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Why take this test?
The TRT Check Plus tests key markers in the blood to help you monitor and manage your testosterone replacement therapy. While testosterone can have a positive impact on strength, libido, sexual performance and mood, there can be risks to health, especially with over-supplementation. This check includes tests for red and white blood cells, liver and kidney function, diabetes, cholesterol (high doses of testosterone can reduce HDL "good" cholesterol) and thyroid function.
Elevated testosterone can impact levels of other hormones in you body. This profile includes testosterone, free testosterone (calculated), oestradiol, prolactin and SHBG.
There is an extended upper limit on this testoterone test which means that it will measure values above 52 nmol/L. This is especially useful for men taking testosterone replacement.
You should understand that this test includes a check on your Prostate Specific Antigen (PSA) level. Whilst current research indicates that it is unlikely that testosterone replacement therapy increases the risk of prostate cancer, caution is still advised, particularly for men who already have prostate cancer.
Whilst the PSA test can help to detect prostate cancer earlier it has several shortcomings when used as a screening test. Besides being increased by prostate cancer PSA can also be increased by innocent conditions such as urinary tract infection, recent ejaculation and even some forms of exercise.. This means that there is a risk of PSA being positive when no cancer is present (a false positive). If we take 100 men with a high PSA result then approximately 75 of them will have a false positive result, and 25 will have a true positive (i.e. they will have prostate cancer). Currently the most reliable way of working out whether someone has a true positive or a false positive is by performing a prostate biopsy. Because the PSA test has a high false positive rate many of these prostate biopsies will have been unnecessary.
You should also be aware that PSA tests can cause false negative results. This means that the PSA is in the normal range but the person has underlying prostate cancer. PSA levels can remain normal in the early stages of prostate cancer, providing false reassurance. If we test 100 men with prostate cancer then approximately 15 of them would have a normal PSA result (a false negative).
In some cases prostate cancer grows very slowly and may never cause symptoms or shorten lifespan, so a significant proportion of the men who receive a true positive result may undergo surgery that they did not need.
This test is for men who are, or are about to start, taking testosterone replacement thereapy and wish to monitor its effect on their hormones and other health markers. This test should be taken prior to starting TRT and at regular intervals after commencing for monitoring purposes.
We send you an easy-to-use kit to collect your blood sample.
Post your sample to our lab in the prepaid envelope provided.
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A PSA (prostate specific antigen) test is included in this health screen. PSA is a protein which can be elevated in prostate cancer. However, like all tumour marker tests, the PSA has limitations as it can be raised in benign conditions and even after recent ejaculation or bike riding. It can also be normal when cancer is present. The PSA test is accepted as a screening test for cancer., especially in men over the age of 50. An elevated result will require further investigation, some of which may be invasive e.g. biopsy, and may still lead to a negative result. However, a positive test gives you the chance to detect cancer early when treatment is more likely to be successful. Please make sure you think carefully about the risks and benefits of a PSA test before taking this test.
Our tests are not a substitute for seeing your doctor, especially if you are suffering symptoms. Our doctors will interpret your results based on the information you have provided, but will not diagnose, consult or provide any treatment. You will be advised to see your doctor for any necessary follow-up action.
Haemoglobin carries oxygen and gives the red blood cell its red colour. This test measures the amount of haemoglobin in the blood and is a good measure of the blood's ability to carry oxygen around the body.
A high haemoglobin result can mean increased red cell production to compensate for chronically low oxygen levels in the blood caused by lung disease or living at altitude. While it can also indicate "blood doping" other causes can include dehydration, smoking and bone marrow disorders.
A low haemoglobin result indicates anaemia which can have many causes including pregnancy, blood loss, liver damage, iron deficiency and much more. A low haemoglobin level should be investigated in line with other symptoms and results.
HCT (haematocrit) measures the amount of space (volume) red blood cells take up in the blood.
Raised levels can result from pregnancy, living at altitude, dehydration as well as low availability of oxygen through chronic lung disease and even sleep apnoea.
Low levels indicate anaemia.
