Testosterone, estrogen, thyroid, cortisol. What your labs should actually look like, what to do when they don't, and when TRT is the right call.
Your hormones control your energy, libido, mood, muscle mass, and how fast you age. Most standard blood panels only check total testosterone — which tells you almost nothing. You need a full hormone panel: total T, free T, estradiol, SHBG, LH, FSH, prolactin, and thyroid. Only then can you actually optimize.
Total testosterone is the least useful marker — bioavailable and free T determine actual androgen signaling. SHBG modulates free T dramatically; elevated SHBG (common with high fiber, liver issues) tanks free T even with normal totals. Estradiol needs to stay in the 20-30 pg/mL range on TRT — too low kills libido and joint health. DHT conversion and 5-alpha reductase activity matter for hair and prostate. The HPTA axis (LH, FSH, GnRH pulsatility) determines endogenous production viability.
How to get started, what protocol to run, how to manage estradiol, what to expect at 6, 12, and 24 weeks. The guide clinics won't give you.
Sleep, zinc, vitamin D, ashwagandha, tongkat ali, creatine. What actually moves the needle on total and free testosterone without TRT.
What happens to your hormones on GLP-1s. Fat loss changes aromatization. Caloric restriction affects LH. The full interaction guide.
Anastrozole vs DIM vs dietary management. When to use an AI, when not to, and why crashing your E2 is worse than running it high.
TSH, Free T3, Free T4, Reverse T3. Why TSH alone is useless. How subclinical hypothyroidism tanks energy and body comp. Natural and pharmaceutical options.
Every marker, every optimal range, how to order without a doctor, how to interpret your results, and what to do when you're out of range.
| Marker | "Normal" Range | Optimal Range | Why It Matters |
|---|---|---|---|
| Total Testosterone | 300–1000 ng/dL | 700–900 ng/dL | Energy, libido, muscle, mood |
| Free Testosterone | 9–30 ng/dL | 20–25 ng/dL | Bioavailable fraction — what counts |
| Estradiol (E2) | <40 pg/mL | 20–30 pg/mL | Too low kills libido; too high causes gyno |
| SHBG | 16–55 nmol/L | 25–40 nmol/L | High SHBG tanks free T even with normal total |
| LH | 1.5–9.3 IU/L | 3–6 IU/L | Signals natural production; suppressed on TRT |
| TSH | 0.4–4.5 mIU/L | 1.0–2.0 mIU/L | Most labs accept 4.5 — that's hypothyroid |
| Free T3 | 2.3–4.2 pg/mL | 3.2–4.2 pg/mL | Active thyroid hormone — energy, metabolism |
| Cortisol (AM) | 6–23 mcg/dL | 15–20 mcg/dL | Low morning cortisol = adrenal fatigue pattern |
| DHEA-S | Age dependent | Upper quartile for age | Precursor to T and E; declines with age |
| IGF-1 | Age dependent | 200–300 ng/mL | Proxy for GH status; longevity marker |
Important: These are general optimal ranges based on published functional medicine literature. Optimal ranges vary by individual, age, sex, and health status. Always work with a knowledgeable physician for interpretation and treatment decisions.
Real questions from real people about TRT, labs, and optimization — answered by Job in The Daily Biohack.
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