your Vitamin D3 assists in lowering SHBG, which then promotes more free testosterone (the beneficial testosterone). Low vitamin D levels have shown to cause suppressed immunity, increased risk of chronic diseases like heart disease, and several kinds of cancer. Vitamin D also regulates inflammation throughout the body, which is extremely important because 99% of diseases are inflammation-based in the first place. Vitamin D is essential to keeping the immune system in top shape and to help you combat the effects of the COVID 19 virus.
Magnesium
Magnesium is a co-factor in more than 800 enzymatic pathways that regulate diverse biochemical reactions in your body. This includes protein synthesis, muscle and nerve function, blood glucose control, blood pressure regulation. It’s required for energy production, muscle contraction, blood coagulation, and nutrient metabolism, especially when it comes to carbohydrate and bone cell formation. Having low magnesium levels and administering testosterone is a recipe for disaster because it may cause extreme levels of anxiety. To combust testosterone, you need to utilize magnesium and a low magnesium level is essential to identify prior to testosterone replacement therapy. If you have low levels of magnesium as long as you supplement in conjunction with testosterone therapy, the anxiety side effect can be completely avoided.
WHAT A COMPLETE PRE-DIABETIC OR DIABETES TEST LOOKS LIKE
HEMOGLOBIN A1C
This test provides information about a person’s average levels of blood glucose (sugar), over the past three months. For people without diabetes, the optimal range for hemoglobin A1c is between 4.5% and 5%. Hemoglobin A1c levels between 5.7% and 6.3% mean you are pre-diabetic. Concentrations of 6.4% and above, mean you have diabetes. However, with an experienced clinic like ours, being prediabetic for us is as good as saying you are sort of pregnant. You either are pregnant or not pregnant. Also, having a high hemoglobin A1c, means you are metabolically inflamed and oxidizing are a faster pace. So you have an idea, the average red blood cell in a healthy individual lasts roughly 120 days, in a diabetic patient 81 days. Meaning you are dying at a faster pace. The good news for you is that we have excellent protocols that can mitigate, and in most cases completely reverse pre-diabetes or diabetes for those who suffer from this disease.
INSULIN
Insulin testing has several important uses. It is the body’s primary source of energy, and it helps transport sugar (glucose) from the blood to the cells. The higher your insulin levels are, the more likely you are to be insulin resistant. If so, your body starts to age and deteriorate at a faster pace. Insulin resistance is the single most important phenomenon that leads to rapid premature aging and leads to diseases. This includes heart disease, stroke, dementia, and cancer. Insulin resistance and the resulting metabolic syndrome often comes accompanied by a number of symptoms. These symptoms include increased central obesity, feeling fatigued after meals, hunger cravings, mental irritation, high triglycerides, low HDL, high blood pressure, problems with blood clotting, and increased inflammation
Doctors rarely order this panel, and they usually don’t express concern until blood sugar (glucose) is over 100 or worse, over 120. This is diabetes and glucose is another test indicator our Miami low T clinic looks for and falls under the comprehensive metabolic panel.
OTHER DISEASE RISK FACTORS TO TEST FOR DURING A LOW T BLOOD TEST
HOMOCYSTEINE
High levels or abnormal accumulation of homocysteine are linked to the early development of heart disease, MTHFR, and age-related brain shrinkage. It’s also associated with low levels of vitamins B6, B12, and folate. The good news is that we can treat these abnormal levels with the proper treatment. Read more about the MTHFR gene on our MTHFR Testing page.
C-REACTIVE PROTEIN
Is a blood test marker for inflammation in the body. High CRP levels can indicate that there’s inflammation in the arteries of the heart, which can mean a higher risk for a heart attack. In addition, a high level of CRP can be caused by a wide variety of conditions, from infection to cancer.
FERRITIN
A ferritin test helps your doctor understand how much iron your body is storing. If your ferritin level is lower than normal, it’s an indicator of an iron deficiency. As a result, this causes anemia (a reduction in the number of red blood cells). If you have cancer, kidney failure, or another chronic condition, you may be at risk of anemia or chronic disease. These conditions can lead to a shortage of red blood cells. In addition, slow chronic blood loss from an ulcer or other sources within your body can deplete your body’s store of iron, leading to iron deficiency “anemia”. Now, high levels of ferritin can indicate an iron storage disorder, such as hemochromatosis. Furthermore, it can reveal a chronic disease process that is very rare to find in a patient’s blood work result.
TRADITIONAL PANELS TESTED IN OUR BLOOD WORK DURING A LOW T BLOOD TEST
Now, after everything you just read, If you really want to legitimately check your overall wellness status, do you think checking for CBC, CMP, and lipid panel alone is going to tell you a whole lot about your health? At this point, we can agree that would be ridiculous to consider. However, these following panels do provide some valuable but limited insight about a patient’s current health status, but not merely enough to make a full assessment of a patient’s complete wellness status. Being the best low T doctors in Miami we leave no stone unturned. Part of our blood work test includes these traditional blood panels as well.
COMPLETE METABOLIC PANEL
The complete metabolic panel measures 14 test panels that give our doctor valuable information about the current status of a person’s metabolism. This includes the health of the kidneys and liver, electrolyte and acid/base balance as well as blood glucose. Glucose is a type of sugar your body uses for energy and electrolytes to keep your body’s fluids in balance.
COMPLETE BLOOD COUNT WITH DIFFERENTIAL (CBC W/DIFF)
The CBC W/Diff test measures a number of things. It includes the levels of red blood cells, white blood cells, platelet levels, hemoglobin, hematocrit, and screening for anemia or detection of infections. This test is vital for patients administering testosterone replacement therapy because long-term use with testosterone causes hormone-induced secondary erythrocytosis which is an abnormal increase concentration in hemoglobin and hematocrit which causes your blood to thicken. Thick blood makes you more likely to develop blood clots, stroke, or suffer from a heart attack. However, depending on the patient’s blood work results, this could be easily avoided by donating blood 1 to 3 times per year.
LIPID PANEL
This test measures the amount of cholesterol and triglycerides in your blood. High cholesterol levels usually don’t cause any signs or symptoms; nevertheless, high cholesterol levels could obstruct blood flow through the arteries, increase cardiovascular disease, and stroke risks. Lipids include cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), and triglycerides. So, a lipid test is a valuable test to determine a partial part of the patient’s health.