Red blood cell (RBC) count analyses the number of red cells in the blood. Red blood cells carry oxygen from the lungs to the rest of the body. They also carry carbon dioxide back to the lungs so that it can be exhaled.
A high count (thicker blood) means there is a chance that the red blood cells will clump together and block tiny blood vessels. This also makes it difficult for your red blood cells to carry oxygen.
A low count (anaemia) means that your body may not be getting the oxygen it needs and can be caused by nutritional deficiency (lack of iron, folic acid, vitamin B12), over-hydration as well as bleeding and bone marrow disorders.
MCV (mean corpuscular volume) reflects the size of your red blood cells.
A high result may indicate a vitamin deficiency of folate or vitamin B12 and is often seen in excessive alcohol consumption associated with liver inflammation.
A low result indicates anaemia, often caused by iron deficiency.
MCH (mean corpuscular haemoglobin) is the average amount of haemoglobin contained in your red blood cells.
Together with MCV and MCHC, MCH results can help in the diagnosis of different types of anaemia.
MCHC (mean corpuscular haemoglobin concentration) is the average concentration of haemoglobin in your red blood cells.
A high level can indicate the presence of spherocytes (a type of red bood cell with too much haemoglobin) or a deficiency of folic acid or vitamin B12 in the diet.
A low level can indicate chronic blood loss or iron deficiency.
RDW (red cell distribution width) shows whether the cells are all the same size or different sizes or shapes. Normally cells are fairly uniform, although a raised RDW result (indicating greater variation in cell size and shape than is normally seen) can be caused by deficiency in iron, vitamin B12 or folic acid.
White blood cells are key to your body's immune or defence system. They fight infections and protect your body from foreign invaders such as harmful germs and bacteria.
A raised white blood cell (WBC) count can indicate recent infection, inflammation, trauma and even stress. Your WBC can also be raised when taking certain medications.
A decreased WBC can result from a vitamin deficiency such as folate or vitamin B12, as well as liver disease and diseases of the immune system.
Neutrophils are a type of white blood cell that are responsible for helping your body fight infection. When neutrophils are low you can be more vulnerable to illness and infection.
Neutrophils can be raised after severe stress on the body from a bacterial infection, recent exercise or sudden kidney failure.
Low neutrophils can be caused by a deficiency in vitamin B12 or folic acid, severe bacterial infection and some autoimmune diseases.
Lymphocytes are a type of white blood cell which fight bacterial and viral infections. They include T cells, B cells and natural killer cells.
Lymphocytes can be elevated for many reasons but it is common for them to be raised after recent infection, particularly after the flu. They can also be raised due to autoimmune disorders and some cancers.
The most common cause for lymphocytes to be depleted is the common cold.
Monocytes are a type of white blood cell that engulf and remove pathogens and dead or damaged cells from our blood. The heat and swelling of inflammation is caused by the activities of these cells.
Elevated monocytes can indicate chronic inflammatory disease, chronic infection, parasitic infection and Cushings disease.
Low levels can be due to autoimmune disorders such as lupus and rheumatoid arthritis as well as drugs which affect the bone marrow such as those used in chemotherapy.
Eosinophils are a type of white blood cell whose function is to remove parasitic infections as well as to regulate inflammation to mark an infected site.
Levels of eosinophils can be elevated if the scale of inflammation is greater than necessary to control the damage (as is the case in asthma and allergic responses) as well as in parasitic and fungal infections, autoimmune diseases and skin disorders.
Low levels of eosinophils are not usually cause for concern and can be caused by the administration of steroids.
Basophils are a type of white blood cell that protect your body from bacteria and parasites such as ticks.
An elevated basophil count can be due to inflammatory conditions such as Crohn's disease, ulcerative colitis and dermatitis, recent infection and hormone imbalance (e.g. hypothyroidism).
A low basophil count can be caused by pregnancy, stress and use of steroids.
Platelets or clotting cells are the smallest type of blood cell and are important in blood clotting. When bleeding occurs, the platelets swell, clump together and form a sticky plug (a clot) which helps stop the bleeding.
If platelet levels are raised there is an increased risk of blood clots forming in blood vessels.
If platelet levels are too low there is a risk of easy bruising and uncontrolled bleeding.
