혈액 검사 및 자가 진단 도구

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Blood tests are the cornerstone of HRT safety management. Without blood test data, you have no way of knowing whether the medication is working, if your dosage is safe, or if your body is taking on unnecessary risks. This page will guide you through when to get tested, what to test for, and how to understand your results ^{[1] [2]} .

Accessing Blood Tests

Depending on your location, you may access blood tests through a primary care provider, an informed consent clinic (like Planned Parenthood in the US), specialized gender identity clinics (like the NHS or GenderCare in the UK), or private testing services (like Medichecks). Regardless of your route, getting tested is critical. After receiving your results, compare them against our traffic light system below.

6.1 What to Test and When

The blood test schedule is divided into three phases, aligning with our HRT Pathway ^{[1] [2]} :

Phase 1: Initiation (Months 1-6)

This is the most intensive adjustment period, requiring more frequent monitoring to ensure the medication is working and to rule out early side effects.

Week 4 Check:

Test Item	Purpose	Targeted Users
Sex Hormone Panel (E2, T, LH, FSH, PRL, P4)	Confirm E2 is rising and T is falling	All users
Liver Function (ALT, AST)	Rule out early hepatotoxicity	CPA / Bicalutamide users
Electrolytes (K⁺, Na⁺)	Rule out hyperkalemia risk	Spironolactone users

Week 12 Check:

Test Item	Purpose	Targeted Users
Sex Hormone Panel	Assess if stage goals are met (E2 50-100 pg/mL)	All users
Liver Function (ALT, AST)	Continuous monitoring of liver safety	CPA / Bicalutamide users
Lipid Panel (TC, TG, LDL, HDL)	Assess metabolic impact	All users
Electrolytes (K⁺)	Continuous monitoring of blood potassium	Spironolactone users

Phase 1 Goals

E2 reaching 50-100 pg/mL, T trending downwards. If E2 is below 30 pg/mL, you may need to adjust the administration method or dosage (see our Pathway) ^[1] . Do not arbitrarily increase the dose during this stage just because you “don’t feel anything”.

Phase 2: Adjustment (Months 6-12)

Check every 3 months ^[2] :

Test Item	Frequency	Target
Sex Hormones (E2, T, PRL)	Every 3 months	E2 100-200 pg/mL, T <50 ng/dL
Liver Function (ALT, AST)	Every 3 months (CPA/Bica)	ALT/AST ≤ Upper normal limit
Prolactin (PRL)	Every 6 months	PRL <50 ng/mL
Electrolytes (K⁺)	Every 3 months (Spiro)	K⁺ 3.5-5.0 mmol/L

Phase 3: Maintenance (12 Months+)

Once hormone levels are stable, frequency can be reduced ^{[1] [2]} :

Routine 6-Month Checks:

Test Item	Description
Sex Hormones (E2, T, PRL)	Confirm you remain in the target range
Liver Function (ALT, AST)	Ongoing monitoring (CPA/Bica users every 3-6 months)
Electrolytes	Ongoing monitoring for Spironolactone users

Annual Comprehensive Checks:

Test Item	Description
Lipid Panel	Assess long-term metabolic impact
Fasting Blood Glucose	Rule out progressive insulin resistance
CBC (inc. Hb)	Monitor anemia trends
Coagulation + D-Dimer	Assess VTE risk (crucial for oral E2 users)
Bone Density (DXA)	Consider, especially if estrogen was withheld for a long time

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6.2 Understanding Your Report (Traffic Lights)

The following visually demonstrates 7 core blood test markers related to HRT. Green = Target Range, Yellow = Caution, Red = Danger, requiring action ^{[1] [2]} .

Timing Is Everything

Blood draw timing directly impacts readability ^[1] . Please follow these rules (measure trough levels):

• Transdermal Patches: 12-24 hours before your next patch change
• Oral/Sublingual: Right before your next dose
• Injections: The morning of, right before your next injection

If you do NOT draw blood at trough, E2 readings will be artificially high, leading to misinterpretations about whether the dose is adequate.

Estradiol (E2)

E2 pg/mL

100 200 300 500

目标 注意 危险

E2 100-200 pg/mL is the international guideline recommendation for maintenance ^[1] . Exceeding 200 pg/mL will NOT result in faster feminization; it only increases the risk of blood clots and premature breast bud fusion. E2 levels below 20 pg/mL after treatment suggest an administration issue.

