TRT Monitoring Schedule &
Blood Work Protocol
Testosterone replacement therapy is not a “set and forget” treatment.
We utilize rigorous medical monitoring to optimize your hormones while ensuring long-term cardiovascular and metabolic safety.
Check Your Eligibility for TRT Consultation
Answer 8 questions to see if you meet the basic criteria for a medical assessment. This is not a diagnosis.
What is your age?
TRT consultation requires minimum age criteria
Have you noticed changes in energy levels?
Common concern for men considering consultation
What about changes in body composition?
Physical changes despite consistent lifestyle
Changes in libido or sexual function?
Common concern prompting medical consultation
Mood or cognitive changes?
Brain fog, irritability, or low mood
Do you have any of these conditions?
Medical contraindications that may affect eligibility
Have you had testosterone levels tested before?
Previous blood work can streamline assessment
What’s your main goal for seeking consultation?
Understanding your consultation priorities
Why Monitoring is Non-Negotiable
We balance symptom relief with long-term health markers.
🎯 Dose Optimization
Every man metabolizes testosterone differently. We monitor “trough” levels (hormone levels just before your next dose) to ensure you remain in the therapeutic range all week, avoiding the roller-coaster effect of peaks and crashes.
❤️ Cardiovascular Safety
Testosterone stimulates red blood cell production. We strictly monitor Haematocrit and Haemoglobin to prevent blood thickening (polycythemia), reducing cardiovascular risk through dose adjustment or therapeutic donation.
⚖️ Hormone Balance
We watch for aromatization (conversion of testosterone to oestrogen). We aim to keep oestradiol in a healthy physiological range to support libido and bone health without causing side effects like water retention or mood swings.
The Monitoring Timeline
A structured medical pathway from initiation to long-term maintenance.
Initial Comprehensive Assessment
Before treatment begins, we establish a complete baseline of your metabolic and hormonal health. This ensures no underlying conditions (like prostate cancer or severe sleep apnea) are present that would make TRT unsafe.
- Full hormone panel (Total & Free T, LH, FSH, SHBG, Oestradiol)
- Prostate specific antigen (PSA) for men 40+
- Full blood count & metabolic panel (Liver, Kidney, Lipids)
- Doctor review of medical history and contraindications
The “Response” Review
The most critical phase. After 6 weeks, your natural production has shut down and you are running solely on exogenous testosterone. We test to see how your body absorbs the medication and check for immediate side effects.
- Testing Focus: Total T, Free T, Oestradiol, Hematocrit.
- Goal: Determine if dose is too high (estrogenic side effects) or too low (unresolved symptoms).
- Action: Dose is adjusted up or down based on “Trough” readings.
Metabolic & Safety Check
By month 6, physical changes (muscle mass, fat redistribution) are often visible. We conduct a deep dive into metabolic markers to ensure the therapy is positively impacting your overall health profile.
- Lipid Panel: Checking for changes in HDL/LDL cholesterol.
- Full Blood Count: Ensuring red blood cell count remains safe.
- PSA: Ensuring no rapid rise in prostate markers.
- Symptom Review: Assessing improvements in libido, mood, and energy.
Annual Comprehensive Review
Once stable, monitoring frequency reduces to every 6 months or annually, depending on risk factors. We look at long-term health optimization and make minor adjustments as you age.
- Annual comprehensive blood panel covering all markers.
- Blood pressure monitoring review.
- Review of treatment goals and lifestyle factors.
- Renewal of long-term prescription authority.
What We Measure & Why
Decoding your pathology report. We look far beyond just “Total Testosterone”.
We focus on Free T, not just Total T. This is the unbound hormone actually available for your receptors to use for muscle repair, libido, and mental clarity.
Measures the percentage of red blood cells in your blood. If this gets too high (>0.52-0.54), blood becomes thick, increasing clot risk. We manage this strictly.
Testosterone converts to Estrogen. We don’t want to crush it (bad for joints/libido) or let it spike (bloating/moodiness). We aim for the “Goldilocks” zone.
Prostate Specific Antigen. While TRT doesn’t cause cancer, we monitor this to ensure existing issues aren’t aggravated. Essential for men 40+.
Sex Hormone Binding Globulin. High SHBG “locks up” testosterone. Low SHBG implies rapid metabolism of T. This dictates your injection frequency.
We monitor Liver Function and Cholesterol (HDL/LDL). Properly managed TRT often improves metabolic profiles, but oral AAS can strain the liver.
Precision Dose Adjustment
Unlike generic clinics that prescribe a “cookie-cutter” 200mg/week protocol, we adjust your dose based on Trough Levels.
The Trough Protocol: We ask you to perform blood tests on the morning you are due for your next injection, before you take it. This shows us your lowest level of the week.
- If Trough is < 15 nmol/L: You likely feel fatigued before your next shot. We may increase dose or frequency.
- If Trough is > 30-35 nmol/L: You are supraphysiological. We reduce the dose to minimize side effects like high hematocrit.
- If E2 is High: We assess body fat and injection frequency before prescribing aromatase inhibitors.
⚠️ Safety Protocols
If HCT > 0.54, prescription is paused. Patient advised to donate blood or undergo therapeutic venesection. Dose lowered upon resumption.
If PSA rises > 0.75 ng/mL in one year, TRT is paused and referral to Urologist is provided to rule out pathology.
Injection frequency is increased (e.g., from twice weekly to every other day) to smooth out hormonal spikes that trigger these issues.
Monitoring Costs
Transparent pricing for your ongoing care. No hidden monthly subscriptions.
Review Consultation
Required at Week 6, Month 6, then Annually
- Telehealth video review with Doctor
- Detailed analysis of all blood markers
- Adjustment of medication dosage
- Renewal of prescription scripts
- Letter to GP (optional)
Pathology Requests
Depends on Medicare eligibility
- Medicare Bulk-Billed: Available if you meet specific hypogonadism criteria (PBS/MBS authority).
- Private Pathology: ~$150-$180 if testing for optimization/screening outside Medicare guidelines.
- Referrals sent directly to your phone/email.
- Compatible with all major pathology centers.
Monitoring FAQ
Common questions about blood work logistics.
When exactly should I get my blood test done?
Timing is crucial. You must test in the morning (before 10am) on the day your next injection is due, before you inject. This measures your “trough” (lowest) level. If you test the day after injection, your levels will show falsely high (“peak”), leading to incorrect dose reductions.
Do I need to fast for the blood test?
Yes. Because we check metabolic markers like Lipids (Cholesterol) and Glucose alongside your hormones, please fast for 8-12 hours before your blood draw. Water is fine and encouraged to make the draw easier.
What happens if I miss a scheduled review?
Medical regulations prevent us from prescribing Schedule 4 medication without up-to-date monitoring. If you miss a review window, we may not be able to issue repeat scripts until safety blood work is confirmed. We send reminders well in advance.
Can I use blood tests from my GP?
Yes, provided they cover the specific panel we require (Total T, Free T, E2, FBC, etc.) and are recent (within 4 weeks). Please upload these to your patient portal prior to your consultation.
Why do you test Hematocrit so strictly?
Thick blood puts strain on the heart. It is the most common side effect of TRT in men. By keeping Hematocrit below 0.54, we ensure the therapy remains cardiovascularly safe long-term. Hydration and regular blood donation usually manage this easily.
Ready for Evidence-Based Treatment?
Join a clinic that prioritizes your long-term health over short-term gains.
Professional monitoring, transparent protocols, and expert medical guidance.
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