MPV (mean platelet volume) is a measurement of the average size of your platelets. New platelets are larger than older ones and a raised MPV result occurs when increased numbers of platelets are being produced. MPV provides an indication of platelet production in your bone marrow.
Creatinine is a chemical waste molecule that is generated from muscle metabolism. Measurement of this is an indicator of the levels of other waste products in the body. Creatinine is an accurate marker of kidney function.
Elevated creatinine can be caused by high intake of animal protein, taking creatine supplements and vigorous exercise but can also indicate that the kidneys are not working properly.
Low creatinine can be caused by a low protein diet, reduced muscle mass or sometime that the kidneys are simply functioning efficiently.
The estimated glomerular filtration rate (eGFR) assesses how well the kidneys are working by estimating the amount of blood filtered through the kidneys. The glomeruli are tiny filters in the kidneys responsible for removing waste products. If these filters do not do their job properly, kidney function can be impaired. The eGFR calculation is an estimate of actual glomerular filtration rate, calculated using your age, weight, gender, and serum creatinine levels.
A normal or high eGFR indicates good kidney function.
A low eGFR result can indicate your kidneys are not working as well as they should. eGFR can be used to assess the severity of chronic kidney disease (CKD).
It is important to note that individuals with high muscle mass as well as people of certain ethnicities can have a low eGFR which is normal for them. If kidney damage is suspected then other investigative tests are recommended.
Alkaline phosphatase (ALP) is an enzyme found mainly in the liver and bones. Raised levels can indicate bone or liver disease. Elevated ALP is assessed in conjunction with other liver function tests to determine whether the problem lies in the liver or the bones.
Pregnancy can also cause raised ALP and it is often elevated in growing teenagers.
Alanine transferase (ALT) is an enzyme which is produced by the liver and can indicate liver damage caused by alcohol, drugs or viruses (hepatitis). Small amounts of ALT are normal, but raised levels may indicate that your liver is inflamed.
Elevated levels of ALT can also be caused by recent vigorous exercise.
CK (creatine kinase) is a muscle enzyme which signifies muscle cell damage and death. CK levels tend to be higher in people with greater muscle mass.
The level of CK in the blood is measured to assess muscle damage - it can rise rapidly after muscle trauma, but will subside as the damage repairs. If CK continues to rise it indicates that muscle damage is not being repaired. If you have been to the gym the day before your blood test you may well exhibit raised levels of CK.
Gamma GT is a liver enzyme which is raised in liver and bile duct diseases. It is used in conjunction with ALP to distinguish between bone or liver disease. Gamma GT is also used to diagnose alcohol abuse as it is raised in 75% of long term drinkers.
Total Protein represents the sum of albumin and globulin. Abnormal levels can indicate malnutrition as well as a liver or kidney disorder.
Albumin is made mainly in the liver and helps to keep the blood from leaking out of blood vessels. It also helps carry some medicines and other substances through the blood and is important for tissue growth and healing.
Low albumin levels can indicate liver disease and can also be a marker for chronic ill-health, malnutrition and inflammation. It can also occur in kidney conditions such as nephrotic syndrome and diabetes.
Raised levels are usually caused by dehydration.
Globulin consists of different proteins and is made by the liver and the immune system. Certain globulins bind with haemoglobin while others transport metals, such as iron, in the blood and help fight infection.
HbA1c or Haemoglobin A1c is also known as glycosylated haemoglobin and is a longer term measure of glucose levels in your blood than a simple blood glucose test. Glucose attaches itself to the haemoglobin in your red blood cells, and as your cells live for around 8-12 weeks it provides a good indication of the level of sugar in your blood over a 2-3 month period.
This is an important measure for diagnosing type 2 diabetes as well as understanding how well blood sugar levels are being controlled in people who have already been diagnosed with diabetes.
Ferritin is a protein which stores iron in your cells for your body to use later. Measuring ferritin levels gives us a good indication of the amount of iron stored in your body.
Low levels of ferritin can indicate anaemia which can be caused by excessive or chronic bleeding, poor absorption of iron or too little iron in the diet.
