Protocol

What gets checked, and why

Every item below is included in the $395 first visit. It is published so you can read it before booking, and so you can compare it with whatever else you are considering. Each test links to what it measures, what moves it, and what an abnormal result triggers next.

Androgens

The hormones themselves, plus what carries them and what controls them.

6 tests
Total testosterone2 morning draws, before 10am, separate days
Free testosteronedrawn on everyone, method matters
SHBGbinding capacity
LH and FSHdistinguishes primary from secondary
Prolactinrules out a pituitary cause
Estradiol, sensitive assaysensitive assay, drawn on everyone

The causes nobody else checks

Conditions that produce the exact symptoms of low testosterone and are missed when only testosterone is drawn.

6 tests
TSH and free T4thyroid presents exactly like low testosterone
Ferritin, iron, TIBCiron deficiency produces the same fatigue
A1c and fasting glucosedrawn on everyone, often the first thing found
Lipidscardiometabolic baseline
CBC and CMPhaematocrit matters before and during therapy
Vitamin D, B12common, correctable, frequently missed

Screening and safety

What has to be known before therapy starts, and what has to be ruled out first.

3 tests
PSAage 40 and over, and before any therapy
Sleep screenapnoea both mimics and worsens low testosterone
Mood screenmale depression presents as low energy and low libido

Why two draws

Testosterone moves through the day and from day to day. A single low reading is not a diagnosis, and urology guidance is to confirm on two separate morning samples before treating. Roughly 30 percent of first low results come back normal on the repeat. Treating on one reading is how men end up on a protocol they never needed.

What happens if it is normal

You get told. Then we look at what the rest of the panel found, because low energy and low libido come from at least six places and testosterone is only one of them. That is usually the point at which something treatable turns up.


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