What lab test should i ask for?

[CaesarWilliam]

I am down in Latin America. I have never had labs done before. I have located a Blood lab in a town near hear. I want to go get my levels checked. My question is, what test do I have them run? Do I ask for a Hormone test (Testosterone, Estrogen Ect?) Or is there a specific named test? Down here you don't need a doctor for test referals and health care is cheap and very good. I just don't know what to ask for.

[marianco]

Originally Posted by CaesarWilliam

I am down in Latin America. I have never had labs done before. I have located a Blood lab in a town near hear. I want to go get my levels checked. My question is, what test do I have them run? Do I ask for a Hormone test (Testosterone, Estrogen Ect?) Or is there a specific named test? Down here you don't need a doctor for test referals and health care is cheap and very good. I just don't know what to ask for.

Look up sticy called TRT: A Recipe for Success for SWALE/Dr. Crisler's protocol including the initial labs.

The labs need to be customized to the individual. A comprehensive set of labs for my patiens would cost close to $5,000 or more. Not everyone can afford this, even with insurance, nor may it be necessary or practical in order to address the most important problems, so I customize the lab tests for the person.

A fairly comprehensive general initial lab work-up using standard blood and urine tests may include:

REPRODUCTIVE:
Free and Total Testosterone Panel (this includes Total Testosterone, Free Testosterone, Bioavailable Testosterone, and Sex Hormone Binding Globulin), Estradiol, Progesterone, Luteinizing Hormone, Follicle Stimulating Hormone, Prolactin, Prostate Specific Antigen (in men)

THYROID:
Free T4 (Free Thyroxine), Free T3 (Free Liothyronine), Thyroid Stimulating Hormone, antithyroglobulin antibody, antithyroid peroxidase antibody, thyroid stimulating immunoglobulin.

ADRENAL:
Cortisol AM, Cortisol PM, Cortisol-Binding Globulin, Adrenocorticotropic Hormone (ACTH), Dehydroepiandrosterone Sulfate (DHEA-s),

CARBOHYDRATE METABOLISM:
fasting glucose (included in comprehensive metabolic panel when fasting), Hemoglobin A1c, fasting insulin, 3-Hour Glucose Tolerance Test (samples of blood for measuring glucose and insulin are taken at 0, 60, 120, and 180 minutes after ingesting a 1.75 g/kg glucose solution).

GROWTH HORMONE:
IGF-1 (Insulin-like growth factor I / Somatomedin-C), Growth Hormone Stimulation Test using GHRH (growth hormone releasing hormone) plus Arginine (samples of blood for measuring growth hormone are taken at 0, 30, 60, 90, and 120 minutes).

GENERAL:
Comprehensive Metabolic Panel (glucose, urea nitrogen, creatinine, calcium, sodium, potassium, CO2, cholride, total protein, albumin, globulin, total bilirubin, alkaline phosphatase, AST, ALT)
CBC (complete blood count)
Lipid Profile (including total cholesterol, triglycerides, HDL cholesterol, VLDL cholesterol, calculated LDL cholesterol)
Urinalysis
Magnesium
Vitamin D, 1, 25-Dihydroxy
Vitamin B12
Folate
Heavy Metal Screen (blood)

The tests are done in the morning after fasting overnight (no food or drink after dinner except for water). The patient should drink 0.5 liters of water before the test to avoid dehydration. The patient should avoid strenuous activity the day before, avoid restaurant food and stimulants such as coffee, eat their regular meals, and avoid stressful situations for at least 2 days before the test.

Cortisol-PM is done in the afternoon between 4-6 PM on the same day as the morning test.

The 3-hour glucose tolerance test and growth hormone stimulation tests should be done on different days.

ADDITIONAL SPECIALIZED TESTS:

A comprehensive 24-hour urine hormone panel (including DHEA, Androsterone, Etiocholanolone, Pregnanetriol, Cortisone, Cortisol, Tetrahydrocortisone, Tetrahydrocortisol, Allo-tetrahydrocortisol, Aldosterone, Tetrahydrocorticosterone, Allo-tetrahydrocorticosterone, Estrone, Estradiol, Estriol, Pregnanediol, Testosterone, Androsterone, 2-hydroxyestrogens, 16a-hydroxyestrone, 4-hydroxyestrone, 2-methoxyestrone, 2-methoxyestradiol, 5a-androstanediol, 5b-androstanediol, 11b-hydroxyandrosterone, 11b-hydroxyetiocholanolone, Free T3, Free T4, Sodium, Potassium, Calcium, Phosphorus, Magnesium).

24-hour urine growth hormone

Saliva test for Cortisol (4 samples in a day), DHEA-s (2 samples in a day).

Urine test for neurotransmitters (including sertonin, norepinephrine, dopamine, GABA, glutamate, epinephrine)

MRI of Brain

Chest X-Ray

EKG

The follow up tests include a subset of these tests as well as other tests depending on the situation.

[pmgamer18]

Wow I wish you were here in MI. I think I am moving to CA.

[marianco]

Originally Posted by pmgamer18

Wow I wish you were here in MI. I think I am moving to CA.

