Hormone levels may be drawn and evaluated before therapy is started. This may include an FSH, estradiol, and testosterone (free and total) for women. Men need a PSA (prostate specific antigen), estradiol, testosterone, and blood count prior to starting therapy. Thyroid hormone levels (TSH) may also be evaluated. In men, follow up levels, including a PSA, blood count and estradiol, may be obtained prior to some of the subsequent testosterone implantation. Men are encouraged to notify their primary care physician and obtain a digital rectal exam each year. Women are advised to continue their monthly self-breast exam and obtain a mammogram and/or pap smear as advised by their gynecologist or primary care physician.
Using appropriate tests for monitoring hormone therapy is crucial in establishing the appropriate dosing regimen. This reduces the chance of undesirable side effects and maximizes beneficial effects. For example, excessive use of androgens (testosterone, androstenedione, DHEA, and testosterone derivatives) can activate subclinical prostate tumors which are androgen-dependent. Monitoring is especially important in older males. By the age of 70, at least 50% of men have subclinical prostate cancer. These men are especially susceptible to prostate growth stimulation by androgens.
In autoimmune gastritis , the immune system attacks the parietal cells leading to hypochlorhydria (low stomach acid secretion). This results in an elevated gastrin level in an attempt to compensate for increased pH in the stomach. Eventually, all the parietal cells are lost and achlorhydria results leading to a loss of negative feedback on gastrin secretion. Plasma gastrin concentration is elevated in virtually all individuals with mucolipidosis type IV (mean 1507 pg/mL; range 400-4100 pg/mL) (normal 0-200 pg/mL) secondary to a constitutive achlorhydria. This finding facilitates the diagnosis of patients with this neurogenetic disorder.  Additionally, elevated gastrin levels may be present in chronic gastritis resulting from H pylori infection.