TRT monitoring blood test for testosterone therapy
Monitoring panel for testosterone replacement therapy: hormones, liver, lipids, PSA, and blood count.
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Biomarkers Included
15 markersTRT monitoring is a blood test for men using testosterone replacement therapy (TRT). The panel brings together fifteen blood values, from your hormones to your hematocrit, liver, lipids and PSA.
This gives you a clear view of how your body responds to therapy. With that data, you and your doctor can make informed choices.
Why this test?
Testosterone plays an important role in your energy, recovery and performance. TRT stands for testosterone replacement therapy. Many men use it to support their energy and recovery, and not only to improve their performance.
During TRT, more changes than just your testosterone value. Your body can also respond with a higher hematocrit, a different estradiol level or a changed liver function. A TRT blood test brings these values together in one view.
This way you work with objective data instead of guesswork. That fits an approach where you want to understand your body.
Who is this test for?
Many active men look for a blood test built around their training data. This TRT panel can suit men who use testosterone therapy.
This blood test may be relevant for men who want to follow their therapy with objective numbers. It may suit:
- Men who have used TRT for a while and want to check their values
- Recreational athletes who keep an eye on their hormonal balance
- Men dealing with reduced libido or low energy
- Men who want to adjust their dosage together with their doctor
- Men who want to keep following their values periodically
What is tested?
This panel measures fifteen blood values that may change during TRT:
- Total Testosterone shows the total amount of testosterone in your blood.
- Free Testosterone shows the portion your body can use directly.
- SHBG binds testosterone and influences how much of it is available.
- Estradiol (E2) is a hormone that also plays a role in men.
- Prolactin can influence your libido and your hormonal balance.
- Complete Blood Count (CBC) measures your red blood cells and your hematocrit, among other values.
- HDL Cholesterol is often called the favourable cholesterol.
- LDL Cholesterol may, at high levels, be associated with cardiovascular disease.
- Triglycerides are fats in your blood that say something about your fat metabolism.
- ALT is a liver enzyme that can say something about your liver function.
- AST is a liver enzyme that is reviewed alongside ALT.
- GGT is a liver value that reacts sensitively to strain on the liver.
- ALP is an enzyme connected, among other things, to the liver.
- Albumin is a protein produced by your liver.
- PSA is a prostate value that men often include during TRT.
What can this test tell you?
The results can show you how your values compare to the reference ranges. With this panel you can measure your hematocrit and follow how it develops over time.
A high hematocrit may indicate that your blood is becoming thicker, while a low hematocrit may raise other questions. Your hematocrit reflects the amount of red blood cells in your blood.
Your estradiol, liver values and lipids also gain context this way. This can help bring a possible hormonal imbalance into view early.
How is the sample collected?
For this blood test, a staff member draws a small tube of blood at a certified location. You can choose from more than 750 collection sites in the Netherlands, so there is almost always a location near you.
You need little for this, apart from your appointment confirmation and a valid ID. The draw itself usually takes only a few minutes.
When is this test useful?
TRT monitoring can be useful at different moments. Many men choose to test:
- When they have just started testosterone therapy and want to see how their body responds
- When they have adjusted their dosage and want to follow the effect
- When their blood values were elevated before and they want to keep following their hematocrit
- When they experience symptoms such as low energy or reduced libido
- When they simply want to keep an eye on their values periodically
What do the results mean?
What the results mean depends on your personal situation. Each value is compared to a reference range, but a value outside that range does not automatically mean something is wrong.
With TRT, a doctor often looks at the whole picture: your testosterone, estradiol and hematocrit together. An estradiol blood test for men helps, for example, to see whether your testosterone is converting too much into estradiol.
Always discuss any deviating values with your GP, so you know what the results may mean for you personally. A value only gains real meaning in combination with your symptoms and history.
Preparation
For most hormone values, it is advisable to have your blood drawn in the morning, when testosterone is often highest. For your lipids, fasting before the draw can be helpful.
