Most men receive a page of numbers with a few asterisks and very little explanation. This guide walks through the panels that are ordered most often, what each marker is actually measuring, and how clinicians read them together rather than one at a time.
The complete blood count (CBC)
The CBC counts red cells, white cells and platelets. It is used to detect anaemia, signs of infection or inflammation, and problems with clotting.
Haemoglobin and haematocrit are worth knowing for a second reason: both can rise on testosterone therapy, which is why they are monitored during treatment.
The metabolic panel
A comprehensive metabolic panel covers kidney function (creatinine and eGFR), liver enzymes (ALT, AST), electrolytes, and fasting glucose.
Mildly elevated liver enzymes in men over 40 are frequently related to fatty liver associated with excess visceral fat or alcohol intake, rather than a primary liver disease, but they should still be interpreted by a clinician rather than dismissed.
Lipids, and why LDL is not the whole picture
The standard lipid panel reports total cholesterol, LDL cholesterol, HDL cholesterol and triglycerides. LDL is the primary treatment target because lowering it lowers cardiovascular events.
Two additional markers are increasingly discussed. Apolipoprotein B (ApoB) counts the actual number of atherogenic particles, which can be high even when LDL looks acceptable. Lipoprotein(a) is largely genetic, is measured once in a lifetime for most people, and identifies men with inherited elevated risk.
Glucose control: fasting glucose, HbA1c and insulin
Fasting glucose is a single moment. HbA1c estimates average blood sugar over roughly three months. Fasting insulin, when measured, can reveal that the body is working harder to keep glucose normal, an early stage that a glucose reading alone can miss.
Hormones and thyroid
Total testosterone is measured on a morning sample, and confirmed with a second morning sample before anything is concluded. Free testosterone and SHBG add context, because SHBG changes with age, weight and liver health.
TSH screens thyroid function. Symptoms attributed to low testosterone (fatigue, low mood, weight change) overlap heavily with thyroid dysfunction, anaemia, depression and sleep apnea, which is why a full picture matters.
Reading the results properly
Reference ranges describe a population, not your optimum. A value just outside the range is not automatically a diagnosis, and a value inside the range is not automatically fine if it has moved sharply from your own baseline.
Trend, symptoms and combinations carry more meaning than any single flagged line. That is precisely how a longitudinal picture (the same markers, tracked over years) becomes more valuable than a one-off panel.
Key takeaways
- The core panels are CBC, metabolic panel, lipids and glucose markers.
- ApoB and Lp(a) can reveal risk that a normal LDL result hides.
- HbA1c shows a three-month average; fasting glucose shows one moment.
- Testosterone requires two morning samples plus context from SHBG and TSH.
- Reference ranges are population statistics: your own trend matters more.
References
- American College of Cardiology / American Heart Association. Guideline on the Management of Blood Cholesterol
- American Diabetes Association. Standards of Care in Diabetes: Classification and Diagnosis
- Endocrine Society. Testosterone Therapy in Men With Hypogonadism: Clinical Practice Guideline
How this article is reviewed
Aldrick articles are written from published guidance and peer-reviewed research, checked against our evidence standards and re-reviewed when guidance changes. Spotted something inaccurate or out of date? Tell us and we will correct it and update the review date.
This article is educational. It does not diagnose conditions or replace evaluation by a qualified clinician.