The panel most men never get
Before you let anyone
prescribe you testosterone
The military screens for one number. Most clinics run the same one. Here is the full panel — what to ask for, and what each marker actually tells you.
Tier 1
The five that matter most
If you get nothing else, get these.
- Total Testosterone
- The number everyone runs. On its own it tells you almost nothing — a "normal" total can hide a severe deficiency.
- Free Testosterone
- The fraction your body can actually use. This is the one that tracks how you feel. Ask for it every time.
- SHBGSex Hormone Binding Globulin
- The protein that locks testosterone up. High SHBG is why total looks fine while free is on the floor. Rises with age.
- LHLuteinizing Hormone
- The brain's signal to produce testosterone. Separates a signaling problem from a production problem — and they are treated differently.
- Estradiol (E2)Sensitive assay
- Testosterone converting to estrogen. Drives puffiness, mood swings and stubborn fat. Too low is as bad as too high.
Tier 2
Where the real answer usually lives
The markers that explain why Tier 1 looks the way it does.
- FSH
- Pairs with LH to confirm whether the signal or the testes are the issue.
- Prolactin
- A libido killer almost nobody checks. Elevated levels can flag a pituitary issue.
- DHEA-S
- Adrenal reserve — what carries you through a hard week without falling apart.
- Hematocrit
- Testosterone thickens blood. You need the "before" number, then monitoring.
- PSA
- Baseline before any therapy begins. Non-negotiable over 40.
The wider picture
The systems that drive testosterone
Hormones don't operate in isolation. Run these too.
Thyroid
TSH, Free T3, Free T4, Reverse T3, TPO antibodies
Adrenal
AM and PM cortisol
Metabolic
Fasting insulin, HbA1c, fasting glucose
Cardiovascular
ApoB, Lp(a), full lipid panel
Liver & inflammation
ALT, AST, GGT, hs-CRP, homocysteine
Nutrients
Vitamin D, B12, magnesium (RBC), ferritin, zinc
How to get it drawn
Ask your physician directly:
"I'd like a full male hormone panel including free testosterone, SHBG, LH, FSH, estradiol by sensitive assay, and prolactin — plus a full thyroid panel and fasting insulin."Timing matters. Draw between 7–10am, fasted, and off biotin supplements for 72 hours beforehand. If a result is borderline, confirm it on a second morning draw before anyone acts on it.
If you're told "you're in range" and you still feel wrong — ask which markers were actually run. Four labs is a screen. It is not an answer.
Elevate Chicago
Want these read properly?
Numbers only matter when someone connects them — hormones, thyroid, metabolism, inflammation and nervous system, together.
Book a consultation Prefer a text? Get updates by SMSEducational information only. Not medical advice, diagnosis or treatment, and not a substitute for care from your physician. Do not start, stop or change any therapy based on this document. Elevate Chicago.