Drink enough water on the day of the draw, as dehydration can temporarily affect your hematocrit. If you inject testosterone on a fixed schedule, discuss with your doctor when it is best to test.
What happens after the results?
You receive your results digitally in your account, usually within a few working days. For each value, you can see whether it falls within the reference range. You can then share your results with your own GP or treating physician.
Every blood test result includes a professional assessment from a BIG-registered doctor. For treatment decisions, discuss your results with your GP.
Frequently Asked Questions
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Choose your markers
Pick a performance panel or build your own test. Testosterone, CRP, ferritin, thyroid. You choose what gets measured.
Receive your lab referral
Within 2-3 hours you'll receive an email from ZorgDomein with a barcode. Orders outside business hours are processed the next business day.
Get tested at a lab near you
Show the barcode on your phone and bring a valid ID. Done in under 15 minutes.
Receive your report from the doctor
A BIG-registered physician assesses your results and writes a personal report. On your dashboard within a few business days.
Choose your markers
Pick a performance panel or build your own test. Testosterone, CRP, ferritin, thyroid. You choose what gets measured.
Receive your lab referral
Within 2-3 hours you'll receive an email from ZorgDomein with a barcode. Orders outside business hours are processed the next business day.
Get tested at a lab near you
Show the barcode on your phone and bring a valid ID. Done in under 15 minutes.
Receive your report from the doctor
A BIG-registered physician assesses your results and writes a personal report. On your dashboard within a few business days.
Always a location near you
With more than 450+ certified phlebotomy points across the Netherlands.
What's Included
This panel covers 15 biomarkers related to your training, recovery, and overall health.
PSA, or prostate-specific antigen, is a protein produced exclusively by the prostate gland. A small amount of PSA always leaks into the bloodstream, and its concentration can be measured through a blood test. An elevated PSA level can point to prostate cancer, but often has a harmless cause: an enlarged prostate, inflammation, or even cycling shortly before the blood draw. PSA is therefore a sensitive marker, but not a diagnosis in itself — the result always requires interpretation in the right context.
Learn moreA prolactin blood test measures the level of prolactin, a pituitary hormone primarily known for its role in lactation. Prolactin also influences reproductive function, immune regulation, and metabolic processes in both men and women.
Learn moreALT, also known as ALAT or GPT, is an enzyme found primarily in the liver. When liver cells become damaged, ALT is released into the bloodstream. An elevated ALT level is therefore one of the earliest signals of liver stress or damage. It can indicate fatty liver disease, hepatitis, medication that burdens the liver, or excessive alcohol use — but also something temporary such as intense physical exercise.
Learn moreTriglycerides are the most common type of fat in your body and your main way of storing energy. A raised level may be linked to a higher risk of heart and vascular disease, especially when it occurs alongside other lipid abnormalities. These fats come from the food you eat as well as from energy your body has not used yet. Your value is usually measured after fasting so it reflects your baseline rather than a recent meal.
Learn moreAlkaline Phosphatase (ALP) is an enzyme found in the liver, bones, kidneys, and digestive system. ALP levels can help evaluate liver health, bone disorders, and bile duct function.
Learn moreAST (aspartate aminotransferase) is an enzyme found in the liver, heart, and muscle cells. Elevated levels may indicate liver damage, but because AST is present in multiple tissues, results are best interpreted alongside other liver markers such as ALT.
Learn moreGGT stands for gamma-glutamyltransferase. Gamma-glutamyltransferase (GGT) is a liver and bile duct enzyme considered one of the sensitive markers for liver and bile duct conditions. It responds strongly to alcohol use and may be raised in bile duct obstruction, liver disease or with certain medications.
Learn moreLDL cholesterol, often referred to as "bad" cholesterol, is the fraction that can deposit in the walls of your blood vessels. Over time, this leads to atherosclerosis and increases the risk of heart attack or stroke. The desirable LDL level depends on your total cardiovascular risk profile — stricter targets apply for people with diabetes or a history of heart disease than for healthy individuals.
