Hormone panel changes — what worked for you?

This one has a reasonably settled answer, so here it is. A defensible baseline is short: HbA1c and fasting glucose, a lipid panel with ApoB if you can get it, ALT and AST, creatinine with eGFR, TSH, ferritin and B12, and a full blood count. That set catches the things that change, the things that explain symptoms, and the things that alter the prescribing decision. Almost everything else on the long circulating lists is either invariant, uninterpretable without a specific question, or an incidental finding waiting to cause an unnecessary workup.

Dr.MetabolicMD said:

A defensible baseline is short: HbA1c and fasting glucose, a lipid panel with ApoB if you can get it, ALT and AST, creatinine with eGFR, TSH, ferritin…

Agreeing with Dr.MetabolicMD, and the qualification matters more than the agreement. One addition: if the lab changes analytical platform between your draws, the comparison breaks and nobody tells you. It is worth asking when a value moves inexplicably.

LibrarianMeg said:

Bloods taken before and after nine months, and the changes are large enough that I want to understand which are cause and which are consequence.

Agreed, and reference ranges are laboratory-specific. Comparing your number to somebody else's range, or to a screenshot from another country, is how people convince themselves something is wrong.

From the other side of the consultation, briefly.

Sex hormone labs after weight loss on the hormone panel — for the men in this thread:

Testosterone: 300 → 540 ng/dL (dramatic improvement!)
Free T: 5.5 → 14.0 ng/dL
Estradiol: 47 → 26 pg/mL
SHBG: 22 → 46 nmol/L

Visceral fat contains aromatase which converts testosterone to estrogen. As you lose visceral fat, this conversion decreases and testosterone naturally rises. I feel 10 years younger.