The eight-marker hormone panel most primary-care offices will run is not a hormone panel. It is a screen — and it misses most of the patterns that change clinical decisions. The complete panel adds 10–15 markers that turn a confusing reading into a coherent one. This piece is the checklist Dr. Chaudhari uses for new members at Wellness Elite Fitness, organized by what each marker tells you.
The complete panel — men
| Marker | What it tells you |
|---|---|
| Total testosterone (×2, AM, separate days) | Baseline gonadal output. Single readings have ±100–200 ng/dL noise. |
| Free testosterone | Bioavailable fraction. More clinically useful than total alone. |
| SHBG | Binds testosterone. Low SHBG often signals insulin resistance. |
| Estradiol (sensitive assay) | Aromatization product. Both too high and too low cause symptoms. |
| LH and FSH | Distinguish primary (testicular) from secondary (pituitary) hypogonadism. |
| Prolactin | Elevated levels warrant pituitary imaging before any hormone treatment. |
| DHT | Active androgen for prostate, hair, skin. Useful when symptoms diverge from testosterone. |
| DHEA-S | Adrenal output. Drops with age; often correctable. |
| TSH, free T3, free T4, anti-TPO | Complete thyroid. TSH-only screens miss subclinical disease. |
| Cortisol AM (8–9) | HPA axis baseline. Salivary 4-point if pattern is the question. |
| IGF-1 | Growth hormone proxy. Low IGF-1 in midlife is meaningful. |
| Fasting insulin + HbA1c | Insulin resistance modulates almost every hormone. Always run together. |
| Hematocrit, PSA (40+) | Baseline before any TRT conversation. |
For women, add
- Progesterone (cycle days 19–21 if cycling)
- AMH (ovarian reserve, useful for late-30s/40s women)
- Estradiol timing matters (cycle phase or post-menopausal)
- Iron studies (ferritin, iron, TIBC) — heavy cycles produce iron deficiency
- Thyroid antibodies (anti-TPO, anti-Tg) — autoimmune thyroid is more common in women
How to read patterns, not points
The single most common reading error is treating each number as independent. Useful patterns to know:
- Low SHBG + high-normal free testosterone — usually masking insulin resistance. Treat the metabolic side first.
- Low LH + low testosterone — secondary hypogonadism. Pituitary imaging if no obvious cause (sleep apnea, severe obesity).
- Normal TSH + low free T3 — subclinical hypothyroidism. Often missed by TSH-only screens.
- Low DHEA-S in 40s/50s — common, often correctable, sometimes meaningful for energy and recovery.
- High prolactin — order an MRI before any hormone treatment.
FAQ
What should be in a complete hormone panel?
For men: 2× total testosterone, free testosterone, SHBG, estradiol, LH, FSH, prolactin, DHT, DHEA-S, complete thyroid, cortisol AM, IGF-1, fasting insulin, HbA1c, ApoB, lipid panel, hematocrit, PSA (40+). Women add: progesterone (cycle days 19–21), AMH, anti-TPO.
How do you read a hormone panel?
Patterns over points. Low SHBG + high free T = often insulin resistance. Low LH + low T = secondary hypogonadism (pituitary). High prolactin = imaging warranted. Low free T3 with normal TSH = subclinical thyroid most PCPs miss.
Difference between total and free testosterone?
Total = everything in circulation. Free = bioavailable fraction (1–3% of total), more clinically useful. SHBG modulates: high SHBG lowers free without changing total; low SHBG raises free.
Where can I get a complete hormone panel?
At Wellness Elite Fitness in Friendswood, Texas, the full panel can be run through Elite Aesthetic MD — the independent practice located inside the facility — for members who opt into a physician intake. Self-pay options through Quest/Labcorp ($200–$500) for those who want lab access first. Book a private tour.
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