E2 > 500 pg/mL

If trough E2 exceeds 500 pg/mL, reduce the dosage immediately and seek medical evaluation. This level significantly increases deep vein thrombosis (VTE) risks ^[3] .

Testosterone (T)

T ng/dL

0 50 100

目标 注意 危险

Suppressing T to <50 ng/dL (typical cis female range) is a core HRT goal ^[1] . If T remains >100 ng/dL after 6 months, you usually need to adjust your anti-androgen instead of just brute-forcing a higher E2 dose ^[2] .

Prolactin (PRL)

PRL ng/mL

0 25 50

目标 注意 危险

Both estrogen and CPA can elevate prolactin ^[1] . Mild elevations (25-50 ng/mL) are often clinically insignificant but warrant monitoring. PRL above 50 ng/mL should be evaluated to rule out prolactinomas. CPA users must watch this closely.

Liver Function (ALT/AST)

ALT/AST U/L

0 40 120

目标 注意 危险

CPA and bicalutamide carry hepatotoxicity risks ^[1] . The upper normal limit is typically 40 U/L. Elevations to 1-3x the upper limit require close monitoring; exceeding 3x (>120 U/L) means you should stop CPA or bicalutamide immediately and consult a doctor ^[2] .

Warning Signs of Liver Damage

If you develop yellowing skin/eyes (jaundice), dark urine, persistent nausea, or upper right abdominal pain, stop the medication immediately regardless of your last ALT/AST numbers ^[4] . These are acute symptoms requiring emergency care.

Blood Potassium (K⁺)

K⁺ mmol/L

3.5 5 5.5

目标 注意 危险

Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia ^[1] . Suspend spironolactone if K⁺ exceeds 5.5 mmol/L. While using spironolactone, minimize high-potassium foods and do not use salt substitutes.

Hyperkalemia Symptoms

Muscle weakness, numbness or tingling in the extremities, palpitations, or arrhythmias. If on spironolactone and experiencing these, get your potassium checked immediately ^[2] .

Hemoglobin (Hb)

Hb g/L

110 120 160

目标 注意 危险

Hb predictably drops into the cis female range after initiating estrogen; this is physiological ^[1] . But an Hb below 110 g/L signals anemia requiring diagnosis.

D-Dimer

D-Dimer mg/L

0 0.5 1

目标 注意 危险

D-dimer elevations suggest thrombosis/fibrinolysis ^[1] . Mildly elevated (0.5-1.0) needs clinical context. Over 1.0 mg/L—especially if alongside calf swelling, chest pain, or shortness of breath—constitutes an emergency to rule out DVT or PE ^[3] .

D-Dimer + Symptoms = Emergency

Elevated D-dimer alone isn’t automatically a clot, but combined with calf swelling/heat, sudden chest pain, or coughing blood, go to the ER immediately. Oral estradiol carries higher VTE risks than transdermal ^[3] .

Comprehensive Guide

Marker	Target (Green)	Caution (Yellow)	Danger (Red)
E2 (pg/mL)	100-200	<50 or 200-300	>500 or <20 (post-med)
T (ng/dL)	<50	50-100	>100 (after 6mos)
PRL (ng/mL)	<25	25-50	>50 (rule out prolactinoma)
ALT/AST (U/L)	≤40	40-120 (1-3x limit)	>120 (Stop CPA/Bica)
K⁺ (mmol/L)	3.5-5.0	5.0-5.5	>5.5 (Stop Spiro)
Hb (g/L)	>120	110-120	<110 (Anemia)
D-Dimer (mg/L)	<0.5	0.5-1.0	>1.0 (Rule out clot)

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6.3 Interactive Self-Check Tool

Coming Soon

The BloodTestChecker Interactive React component will be launching soon. It allows you to input your values for instant traffic-light feedback and tailored advice.

All calculations occur in your browser—no data is saved or sent to any servers.

다음에 읽어볼 내용

• HRT 경로 맵 — 검사 결과에 따른 다음 단계
• 용량 한계 — 용량이 안전 범위인지 확인
• 위험 및 응급 상황 — 즉시 중단해야 할 상황