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24th February 2020

I do not suggest hormone replacement for anybody who isn't going to go into a doctor's office for regular blood work and checkups. When you simply "self-supplement" for an indefinite length of time, you are playing with fire without knowing how your blood work looks on a regular basis. Blood work is most commonly required once every 12 weeks, and your doctor will make you come in to have it done in order to renew the prescription and continue on with testosterone injections. The insurance company may also require it, but just know that most insurance companies will only cover labs that are performed 12 weeks apart from each other. So the dilemma can often lay in a small gap of 2 weeks between your last shot and when you're eligible for another blood draw.

Allow me to explain more here: I get 200mg/wk of testosterone for 10 weeks, but I cannot do my blood work until week 12, therefore I have a 2 week lapse. So with my regimen, usually by about week 8-9 I am lowering my testosterone dosages so I can hit another shot between the end of week 10 and week 11. This isn't a bad thing, because the last thing you need is to go in for your blood draw with higher levels than average. When your blood is drawn and your test level is 600, then you're fine, but if it's 1200-1300ng/dl, then it may throw up a flag to insurance providers, or even the doctor. With that being said, we want to ride on the higher side of hormone replacement, so I strongly suggest making your last shot about 1 week before the lab work or even cutting the shot to 100mg rather than 200mg.


Now, understand that I'm certainly no doctor here, but this is what I normally check for in my blood work. Cholesterol levels are going to be a big one to look out for, and over time testosterone replacement can increase bad cholesterol and decrease good cholesterol. Your (LDL) is going to be your bad cholesterol and your (HDL) is your good cholesterol. I always come in a bit lower on my good cholesterol and on the high end of average on my bad cholesterol.

But the biggest factor to look for is a total number which is basically a ratio for future "risk of cardiovascular event" (AKA a heart attack). The ratio number on the chart for this corresponds to a list of odds for "risk of cardiovascular event" and the odds are normally listed as "½ average risk, average risk, 1.5 times higher than average risk, 2 times higher than average risk, and 3 times higher than average risk." So keep an eye out on your cholesterol levels during hormone replacement. The first few years on testosterone you may be fine, but things may start creeping up on you down the road. Your blood work chart will have a reference range next to your number and if anything is too high or low it will usually be highlighted.


The next thing on my blood work that I look for is my hematocrit levels. Hematocrit is the measure of the percentage of red blood cells in your body. It does become easier to have elevated hematocrit levels while on testosterone replacement therapy. When hematocrit becomes too high, you are at a possible increased risk for a stroke. Dehydration can also elevate hematocrit levels so make sure you're drinking plenty of water on hormone replacement, which you should be doing anyway. An elevation in red blood cells can enhance performance to a major degree, which is the primary reason why endurance athletes do blood doping (withdrawing blood for several weeks leading up to an event, and then pumping it back into the body before the event). But prolonged elevation/too high of elevation can be very dangerous and should be avoided. It's best to keep your hematocrit and red blood cell count in normal range. Honestly I float at the upper end of normal range, but if I hydrate myself enough I can drop down into average range.


The liver is one of the most important organs in the entire body. It's responsible for hundreds of chemical reactions in the body and used to detoxify the blood. Without a healthy liver, you're no good. The liver also plays a major part in protein synthesis, the production of bile to break down foods, breaking down insulin as well as glucose production, and clotting factors. The liver stores chemicals and other vitamins that are used by the body on a daily basis, and stores iron that is used for the production of new red blood cells.

Liver values are expressed on a lab chart as 2 main values called "AST" and "ALT". To simplify what these values mean, they're basically measures of liver damage or possibly tissue damage from other places in the body such as your heart or kidneys (since elevated liver values can also indicate damage in other organs in the body).

One thing to note here is if you work out on a regular basis these levels can simply be elevated due to muscle damage. My liver values are always a little high and they've stayed around the same markers for a number of years now. Each value is usually about 20 points higher than normal. This doesn't mean that my liver is unhealthy and not functioning properly. There is a lot of mixed information on what unhealthy liver values are, despite a common reference range on lab charts. When there is damage to the liver or signs of organ damage somewhere else, these numbers may be elevated by a lot, or elevated by just a little. Just know that if you lift weights a lot, it will almost always cause these two numbers to be at the top end of normal range or slightly above normal range. In some individuals these numbers can even double the top end of the normal range just from lifting weights!! Nonetheless, it's a good idea to keep close watch on them.


Triglycerides are the measure of fat content in your blood. You need some triglycerides to be healthy, but too many triglycerides can lead to heart disease and metabolic syndrome. The biggest factors that contribute to high triglycerides with most people are being overweight and consuming alcohol. Other contributing factors include poorly controlled diabetes, an underactive thyroid, and kidney disease. Triglycerides usually aren't as big of an issue with people who eat healthy and exercise, but it's always a good idea to keep an eye on them.

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