Blood Testing
Blood tests are the single most important safety tool in HRT. Your hormone levels — not your dose — tell you whether therapy is working and whether it is safe. Testing is just as important for people doing DIY HRT as for those with a prescriber.
Medical disclaimer
For educational purposes only; not medical advice. Interpret results with a qualified provider where possible.
When to test
- Get your first test around 3 months after starting or changing a regimen, then adjust if needed.
- For injections, take your blood as close as possible to your next scheduled dose — ideally the day of, or the day before, your next injection. This measures your trough (lowest) level.
- Many private labs let you print a requisition form and walk into a local lab for the draw, without mailing anything or drawing blood at home.
Transfeminine monitoring
Test estradiol (E2) and total testosterone (T) each time. Community target ranges (DIY HRT Directory):
- Total testosterone below 50 ng/dL
- Estradiol above 100 pg/mL
If you take bicalutamide, also test liver enzymes (ALT/AST) every 3 months. Testing can usually stop after about a year if enzymes remain normal.
Transmasculine monitoring
Test total testosterone (T), estradiol (E2), and a complete blood count (CBC) each time (DIY HRT Directory):
- Testosterone in the normal male range (300–1000 ng/dL)
- The CBC monitors hematocrit; a rising hematocrit (polycythemia) raises clot risk.
Private testing typically costs $50–$150 per panel.
Useful additional markers
Depending on your medications and history, providers may also check prolactin, LH/FSH, liver and kidney function, and lipids. Ask a provider which panel suits you.
Source: DIY HRT Directory — Blood Testing.