Hormone panel changes — 6 month update

Dr.NateNeph 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…

HPA axis assessment on the hormone panel: rarely ordered but informative for understanding the stress-metabolism connection:

4-point salivary cortisol:

• Morning: 16 ng/mL → 12 ng/mL (improved)
• Noon: 9 ng/mL → 5 ng/mL
• Evening: 4 ng/mL → 2 ng/mL
• Night: 2 ng/mL → 1 ng/mL

The cortisol curve is normalizing — less flat, better diurnal variation. Reduced visceral fat = reduced cortisol overproduction. The metabolic benefits cascade into stress hormone regulation.

COA_Karl said:

Agreed, and reference ranges are laboratory-specific.

Genuinely useful, thank you. I had the facts and not the framework.

Dr.NateNeph 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…

Hormone panel changes on the hormone panel — relevant for anyone curious about endocrine effects:

• Testosterone: increased 42% (weight loss reduces aromatase in adipose tissue)
• Estradiol: normalized from elevated baseline
• SHBG: increased appropriately
• Free testosterone: increased 18%
• Cortisol AM: within normal limits, no significant change

My reproductive endocrinologist says the testosterone improvement alone could explain the energy and mood benefits I've experienced.

One concrete data point for the thread. Say what you would expect to see if you were wrong, before you look. It is a small discipline and it changes what you notice.

Moderator note: two posts asking for a source have been merged into one. Please search the thread before asking again. No action needed from anybody.