Blood tests (transfem)
Last updated March 2022
Most important: Aim for testosterone levels <50ng/dL and estradiol levels >100pg/mL
Estradiol monotherapy
Critical every time: E2, T
Useful if you can get them once in a while: SHBG, albumin, PRL, FBC, DHT
Estradiol + cyproterone acetate
Critical every time: E2, T, PRL
Useful if you can get them once in a while: B12, LFT, SHBG, albumin, FBC, DHT
Estradiol + bicalutamide
Critical every time: E2, T, LFT (=AST, ALT)
Useful if you can get them once in a while: SHBG, albumin, PRL, FBC, DHT
Estradiol + GnRH agonist
Critical every time: E2, T
Useful if you can get them once in a while: Fasting glucose or A1C, SHBG, albumin, PRL, FBC, DHT
Estradiol + spironolactone
Critical every time: E2, T, U&E
Useful if you can get them once in a while: SHBG, albumin, PRL, FBC, DHT
Raloxifene + CPA/Bica
Critical every time: E2, T, PRL, AST, ALT
Useful if you can get them once in a while: BAP or ALP, vitamin D, T4, TSH, SHBG, albumin, FBC
Raloxifene + GnRH agonist
Critical every time: E2, T
Useful if you can get them once in a while: BAP or ALP, vitamin D, fasting glucose or A1C, SHBG, albumin,
PRL,
FBC, DHT, T4, TSH
AMAB pre-HRT baseline
From most to least useful: PSA if aged >40, FBC, T, E2, PRL, fasting glucose or A1C, T4, TSH
Hair loss despite HRT
From most to least useful: T, E2, FBC, T4, TSH, ferritin, vitamin B12, folate, HIV 1 & 2 antibodies, DHT,
cortisol, fasting glucose or A1C