HRT 4 ALL / Blood Tests

The guide for practicing safe DIY Hormonal Treatment
Made by teens for teens

Contents

How Blood Tests Work
Why we Test
Where to Buy Blood Tests
Locations
Blood Test Dictionary
Blood Test Ranges

Buying Blood Tests as an FTM
When to Get Tested
What to Test
Buying Blood Tests as an MTF
When to Get Tested
What to Test

How Blood Tests Work

A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a hypodermic needle. These can be used to measure various things in the body like cholesterol, vitamin concentrations, electrolytes, hormone levels and more. Note the hormone levels part, which is the primary reason why we do blood tests. To make sure our estrogen and testosterone levels are in satisfactory zones as well for checking organ function too.

Note: Blood Tests are not required to practice DIY HRT. This article is simply here to offer guidance to those whom have extra money and aren't bothered spending it on testing their levels.

Where to Buy Blood Tests

When it comes to purchasing private blood tests, you usually go through an online lab. Whom will then create a lab order for you to fulfill at the clinic you requested to enroll. This is all done remotely and without a doctor, which is why it's called private. These labs do not require insurance and follow HIPAA privacy rules.

Note: All the listed labs below allow minors and teenagers to use their services.


Locations

Private MD Labs | USA ONLY
Randox Health | UK ONLY

Before you buy blood tests you should be educated on what each blood test means and what they're necessarily testing for. I made a brief "dictionary" for information on each blood test including intended applications and purposes.

Note: Many of these tests are included in packs of other tests. For example, if you wanted to test your Testosterone, Estradiol and U&E, don't buy these tests individually. Instead purchase the [Private MD Labs] Women's Hormone Light Test because it includes all these tests and more at a cheaper cost. Yes, both FTMs and MTFs can use the "Women's" Hormone Light.


Testosterone
Testosterone is the male sex hormone responsible for the occurrence of male puberty and masculinization. You can use this test to see how much testosterone you have and if you've gotten it to acceptable levels for your personal goals.

[Private MD Labs] Test your Testosterone with Women's Hormone Light Test


Estradiol (E2)
Estradiol is the female sex hormone, it's the most potent form of estrogen which is why we specifically focus on it. Estrogens are responsible for the occurrence of female puberty and feminization. You can use this test to see how much Estradiol (E2) you have and if you've gotten it to acceptable levels for your personal goals.

[Private MD Labs] Test your Estrogen with Women's Hormone Light Test


Prolactin (PRL)
Prolactin is the hormone responsible for breast milk production, known as lactation. Prolactin is mostly noted in females, of course due to them having breasts. Though all humans produce prolactin as it serves other functions rather than lactation. Taking too much estrogen may cause prolactin to increase to the point of lactation, though this is very rare. I recommend only taking this test if you somehow start producing milk. High prolactin levels generally do not need treatment.

[Private MD Labs] Test your Prolactin with a Prolactin Test


AST/ALT Ratio
AST/ALT Ratio is the ratio comparison of two liver enzymes, AST and ALT. If one enzyme or both are abnormally small/big in comparison then it could imply liver damage. It serves an important function in determining the health of the liver. The liver concerns us since it's responsible for the digestion and breakdown of consumed items. If you were to take pills orally, like estrogen or anti-androgen pills then I would recommend this blood test to analyze liver function.

[Private MD Labs] Test your AST/ALT with Women's Hormone Light Test


Hemoglobin A1C (HbA1C)
Hemoglobin A1C is a blood test that measures the glucose attached to our red blood cells, known as blood sugar levels. Since the average life of a red blood cell is 3 months, you're measuring the blood sugar levels over the past few months. This blood test helps diagnose diabetes and other hormonal diseases. If you have a family history of diabetes, then I would recommend this blood test to analyze your blood sugar levels as a potential diabetic risk factor.

[Private MD Labs] Test your HbA1C with a HbA1C Test


Cholesterol (Lipids)
Cholesterol is a fatty substance carried in our blood that builds and maintains certain cells like vitamin D, hormones, cortisol, etc etc. Which is why it's something relevant for us to test. Testosterone may negatively influence the cholesterol in our bodies, which could lead to heightened risk of Cardiovascular Disease. This is primarily something trans men should test because of that.

[Private MD Labs] Test your Cholesterol with a Lipids Panel


Complete Blood Count (CBC)
Complete Blood Count (CBC) is a blood test, like in it's name that measures the total number of blood cells in your body. Measuring white blood cells, red blood cells and platelets. It measures other things related to the blood too, like how big each blood cell is or how much oxygen it's carrying. This blood test is most important for trans men taking testosterone. Testosterone causes the body to produce more red blood cells, which is why high testosterone levels is association with high blood pressure and Polycythemia. I recommend this blood test if there is history of cardiovascular disease or hypertension.

[Private MD Labs] Test your CBC with Women's Hormone Light Test


Urea and Electrolytes (U&E)
Urea and Electrolytes (U&E) is a blood test that measures the amount of urea and electrolytes present in the blood. This is an important test in evaluating kidney function. This test should only be done when you're taking an anti-androgen, particularly Spirolactone and Bicalutamide.

