Question 1

What blood tests do you need before starting TRT?

Accepted Answer

Before starting TRT you need at least two morning total testosterone tests (drawn between 7-10 AM on separate days), plus free testosterone, LH and FSH, estradiol, a complete blood count for hematocrit, PSA (typically for men 40+), SHBG, and a metabolic panel. Both AUA and Endocrine Society guidelines require two low morning readings before a low testosterone diagnosis.

Question 2

Why does testosterone need to be tested in the morning?

Accepted Answer

Testosterone follows a daily rhythm and peaks between 7-10 AM, then declines through the day — by afternoon, levels can be 20-30% lower. Guidelines base the diagnostic cutoff (roughly 300 ng/dL) on morning values, so an afternoon draw can make normal levels look falsely low. Fasting is also recommended because meals, especially glucose, can temporarily lower testosterone.

Question 3

What is a normal total testosterone level for men?

Accepted Answer

Most labs consider roughly 300-1,000 ng/dL normal for adult men, with the AUA defining low testosterone as below 300 ng/dL on two separate morning tests. However, symptoms matter as much as numbers: a man at 320 ng/dL with clear symptoms may benefit from treatment, while an asymptomatic man at the same level may not need it.

Question 4

What do LH and FSH tell you about low testosterone?

Accepted Answer

LH and FSH show whether low testosterone originates in the testes or the brain. High LH with low testosterone means the testes aren't responding (primary hypogonadism). Low or normal LH with low testosterone points to a signaling problem from the pituitary or hypothalamus (secondary hypogonadism), which can sometimes be treated without TRT using medications like clomiphene.

Question 5

How often do you need blood work on TRT?

Accepted Answer

Standard TRT monitoring is blood work at baseline, again at 6-12 weeks after starting or changing a dose, then every 6-12 months once stable. Follow-up panels typically include total testosterone, hematocrit, estradiol, and PSA for men over 40. Hematocrit is the most important safety marker — if it rises above 54%, your provider should adjust your protocol.

Question 6

Do online TRT clinics include blood work?

Accepted Answer

Most online TRT clinics coordinate blood work through national lab chains like Quest or LabCorp — you get a lab order, walk in for a draw, and results go directly to the clinic's physicians. Some clinics include initial labs in their fee; others charge $100-300 extra. A few offer at-home fingerstick kits, though venous draws are more accurate for diagnosis.

Blood Work on Reclaim Your T - Online TRT Clinic Reviews

TRT Blood Work: Which Tests You Need and What They Mean (2026)