Physical and CBC Questions

  • melloyello

    Posts: 149

    Aug 10, 2012 9:18 AM GMT
    So I'm going to get a physical and a CBC later next week. I understand a CBC, but also what other tests should I get added to the panel?

    For years I have been asking my primary to test my testasterone, as I generally am sort of tired most of the time and even when I was younger, sex was never a priority. I remember asking him when I was like 20 why I wasn't a horndog like half my friends and he asked me if it got hard in the morning and I said yes and he said "Well then you're fine."

    The last CBC I had was about 2 years ago and showed slightly elevated blood pressure and cholesterol. My father has ridiculously high cholesterol and has been on Lipitor since it came out. He also has low test and uses Androgel.

    So what else should I add to the panel besides those? Thanks!
  • TampaENFJ

    Posts: 44

    Aug 10, 2012 1:12 PM GMT
    You could ask for a thyroid check if you're concerned about the low energy. This could also be caused by an anemia, which would show up on a CBC. However, a CBC won't tell you about cholesterol or blood pressure. A lipid panel would be needed for cholesterol, and you want to make sure to get them to explain the breakdown of your cholesterol as far as HDL, LDL, VLDL, triglycerides and your cardiac risk, which is I believe done as a ratio. As for blood pressure, well that's usually done by the nurse/medical assistant while you're waiting around. A complete metabolic panel will probably also be done, it's pretty standard and will tell you about your electrolyte levels, kidney and liver function, blood glucose to check for signs of diabetes.

    That's pretty much it for lab work for a general physical. They may check for a hernia or any low back issues which could be good in someone who lifts or is very active. Beyond that, it gets into EKG and treadmill stress test which are more expensive and more targeted at folks who have more risk factors or symptoms. And for those of us in Florida/sunny places, a thorough skin cancer screening.

    Hope that helps.
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    Aug 10, 2012 5:38 PM GMT
    Since I recently have gone through this and I can advise you as well that I was having symptoms of: lack of energy, irritability, lack of libido, propensity to just sleep, etc. I was placed on Testosterone regimen...ask them to check your Free Testosterone, not just your Total Testosterone. Free Testosterone is usually the most important number.
    Also a side effect of Testosterone regimen is that your Cholesterol level could spike therefore ensure you continue exercising as well as maintaining a healthy diet and that your doctor is checking regularly your levels.


    Tampa ENJF is correct on those test as well the thyroid and pituitary glands should be done as well to rule out anything wrong, but also ask for

    (1) Estrogen levels to be checked - yes men do produce Estrogen - in Men, the production of Testosterone later converts some amount into Estradiol (Estrogen) which you need. If the amount is too low which is usually a signal that testosterone is not being produced as well. It can cause havoc in your endocrine system.

    Therefore ensure, they are testing for Pregnenolone, and DHEA to see how your levels are and if they are low, then they will place you with Estrogen medication to bring the levels to normal. You might need to fight for these test to be done, since some doctors and insurance will not want to order these exams, but it can easily be requested within the CBC draw, for an additional aliquot of blood to be taken to produce these results.

    If your primary doctor is not giving you the care you need, drop him and go to a doctor that will listen to you. I had to fight several rounds until I found a specialist that would listen to me that I was not going nuts about my symptoms and the notion that it was just the aging process...BULLSHIT! Best of luck man.
  • TampaENFJ

    Posts: 44

    Aug 10, 2012 9:11 PM GMT
    If you're seeing a primary, those might be beyond their comfort level, and you may need to see someone with focus on men's health, which is rare, or more likely an endocrinologist. Too often they look at you(probably like the others who dismissed your T concern), and say, Oh, you're young and healthy, you're fine.

    It might also be good to consider looking for a health coach or a naturopath. I'm all for labwork and that, but a more holistic person will probably take the time to delve more deeply into when, where and why you're having these issues. When you hear hoofbeats, think horses, not zebras.

    It might be as simple as hydration, caffeine issues, or vitamins, or blood sugar fluctuations related to your schedule, workout schedule and diet. While technically "more educated," a regular MD/DO (unfortunately) isn't going to (usually) spend time considering these. They're looking for big problems, not fine-tuning your lifestyle. They only want to spend 3-15 minutes with a patient.
  • musclmed

    Posts: 3274

    Aug 11, 2012 2:52 AM GMT
    melloyello saidSo I'm going to get a physical and a CBC later next week. I understand a CBC, but also what other tests should I get added to the panel?

    For years I have been asking my primary to test my testasterone, as I generally am sort of tired most of the time and even when I was younger, sex was never a priority. I remember asking him when I was like 20 why I wasn't a horndog like half my friends and he asked me if it got hard in the morning and I said yes and he said "Well then you're fine."

    The last CBC I had was about 2 years ago and showed slightly elevated blood pressure and cholesterol. My father has ridiculously high cholesterol and has been on Lipitor since it came out. He also has low test and uses Androgel.

    So what else should I add to the panel besides those? Thanks!


    CBC is a complete blood count. It test Red and white blood cells and platelet count.

    It is not a "full panel"

    Fatigue has so many factors. So best to ask your MD which blood tests are the most important.
    Also find out your insurance covers them.


    CBC, BMP, LFT's
    TSH T4 level,

    Urinalysis
    Lipid Panel
    Testosterone Free and Bioavailable, and DHT if you take Propecia