Other than the urine neurotransmitter tests, the other tests should be familiar to physicians studying and practicing anti-aging medicine.

Each physician would then add their own tests based on their interests and specialty.

For example, in psychiatry, I may add a urine drug screen, testing for hepatitis, syphilis and other sexually transmitted diseases, EEG, genetic tests, psychological testing, specific drug levels, etc. depending on the person's circumstance.

[JanSz]

Originally Posted by marianco

Look up sticy called TRT: A Recipe for Success for SWALE/Dr. Crisler's protocol including the initial labs.

The labs need to be customized to the individual. A comprehensive set of labs for my patiens would cost close to $5,000 or more. Not everyone can afford this, even with insurance, nor may it be necessary or practical in order to address the most important problems, so I customize the lab tests for the person.

A fairly comprehensive general initial lab work-up using standard blood and urine tests may include:

REPRODUCTIVE:
Free and Total Testosterone Panel (this includes Total Testosterone, Free Testosterone, Bioavailable Testosterone, and Sex Hormone Binding Globulin), Estradiol, Progesterone, Luteinizing Hormone, Follicle Stimulating Hormone, Prolactin, Prostate Specific Antigen (in men)

THYROID:
Free T4 (Free Thyroxine), Free T3 (Free Liothyronine), Thyroid Stimulating Hormone, antithyroglobulin antibody, antithyroid peroxidase antibody, thyroid stimulating immunoglobulin.

ADRENAL:
Cortisol AM, Cortisol PM, Cortisol-Binding Globulin, Adrenocorticotropic Hormone (ACTH), Dehydroepiandrosterone Sulfate (DHEA-s),

CARBOHYDRATE METABOLISM:
fasting glucose (included in comprehensive metabolic panel when fasting), Hemoglobin A1c, fasting insulin, 3-Hour Glucose Tolerance Test (samples of blood for measuring glucose and insulin are taken at 0, 60, 120, and 180 minutes after ingesting a 1.75 g/kg glucose solution).

GROWTH HORMONE:
IGF-1 (Insulin-like growth factor I / Somatomedin-C), Growth Hormone Stimulation Test using GHRH (growth hormone releasing hormone) plus Arginine (samples of blood for measuring growth hormone are taken at 0, 30, 60, 90, and 120 minutes).

GENERAL:
Comprehensive Metabolic Panel (glucose, urea nitrogen, creatinine, calcium, sodium, potassium, CO2, cholride, total protein, albumin, globulin, total bilirubin, alkaline phosphatase, AST, ALT)
CBC (complete blood count)
Lipid Profile (including total cholesterol, triglycerides, HDL cholesterol, VLDL cholesterol, calculated LDL cholesterol)
Urinalysis
Magnesium
Vitamin D, 1, 25-Dihydroxy
Vitamin B12
Folate
Heavy Metal Screen (blood)

The tests are done in the morning after fasting overnight (no food or drink after dinner except for water). The patient should drink 0.5 liters of water before the test to avoid dehydration. The patient should avoid strenuous activity the day before, avoid restaurant food and stimulants such as coffee, eat their regular meals, and avoid stressful situations for at least 2 days before the test.

Cortisol-PM is done in the afternoon between 4-6 PM on the same day as the morning test.

The 3-hour glucose tolerance test and growth hormone stimulation tests should be done on different days.

ADDITIONAL SPECIALIZED TESTS:

A comprehensive 24-hour urine hormone panel (including DHEA, Androsterone, Etiocholanolone, Pregnanetriol, Cortisone, Cortisol, Tetrahydrocortisone, Tetrahydrocortisol, Allo-tetrahydrocortisol, Aldosterone, Tetrahydrocorticosterone, Allo-tetrahydrocorticosterone, Estrone, Estradiol, Estriol, Pregnanediol, Testosterone, Androsterone, 2-hydroxyestrogens, 16a-hydroxyestrone, 4-hydroxyestrone, 2-methoxyestrone, 2-methoxyestradiol, 5a-androstanediol, 5b-androstanediol, 11b-hydroxyandrosterone, 11b-hydroxyetiocholanolone, Free T3, Free T4, Sodium, Potassium, Calcium, Phosphorus, Magnesium).

24-hour urine growth hormone

Saliva test for Cortisol (4 samples in a day), DHEA-s (2 samples in a day).

Urine test for neurotransmitters (including sertonin, norepinephrine, dopamine, GABA, glutamate, epinephrine)

MRI of Brain

Chest X-Ray

EKG

The follow up tests include a subset of these tests as well as other tests depending on the situation.

================================================== ====
My doctor is quite cooperative when it comes to ordering the tests. I am on Medicare now, previously on Blue Cross Blue Shield, the sticking point always is in properly filling the order form for the tests and latter the prescription. Proper ICD-9 code numbers are required or I rather that insurance will be footing the bill or return visit is needed and tests or medicine delivery is delayed.
Wonder if you could post list of ICD-9 codes that would be applicable to cases often discussed here.

Knowing the code proper name of disease can be found using for example:
http://icd9cm.chrisendres.com/2007/index.php

http://www.cdc.gov/nchs/about/otheract/icd9/abticd9.htm

Thank you for you tremendous help, JanSz