One of the most common questions we get from new patients is some version of: "What tests do I actually need?" It's a fair question — hormone panels can look intimidating on paper, full of abbreviations that mean nothing until someone explains them. Here's what we actually run, and why each piece matters.
Why Testing Comes Before Treatment
Hormone therapy isn't something that should start from symptoms alone. Fatigue, weight gain, and mood changes can come from a dozen different causes, and treating the wrong one wastes time and can mask what's actually going on. A comprehensive panel tells us which hormones are actually off, by how much, and how they relate to each other — which is what makes the treatment plan specific to you instead of generic.
The Core Hormone Panel
What We Test
- Total and free testosterone — the primary marker for low testosterone in men, and also relevant for women's energy and libido
- Estradiol — the primary form of estrogen, key for women's cycle health, perimenopause, and bone health in both sexes
- Progesterone — important for women's cycle regulation, mood, and sleep quality
- DHEA-S — a precursor hormone that feeds into both testosterone and estrogen production, and a marker of adrenal function
- SHBG (sex hormone-binding globulin) — determines how much of your testosterone or estrogen is actually "free" and usable versus bound and inactive
- Cortisol — the primary stress hormone; chronically elevated or dysregulated cortisol disrupts nearly every other hormone system
- Full thyroid panel (TSH, Free T3, Free T4, and antibodies) — thyroid dysfunction mimics hormone imbalance closely and is frequently missed by a TSH-only test
- PSA (men) — a prostate health marker checked before and during testosterone therapy
- Fasting glucose and insulin, or A1C — screens for insulin resistance, which is closely tied to weight and energy symptoms
- CBC (complete blood count) — establishes a baseline and is monitored on testosterone therapy, since hematocrit can rise
- Lipid panel — a general cardiovascular health marker, relevant to overall treatment safety
Why "Just Check My Testosterone" Isn't Enough
It's tempting to want one number and one answer. But hormones work as a system, not in isolation. Low free testosterone with normal total testosterone points to a SHBG problem. Normal testosterone with high cortisol can produce the exact same fatigue and low libido symptoms as low testosterone itself. A single marker, on its own, can send you down the wrong path entirely.
This is also why a standard primary care visit — which often checks TSH alone, if it checks anything hormonal at all — misses so much. See 15 signs your hormones may be off for the symptom picture these labs are meant to explain.
"A number on a lab report doesn't mean anything by itself. It means something when I read it next to your symptoms, your history, and the rest of your panel. That's the actual work — not ordering the test, but interpreting it correctly."
When and How Testing Happens
For most patients, testing happens at or shortly after your first visit — a simple blood draw, done in-office. Some hormones (like testosterone) are best drawn in the morning, when levels are naturally highest, which we'll walk you through when scheduling. Results are typically back within a few days, at which point we schedule a follow-up to go over everything together and build your treatment plan.
Once treatment starts, follow-up labs every three to six months track how your levels are responding and let us fine-tune your dose — hormone therapy isn't a "set it and forget it" prescription.
What To Do Next
If you're ready to find out what your hormones are actually doing, the next step is simple: book a consultation and we'll order the right panel for your symptoms and history. Curious what the visit itself looks like? See what happens during your first hormone appointment.
Ready to Find Answers?
If you've been experiencing persistent fatigue, low energy, mood changes, weight gain, or other symptoms that may be related to hormone imbalance, schedule a consultation with Dr. Justin Abbott. We'll take the time to understand your symptoms, perform appropriate testing, and create a treatment plan tailored to your goals.
This article is for educational purposes only and does not constitute medical advice. Please consult a qualified physician before starting any new treatment. — Justin Abbott, D.O., Abbott Health & Wellness, 45 North State Street, Salina, UT 84654.