Raised ferritin levels can indicate iron overload syndrome (haemochromatosis) or any kind of liver damage. It is also a marker of infection and inflammation.
Triglycerides are a type of fat (lipid) that circulate in the blood. After you eat, the body converts excess calories into triglycerides which are then transported to cells to be stored as fat. Your body releases triglycerides to be used for energy.
Raised triglycerides are thought to be a risk factor for peripheral vascular disease (affecting the blood vessels which supply your arms and legs as well as organs below the stomach) as well as microvascular disease, affecting the tiny blood vessels around the heart.
Cholesterol is an essential body fat (lipid). It is necessary for building cell membranes and for producing a number of essential hormones. Cholesterol is manufactured in the liver and also comes from the food we eat. Elevated cholesterol is a risk factor for heart disease - the recommended level is below 5 mmol/L.
Cholesterol however is made up of both good (HDL) and bad (LDL) cholesterol so it is important to investigate a raised total cholesterol result to determine the cause. High levels of HDL cholesterol can cause a raised total cholesterol result but may actually be protective against heart disease.
HDL cholesterol (high density lipoprotein) removes cholesterol from the bloodstream and transports it to the liver where it is broken down and removed from the body in bile. HDL cholesterol is commonly known as "good cholesterol".
Raised levels are believed to be protective against heart disease, while low levels are associated with increased risk of a heart attack.
LDL cholesterol (low density lipoprotein) carries cholesterol, triglycerides and other fats to various tissues throughout the body. Too much LDL cholesterol, commonly called "bad cholesterol", can cause fatty deposits to accumulate on artery walls, potentially leading to atherosclerosis and heart disease.
Non-HDL cholesterol is calculated by subtracting your HDL cholesterol result from your total cholesterol. It therefore includes all the non-protective and potentially harmful cholesterol in your blood, not just the LDL cholesterol. As such, it is considered to be a better marker for cardiovascular risk than total cholesterol and LDL cholesterol. The recommended level of non-HDL cholesterol is below 4 mmol/L.
HDL % of total cholesterol is considered to be more indicative of your risk of cardiovascular disease than total cholesterol alone.
A result below 20% indicates an increased risk of cardiovascular disease, while one above 20% indicates a lower than average risk.
Triiodothyronine (T3) is one of two thyroid hormones produced by the thyroid gland. Most T3 is bound to protein in the blood. Free T3 measures the level of T3 that is free, or unbound to protein, and is available to regulate metabolism.
Thyroxine (T4) is one of two hormones produced by the thyroid gland. Most T4 is bound to carrier proteins in the blood. This test measures the level of T4 which is free, or unbound, circulating in your blood.
High levels of free thyroxine can indicate an overactive thyroid while low levels can indicate an underactive thyroid.
Thyroid Stimulating Hormone (TSH) is produced in the pituitary gland and stimulates the thyroid gland to produce thyroid hormones thyroxine (T4) and triiodothyronine (T3).
High levels of TSH indicate an underactive thyroid while low levels indicate an overactive thyroid. In primary pituitary failure, a low TSH will be associated with an underactive thyroid.
Testosterone is a male sex hormone which is produced in the testicles of men and, in much smaller amounts, in the ovaries of women. It is responsible for bone and muscle strength, as well as mood, energy and sexual function.
Testosterone levels decline with age and it is unusual to find naturally elevated levels in men. Low testosterone is more common than raised testosterone in the absence of supplementation.
In women, raised testosterone can result in male characteristics such as body hair, greater bulk, a deeper voice and acne - all symptoms of polycystic ovaries, a condition in which elevated testosterone is commonly seen.
Most testosterone circulating in the blood is bound to proteins, in particular SHBG and albumin; only 2-3 % of testosterone is free and available to cells. This test uses an algorithm to calculate the level of free or unbound testosterone in relation to total testosterone, SHBG and albumin.
A low level in a male could lead to symptoms such as low libido, erectile dysfunction, depression and difficulty gaining muscle mass.
In women an elevated level could indicate polycystic ovary syndrome.