Learn moreSex hormone-binding globulin (SHBG) is a protein produced by the liver that binds to sex hormones, including testosterone and estrogen. It helps regulate the amount of free, active hormones available in the body.
Learn moreEstradiol (E2) is the most potent form of estrogen, playing a key role in reproductive health, bone density, and cardiovascular function. Abnormal levels may indicate hormonal imbalances that your healthcare provider can help evaluate.
Learn moreFree testosterone is the unbound, bioavailable form of testosterone that can directly enter cells and activate receptors. It may indicate your body's functional androgen activity. Your healthcare provider can help interpret what your levels mean.
Learn moreTotal testosterone measures the combined amount of bound and free testosterone in the blood. As the primary androgen, testosterone may influence muscle mass, bone density, libido, mood, and energy levels in both men and women.
Learn moreHDL cholesterol is called "good" cholesterol because it transports cholesterol from blood vessel walls back to the liver, where it is broken down. Higher HDL therefore has a protective effect against atherosclerosis and cardiovascular disease. Unlike LDL, where a lower value is better, with HDL you want a higher value.
Learn moreAlbumin is the most abundant protein in the blood, produced by the liver. It maintains fluid balance, transports hormones and nutrients, and serves as an indicator of liver and kidney function.
Learn moreA complete blood count (CBC) is a comprehensive blood test that evaluates the major components of your blood: red blood cells, white blood cells, and platelets. It is one of the most commonly ordered blood tests and provides a broad overview of your overall health.
Learn morePSA (Prostate-Specific Antigen)
Tumor MarkersPSA, or prostate-specific antigen, is a protein produced exclusively by the prostate gland. A small amount of PSA always leaks into the bloodstream, and its concentration can be measured through a blood test. An elevated PSA level can point to prostate cancer, but often has a harmless cause: an enlarged prostate, inflammation, or even cycling shortly before the blood draw. PSA is therefore a sensitive marker, but not a diagnosis in itself — the result always requires interpretation in the right context.
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.
Prolactin
HormonesA prolactin blood test measures the level of prolactin, a pituitary hormone primarily known for its role in lactation. Prolactin also influences reproductive function, immune regulation, and metabolic processes in both men and women.
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 (Alanine Aminotransferase)
LiverALT, also known as ALAT or GPT, is an enzyme found primarily in the liver. When liver cells become damaged, ALT is released into the bloodstream. An elevated ALT level is therefore one of the earliest signals of liver stress or damage. It can indicate fatty liver disease, hepatitis, medication that burdens the liver, or excessive alcohol use — but also something temporary such as intense physical exercise.
A high ALT value can have different causes, from viral hepatitis (such as hepatitis B) to fatty liver. Doctors often look at AST and ALT together, and sometimes at gamma-GT, to get a broader view. A slightly raised value usually means something different from a strongly raised value. An abnormal value on its own does not confirm a diagnosis. Your GP can help you decide whether further steps are needed. If your ALT value is too high, this can have different causes and does not automatically mean something serious is going on. Your GP can help you decide whether further steps are needed.
Triglycerides
CardiovascularTriglycerides are the most common type of fat in your body and your main way of storing energy. A raised level may be linked to a higher risk of heart and vascular disease, especially when it occurs alongside other lipid abnormalities. These fats come from the food you eat as well as from energy your body has not used yet. Your value is usually measured after fasting so it reflects your baseline rather than a recent meal.
A raised triglyceride level may contribute to atherosclerosis and is one part of metabolic syndrome. These fats are often elevated together with insulin resistance, so your GP looks at the wider picture rather than this single value. A raised level may increase the risk of heart and vascular disease, especially alongside an unfavourable total cholesterol. For that reason it is often interpreted together with your <a href="/en/biomarkers/total-cholesterol">total cholesterol</a>, your <a href="/en/biomarkers/hdl-cholesterol">HDL cholesterol</a>, and your <a href="/en/biomarkers/ldl-cholesterol">LDL cholesterol</a>. Together these values give a fuller view of your heart health. The type of fat matters too: saturated fat can affect your values unfavourably, while unsaturated fat from sources such as oily fish may be more favourable. Some medications, such as certain diuretics or beta blockers, can also play a role. Discuss with your GP what your values mean in your situation.
