A baseline test before beginning HRT is nice, but not necessary.
All tests after beginning HRT should be conducted at ’trough levels’, meaning as close as possible to the time before you take your next dose. Any biotin supplements should be paused 48 hours before conducting your tests.
After beginning, a test is recommended 3 months into HRT. You will have reached stable levels for your regimen by this point, and this will give you a good idea of whether you need to change some parts of it. If you are on EEn injectables and don’t have any budgetary concerns, you may have a test at 1.5 months after beginning if so desired.
After this point, tests are recommended every 3 months. Once you have reached 1 year on your regimen, these may be moved to every 6 months.
If the regimen is changed at any point following the first test, tests may be conducted 1.5 to 2 months after the change to check the efficacy of the new regimen.
At minimum, you require testing Estradiol (E2) and Total Testosterone (T). Progesterone should be measured if added to the regimen.
If HRT is taken orally and you have a family history of bad livers, Liver Function Tests (LFTs) should be conducted to watch for liver toxicity. If Bicalutamide is taken, LFTs are mandatory for the first 6 months. They may be eased off and conducted less frequently after this period, as as all case reports of liver toxicity with Bica occur between 3 to 6 months.
If Spironolactone is taken and you have Hyperkalemia (high potassium levels) risk factors, such as older age or bad kidneys in the family, potassium levels should be monitored.
If budget is not a concern, occasional Luteinizing Hormone (LH), Follicle-Stimulating Hormone (FSH), and Sex Hormone-Binding Globulin (SHBG) can also be measured to provide further information although they are not necessary by any means.
Dihydrotestosterone (DHT) is also a useful measure if worried about male pattern baldness, but not necessary. Testing DHT is recommended, however, in the first test after adding Progesterone to your regimen. This is because it can, in very rare cases, turn into DHT in some people.
At minimum, you require testing Estradiol (E2) and Total Testosterone (T). Further details on Trans Masculine blood tests are a work in progress.
Any sample collection laboratory or well-equipped hospital should work. Below are some examples of such places in major cities. Some of these, such as Chughtai Labs, IDC, and Shaukat Khanum, will be found in basically every city. Use Google Maps or check their respective websites.
Keep in mind that this list is by no means exhaustive, and there are bound to be more options. Prices are only included for E2 and T — others can be looked up on either their websites or by contacting them (email/phone).