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혈액 검사 및 자가 진단 도구

A 3가지 채혈관 비교: 보라관(혈구), 노란관(생화학), 파란관(응고)

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] .

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

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:

시작 4주차 검사 항목과 목적, 대상 사용자
Test ItemPurposeTargeted 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:

시작 12주차 검사 항목과 목적, 대상 사용자
Test ItemPurposeTargeted 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

Check every 3 months [2] :

조정기(6-12개월) 3개월 주기 검사 항목과 목표치
Test ItemFrequencyTarget
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

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

Routine 6-Month Checks:

유지기 6개월 정기 검사 항목 설명
Test ItemDescription
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:

유지기 연 1회 종합 검사 항목 설명
Test ItemDescription
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

6.2 Understanding Your Report (Traffic Lights)

섹션 제목: “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] .

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.

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] .

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.

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] .

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.

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 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] .

7대 혈액 지표별 정상·주의·위험 신호등 구간 종합표
MarkerTarget (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)