Hormone panel changes — looking for input

Dr.EndoEP 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: 15 ng/mL → 14 ng/mL (improved)
• Noon: 7 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.

NurseLeah_Nash said:

Agreed, and reference ranges are laboratory-specific.

Thank you for spelling out the reasoning rather than just the conclusion.

Dr.EndoEP 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…

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

Testosterone: 282 → 562 ng/dL (dramatic improvement!)
Free T: 5.7 → 13.2 ng/dL
Estradiol: 54 → 24 pg/mL
SHBG: 20 → 44 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.

Adding the numbers, since they settle part of this. Practical: whatever you change, write down the date and the reason. In three months the reason is what you will have forgotten, and the reason is what makes the record worth having.

Moderator note: two posts asking for a source have been merged into one. Please search the thread before asking again. Tagging this one for the weekly digest.