Oestradiol is a female steroid hormone which is produced in the ovaries of women and to a much lesser extent in the testes of men. It is responsible for the female reproductive system as well as the growth of breast tissue and bone thickness. Oestradiol levels decline with age, culminating in the menopause when the ovaries stop producing eggs.
Raised oestradiol in women can cause acne, constipation, loss of sex drive and depression as well as raising the risk of uterine and breast cancer.
Oestradiol can also be raised in men due to excess fat (which produces oestradiol) or in relation to testosterone levels which have declined with age. Raised oestradiol in men can cause the growth of breast tissue, the loss of libido and infertility.
Low levels of oestradiol in women can lead to osteoporosis, problems with the menstrual cycle and fertility as well as fatigue and depression.
Most of the sex hormones - testosterone, oestrogen and dihydrotestosterone (DHT) - found in your blood are bound to Sex Hormone Binding Globulin (SHBG) which means that they are unavailable to your cells. Measuring the level of SHBG in your blood gives important information about your levels of "free" or unbound hormones which are biologically active and available for use.
Elevated SHBG indicates that there is less testosterone or oestrogen available for use whereas low levels can mean an excess of available hormones.
Prolactin is a hormone which is produced in the pituitary gland and plays a role in reproductive health. Its primary purpose is to stimulate milk production after childbirth, and in pregnant and breastfeeding women prolactin levels can soar.
Raised levels in a woman who isn't pregnant or breastfeeding can signal fertility problems as well as irregular periods.
Raised levels in men can cause reduced sex drive, lack of energy, erectile disfunction and fertility problems.
Follicle Stimulating Hormone is produced in the pituitary gland and is important for women in the production of eggs by the ovaries and for men in the production of sperm. Levels of FSH rise in women as egg production declines, therefore raised FSH often coincides with the onset of the menopause and is a measure of ovarian reserve.
Elevated FSH in women indicates reduced egg supply whereas low levels can signal that you are not ovulating or are pregnant.
Levels of FSH in men rise with age, but can also indicate testicular damage and reduced sperm production. Low levels of FSH are detected when men are not producing sperm.
Luteinising Hormone (LH) is produced by the pituitary gland and is important for male and female fertility. In women it governs the menstrual cycle, peaking before ovulation. In men it stimulates the production of testosterone.
Raised LH in women can signal that you are not ovulating, that you are menopausal or that your hormones are not in balance (as with polycystic ovaries).
Raised LH in men can signal that the testes are not producing enough testosterone.
Prostate Specific Antigen (PSA) is a protein which is released into the blood by the prostate gland. An enlarged gland is often associated with higher levels of PSA. PSA levels can also rise with age, with prostatitis (infected prostate) or even vigorous exercise and ejaculation.
The PSA test in isolation is not to be relied upon to diagnose prostate cancer, as levels can be raised in benign prostate disorders. Raised levels of PSA can lead to unnecessary biopsies and intervention which may decrease quality of life. However, a raised PSA level should always be investigated further.
It is useful to monitor PSA over time so that any change in what is normal for you can be investigated quickly.
We will send you your TRT Check Plus (Testosterone Replacement Therapy) blood sample collection kit together with the details of a convenient clinic where you can go and have your sample taken.
Your TRT Check Plus (Testosterone Replacement Therapy) includes 1st class postage and packaging for you to send your blood sample directly to our laboratory for analysis. If you live in an area where you cannot rely on the post or you simply want to ensure that your sample arrives at the laboratory the following day, you may wish to send your blood sample guaranteed next day delivery for extra reassurance.
Your blood sample will be analysed at one of our chosen laboratories. You can be assured of fast, accurate results from one of our accredited independent providers of clinical diagnostic tests.
Our medical team will comment on out-of-range blood results and give you follow-up advice where necessary. If you need it, a PDF copy of your TRT Check Plus (Testosterone Replacement Therapy) results can be downloaded for your doctor.
Once you have placed your order you will receive login details to mymedichecks.com where you can manage your account, track your orders and view your TRT Check Plus (Testosterone Replacement Therapy) results.
Stay motivated by filling in your online health and lifestyle questionnaire and seeing how improvements in your lifestyle can influence your results. Your medical and family history gives us vital information when interpreting your results.