I read about some having labs checked every 8 weeks. Every doctor I have seen
it seems like you have to fight and argue to get labs done. New doc I just saw
today thinks there is no need do labs but every 6 months. Maybe that’s fine
someday but right now until I get thinks worked out it just doesn’t seem right
to me. I would like to be on a regular schedule so I know how I am doing and
can make adjustments as necessary. What do you all think about this?

The answer is: it depends on what the practitioner wants to do.

Generally, I like obtaining lab tests prior to the next appointment to help assess the person’s condition and help decide what adjustments may need to be done. Labs would test factors that aren’t easily obtained via the history and exam. This interval keeps it simpler since patients may often forget to do intermediate labs in the normal course of their daily activities.

The interval between appointments and tests then may vary depending on the patient’s severity of illness and the work that needs to be done to improve function. As the patient improves and stabilizes, the frequency of appointments and lab tests is reduced. Stable patients generally see me once every 6 to 12 months.

There may be times when intermediate and more frequent labs are needed.

For example, if the treatment has to monitor estradiol formation from testosterone, then I may do intermediate labs to help decide when adding an aromatase inhibitor needs to be done.

As another example, iron may need to be monitored more frequently than the appointments because how fast a person absorbs iron varies tremendously. One patient, for example, had his iron surge within a month from a ferritin of 10 ng/mL to 400 ng/mL using only 15 mg of iron a day. Usually, it would take several months to even reach that level at 240 mg of iron a day. Thus, the need, in certain patients to monitor iron absorption more frequently.

When giving transdermal testosterone, thyroid hormone levels may fall. This may cause an increase in skin thickness or mucin deposition. This reduces absorption of transdermal testosterone unless thyroid hormone is also adjusted. Thus, if I was not seeing the patient in two months, an intermediate set of labs to help determine adjustments may be needed between appointments.

When changes in a patient’s condition may occur between appointments that necessitate significant changes in their treatment, then intermediate labs to help make that decision may be needed.