Spirolactone, showcases anti-Mineralocorticoid activity which could cause stomach cramps, dehydration or chest pain. This is because it can lead to Hyperkalemia through how it reduces Potassium excretion and abnormal regulation of the electrolytes. Bicalutamide, can also cause kidney damage which is why U&Es are done. I'm not familiar with the mechanisms behind this but it's an adverse effect that's possible.

[Private MD Labs] Test your U&E with Women's Hormone Light Test


I will be providing pediatric blood test ranges below. I took reference primarily from two pediatric reference value sheets.

Note: If you are not aware about what the tanner stages are, I recommend reading more below.
Tanner Stages for Biological Females
Tanner Stages for Biological Males


If a table is made for females, emphasized in pink, then trans women should follow that table.

If a table is made for males, emphasized in blue, then trans men should follow that table instead.

I will also include some unisex tables that applies to everyone regardless of gender, emphasized in green.


Testosterone

Tanner Stage [MALE] Range (ng/dL) Mean (ng/dL)
1 You Have Not Started Puberty You Have Not Started Puberty
2 18 - 150 42
3 100 - 320 190
4 200 - 620 372
5 350 - 970 546
Tanner Stage [FEMALE] Range (ng/dL) Mean (ng/dL)
1 You Have Not Started Puberty You Have Not Started Puberty
2 7 - 28 18
3 15 - 35 25
4 13 - 32 22
5 20 - 38 25

Estradiol (E2)

Tanner Stage [MALE] Range (pg/mL) Mean (pg/mL)
1 You Have Not Started Puberty You Have Not Started Puberty
2 5 - 16 11
3 5 - 25 16
4 10 - 36 22
5 10 - 36 21
Tanner Stage [FEMALE] Range (pg/mL) Mean (pg/mL)
1 You Have Not Started Puberty You Have Not Started Puberty
2 10 - 24 16
3 7 - 60 25
4 21 - 85 47
5 34 - 170 110

Prolactin (PRL)

Age [MALE] Range (ng/mL) Mean (ng/mL)
All Ages 3 - 18 10.5
Age [FEMALE] Range (ng/mL) Mean (ng/mL)
All Ages 3 - 24 13.5

AST/ALT Ratio

Age [MALE] AST Range (U/L) ALT Range (U/L)
1-13 Years Old 8 - 60 7 - 55
Over 14 Years Old 8 - 48 7 - 55
Age [FEMALE] AST Range (U/L) ALT Range (U/L)
1-13 Years Old 8 - 50 7 - 55
Over 14 Years Old 8 - 43 7 - 55

Hemoglobin A1C

Percentage (%) Diabetes Risk
< 5.7% Decreased Risk for Diabetes
5.7 - 6.4% Increased Risk for Diabetes
> 6.4% Ongoing High Blood Sugar

Cholesterol (Lipids)

I've decided to not make a table and instead redirect you to the full list on Mayo Clinic's Catalog.
The contents are too long for me to fit into a table.

Complete Blood Count

I've decided to not make a table and instead redirect you to the full list on Mayo Clinic's Catalog.
The contents are too long for me to fit into a table.

Urea and Electrolytes (U&E)

I've decided to not make a table and instead redirect you to the full list on Mayo Clinic's Catalog.
The contents are too long for me to fit into a table.



The earliest you can start doing blood tests is after one month of starting HRT. This is because testosterone takes some time to reach a steady state, where your levels are stable. You should always do blood tests the day before you usually inject, to get trough levels. If you can, after you've done your first blood tests do them every 6 months.


I have made a list of blood tests you should do, ordered in three tiers of significance.

Most Important

  • Testosterone
  • Estradiol (E2)

Important

  • Cholesterol (Lipids)
  • Complete Blood Count (CBC)
  • Hemoglobin A1C (HbA1C) [Yes, Family History of Diabetes]

Least Important

  • Hemoglobin A1C (HbA1C) [No Family History of Diabetes]

For injection users,
the earliest you can start doing blood tests is after one month of starting HRT. This is because estrogen takes some time to reach a steady state, where your levels are stable. You should always do blood tests the day before you usually inject, to get trough levels. If you can, after you've done your first blood tests do them every 6 months.

For pill users,
The earliest you can start doing blood tests is after one week of starting HRT. You should always do blood tests about 4 hours before you'll next take your pills, to get trough levels. If you can, after you've done your first blood tests do them every 6 months.


I have made a list of blood tests you should do, ordered in four tiers of significance.

Most Important

  • Testosterone
  • Estradiol (E2)
  • Prolactin (PRL) [Yes, Present Lactation]

Important

  • AST/ALT Ratio [Yes, Taking Any Pills]
  • Urea and Electrolytes (U&E) [Yes, Taking Anti-Androgens]
  • Hemoglobin A1C (HbA1C) [Yes, Family History of Diabetes]

Least Important

  • Prolactin (PRL) [No Lactation]
  • Hemoglobin A1C (HbA1C) [No Family History of Diabetes]

Not Important

  • AST/ALT Ratio [Not Taking Any Pills]
  • Urea and Electrolytes (U&E) [Not Taking Anti-Androgens]

See Also

FTM Guide on HRT
MTF Guide on HRT
Puberty Blockers Guide

General Frequently Asked Questions

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