Labs can be a source of stress. Here’s some answers to our patients’ most common questions about getting lab work:
Should I get labs done before my first medical visit with you?
We won’t order any labs before we talk to you, so you won’t need to get any done before your first medical visit.
If you’ve had labs done in the previous six months, we’d love to see those results! You can upload a print out or screenshot of your lab results in your patient portal on the Documents tab.
Do I have to get labs done? I hate needles!
We practice informed consent. If you have concerns about getting labs done, we’ll talk about all the reasons why we order them and the risks and benefits of getting them done (or not.) We recommend against bicalutamide without baseline liver testing due to the risk of death from liver failure associated with the medication. We currently believe bicalutamide to be too high risk for use without baseline and monitoring labs.
Check out: Tips for less painful injections!
Where do I get my labs done?
We recommend getting your labs done at Quest Diagnostics.
What if there is no Quest Diagnostics nearby or I want to go somewhere else?
- You can go to any lab you like. It’s important to know:
- We have no contracted pricing with any labs besides Quest – so if there are any issues with your bill at alternative facilities, we can’t help. We also can’t predict the cost at outside facilities.
- We will upload a copy of your lab orders to the portal for you to use anywhere, and you will be responsible for having a copy of your results available at your appointment. If you don’t have a copy uploaded to the portal or that you can screenshare with us at your appointment, you will be charged a late cancellation fee and reschedule.
- You can upload a copy or image of your lab results at the bottom of the “Documents” tab in your secure patient portal.
Why Quest?
- Quest gave us better pricing than LabCorp and we pass the savings on to you!
- There are a lot of Quests out there, so there may be one close to you.
- Quest accepts insurance.
- If you can’t use insurance for any reason, we have clinic billing at Quest and can get you reduced rates on labs.
- You make an appointment with Quest for your draw.
- We’ll send your orders to Quest and they’ll send your results to us: you don’t have to carry around lab orders!
When should I get labs done?
It can take up to a week (or longer!) for tests to be completed. If we’ve ordered labs, we want to see your results at least 24 hours prior to your appointment, so we recommend that you get your blood drawn for labs a week to two weeks prior to your appointment with us. We don’t want them too close to your last appointment because we do want to see the effect of any medication changes! They are usually available about a month before your appointment, and we send you an email reminder about three weeks before your appointment.
Also, it is important that you haven’t missed any doses of your gender care meds the week of your labs. If you have missed doses, we would like you to reschedule the labs and possibly your appointment. Labs are checking levels of hormones, so we need to know how your body is responding to expected doses.
How much do labs cost?
Cost can vary a lot. If you have insurance, check with your insurance provider for cost estimates.
We estimate that a new patient lab panel done at Quest using clinic billing will cost around $55-95 for an adult (in 2024). Quests seems to raise prices annually and they are subject to change without notice. Costs may be less if we order fewer labs. We’ll discuss which labs we’re interested in and can provide a cost estimate at your initial medical appointment.
Check out: Top Nine Labs
(Note – these are for adults. We often order different labs for adolescents.)
How often will I need to get labs done?
In your first year of care, you may need to get labs done three or four times:
- After your initial medical appointment.
- Before your follow-up appointments (every three months for about the first year.)
How do I optimize my chances of getting valid results?
For individuals using injected hormones:
- Blood levels of hormones rise and fall. These changes can be big. For folx who inject their hormones, your levels will be highest just after your dose, and lowest just before your next dose. We don’t need you to get your labs done in the exact middle of your schedule, but it is very helpful for us to know when your last injection was before your labs.
For individuals using hormones or any other products that may be on the skin around the lab draw site (injections, gels, creams, patches):
- Wash that blood draw site! Any hormones on the skin at the site of the blood draw can mess up your results and come back very high.
- Vary your application site! Near your lab date, choose one away from where you expect your blood to be drawn. Shower before your labs, and use clean towels and clothing – don’t rewear an outfit that may have already come in contact with hormones on your skin.
Are there any supplements or products that can affect my lab results?
Biotin!
Many people take biotin to promote hair growth. Biotin interferes with estradiol testing. So if you’re taking it, please let us know. We recommend stopping biotin use 72 hours before getting labs done.
Biotin is a form of VITAMIN B (it’s B7) – so we’ll also want to know if you’re using vitamin B supplements or enjoying food or drink products that have high levels of B7.
What contains biotin?
- Supplements that are labeled “Biotin,” “B-complex,” or “B7.” Also pay attention to “hair growth” products.
- Energy drinks – check the label. Many have added B vitamins, but not all have biotin.
- Nutritional yeast! Do you love some nooch? It’s a great source of B vitamins. Two tablespoons of nutritional yeast contain about 70% of your daily recommended intake of biotin. If you’re eating nutritional yeast frequently, let us know.
- Cosmetics and skin care products. Check EWG.org for a list of products that contain biotin and some of the ingredients on labels that mean biotin. These are less likely to have enough biotin to change your estradiol blood levels, but if we can’t figure out why your labs are high, these might be the reason. Biotin is often an ingredient in hair care products as well as skin care products.
Gonna say it again: if you’re taking biotin, let us know.
Lavender and Tea Tree Oil!
Lavender and tea tree oils may have estrogenic and antiandrogenic effects. If your estrogen levels are higher than expected, do you use lavender or tea tree essential oils, or products containing them?
Other Chemicals That May Impact Hormones
Many chemicals may alter the body’s hormonal balance. They may not be strong enough to change how we prescribe, but if you are concerned about possible exposures, here’s a quick guide to avoiding endocrine disrupting chemicals (those which could affect your hormones) in toiletries, cosmetics, and menstrual products.
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