ALP (Alkaline Phosphatase)
LiverAlkaline Phosphatase (ALP) is an enzyme found in the liver, bones, kidneys, and digestive system. ALP levels can help evaluate liver health, bone disorders, and bile duct function.
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 (Aspartate Aminotransferase)
LiverAST (aspartate aminotransferase) is an enzyme found in the liver, heart, and muscle cells. Elevated levels may indicate liver damage, but because AST is present in multiple tissues, results are best interpreted alongside other liver markers such as ALT.
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 (Gamma-Glutamyl Transferase)
LiverGGT stands for gamma-glutamyltransferase. Gamma-glutamyltransferase (GGT) is a liver and bile duct enzyme considered one of the sensitive markers for liver and bile duct conditions. It responds strongly to alcohol use and may be raised in bile duct obstruction, liver disease or with certain medications.
GGT can be a sensitive indicator for bile duct issues. A raised gamma-GT may point to bile duct obstruction, liver inflammation or long-term alcohol use, sometimes before other liver enzymes change. What a raised value means in your situation is something your GP can help assess. GGT is often viewed alongside other liver values, such as <a href="/en/biomarkers/alt">ALT</a>, <a href="/en/biomarkers/ast">AST</a>, <a href="/en/biomarkers/alp">alkaline phosphatase</a> and <a href="/en/biomarkers/bilirubin-total">bilirubin</a>. Together these values may help your healthcare provider identify the source of a liver or bile duct change.
LDL Cholesterol
CardiovascularLDL cholesterol, often referred to as "bad" cholesterol, is the fraction that can deposit in the walls of your blood vessels. Over time, this leads to atherosclerosis and increases the risk of heart attack or stroke. The desirable LDL level depends on your total cardiovascular risk profile — stricter targets apply for people with diabetes or a history of heart disease than for healthy individuals.
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 (Sex Hormone Binding Globulin)
HormonesSex hormone-binding globulin (SHBG) is a protein produced by the liver that binds to sex hormones, including testosterone and estrogen. It helps regulate the amount of free, active hormones available in the body.
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 (E2)
HormonesEstradiol (E2) is the most potent form of estrogen, playing a key role in reproductive health, bone density, and cardiovascular function. Abnormal levels may indicate hormonal imbalances that your healthcare provider can help evaluate.
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
HormonesFree testosterone is the unbound, bioavailable form of testosterone that can directly enter cells and activate receptors. It may indicate your body's functional androgen activity. Your healthcare provider can help interpret what your levels mean.
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.
Total Testosterone
HormonesTotal testosterone measures the combined amount of bound and free testosterone in the blood. As the primary androgen, testosterone may influence muscle mass, bone density, libido, mood, and energy levels in both men and women.
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 Cholesterol
CardiovascularHDL cholesterol is called "good" cholesterol because it transports cholesterol from blood vessel walls back to the liver, where it is broken down. Higher HDL therefore has a protective effect against atherosclerosis and cardiovascular disease. Unlike LDL, where a lower value is better, with HDL you want a higher value.
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
LiverAlbumin is the most abundant protein in the blood, produced by the liver. It maintains fluid balance, transports hormones and nutrients, and serves as an indicator of liver and kidney function.
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.
Complete Blood Count (CBC)
HematologyA complete blood count (CBC) is a comprehensive blood test that evaluates the major components of your blood: red blood cells, white blood cells, and platelets. It is one of the most commonly ordered blood tests and provides a broad overview of your overall health.
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.
More Test Panels
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360 Health
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Lipids
Essential lipid panel: LDL, HDL, and Triglycerides.
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