TRT Monitoring

PSA is currently the most widely used blood marker for early detection of prostate cancer. Prostate cancer is the most common cancer in men in the Netherlands, and early detection significantly improves treatment options. However, an elevated PSA does not automatically mean cancer. Benign prostatic hyperplasia (BPH), which is common in men over 50, is the most frequent cause of mildly elevated PSA. Prostate inflammation (prostatitis) can also raise the value considerably. Even temporary factors such as cycling, ejaculation shortly before the test, or a digital rectal exam can influence PSA. The value of PSA lies particularly in its trend over time. A gradually rising PSA across multiple measurements (PSA velocity) can be more clinically relevant than a single elevated value. If a result is notable, a doctor will usually recommend further investigation, such as an MRI or biopsy.

Monitoring prolactin is important because elevated levels may be associated with menstrual irregularities, infertility, or pituitary abnormalities. In men, high prolactin could suggest reduced testosterone production or pituitary concerns.

ALT is one of the most commonly used markers to detect liver stress or damage early. The liver has a large regenerative capacity and often only produces symptoms when damage is already advanced. ALT can be elevated before you notice anything. Non-alcoholic fatty liver disease (NAFLD) is the most common cause of chronically mildly elevated ALT in Western countries. An estimated 25% of adults have some degree of fatty liver, often without knowing it. ALT monitoring can reveal this early, allowing lifestyle adjustments to prevent further damage. With alcohol use, the ALT/AST ratio provides additional information. An AST/ALT ratio above 2 is consistent with alcohol-related liver damage, while in fatty liver disease, ALT is typically higher than AST. Medications such as paracetamol (at high doses), statins, and certain antibiotics can also elevate ALT.

Elevated triglycerides may contribute to atherosclerosis and are a component of metabolic syndrome. They are often elevated alongside insulin resistance. Consult your healthcare provider.

ALP is a useful screening marker for liver and bone conditions. Elevated levels may indicate bile duct obstruction, liver disease, or bone disorders. Consult your healthcare provider for interpretation.

AST levels provide important information about the health of your liver, heart, and muscles. Elevated levels may be associated with conditions such as hepatitis, cirrhosis, heart attack, or muscle injury. When evaluated alongside ALT, the AST:ALT ratio can help your healthcare provider identify the underlying cause of liver enzyme elevation. An AST:ALT ratio greater than 2:1, for instance, may suggest alcohol-related liver damage.

GGT is considered the most sensitive enzymatic indicator of bile duct problems. Elevated levels may suggest bile duct obstruction, liver inflammation, or chronic alcohol use, often before other liver enzymes become abnormal. Because GGT responds quickly to alcohol intake, it is frequently used to monitor alcohol-related liver damage. Tracking GGT over time can provide valuable insight into the effectiveness of lifestyle changes and treatment.

LDL cholesterol is the best-established modifiable risk factor for atherosclerotic cardiovascular disease. Every 1 mmol/L reduction in LDL reduces the risk of a cardiovascular event by approximately 20–25%. This effect is independent of how the reduction is achieved — through diet, exercise, or medication. In familial hypercholesterolaemia (FH) — a hereditary condition affecting approximately 1 in 250 people — LDL is elevated from a young age, significantly increasing the risk of early cardiovascular disease. Early detection and treatment are crucial.

SHBG levels may help explain symptoms related to hormone imbalances even when total hormone levels appear normal. Understanding SHBG can provide a more complete picture of hormonal health. Consult your healthcare provider to interpret results.

Estradiol influences bone health, mood regulation, and reproductive function. Imbalanced levels could suggest conditions affecting fertility, menstrual regularity, or overall hormonal health. Discussing your results with a healthcare provider may help identify underlying causes and appropriate next steps.

Free testosterone drives muscle development, energy levels, mood, and sexual function. Even when total testosterone appears normal, low free testosterone could suggest functional deficiency. Discussing your results with a healthcare provider may help identify whether further evaluation is warranted.

Testosterone plays a fundamental role in many bodily functions for both sexes. Imbalances could potentially affect energy, mood, body composition, and reproductive health. Your healthcare provider can help evaluate your levels in the context of your overall health.

HDL has an active protective function: it removes excess cholesterol from vessel walls and transports it to the liver. This process is called reverse cholesterol transport and counteracts atherosclerosis. Low HDL is an independent risk factor for cardiovascular disease, even when LDL is normal. Low HDL is often seen with metabolic risk factors: overweight, lack of exercise, smoking, insulin resistance, and type 2 diabetes. It is therefore a marker of overall metabolic health.

Albumin is important for maintaining blood volume, transporting substances, and reflecting overall health status. Low levels may indicate liver disease, kidney disease, or malnutrition. Consult your healthcare provider.

The CBC is a cornerstone of preventive healthcare and diagnostic medicine. It can help detect a wide range of conditions including anemia, infections, immune disorders, blood cancers, and clotting problems. Regular CBC testing supports early detection and ongoing health monitoring.