The Gaintrust Mikey Panel

The 48-marker intake panel built with Gaintrust's Mikey for his clients, covering hormones, thyroid, heart, metabolism, digestion and nutrients.

This is the panel built with Gaintrust's Mikey for the people he coaches, and it is broad on purpose, because the first job of coaching is finding the thing holding a client back that no amount of training will fix. The hormone section runs the full axis, testosterone with free testosterone and SHBG, DHT, estradiol by the sensitive LC/MS method, the pituitary hormones, DHEA sulfate, morning cortisol and IGF-1. Thyroid goes past TSH to total and free T3 and T4, reverse T3 and the antibodies, which is how conversion problems and the slowdown from long dieting get caught. The cardiac section adds lipoprotein(a), fibrinogen, homocysteine and TMAO to the lipid panel, ApoB and CRP. Metabolism gets A1c, fasting insulin, C-peptide and leptin, which together show insulin resistance and whether appetite signaling has broken down after a long cut. Gastrin, amylase and lipase cover digestion, and PTH with cystatin C covers bone and kidney under a high protein intake. Nutrients are measured where they live, magnesium, zinc and copper inside red blood cells, with methylmalonic acid as the functional B12 check and a full iron panel. A few markers differ by laboratory, and the included-tests list shows exactly what runs at yours. Expect more tubes than usual, and fast for nine to twelve hours.

Blood is drawn at a Quest Diagnostics, Labcorp or BioReference patient service center. Price by laboratory: Quest Diagnostics $1,099, Labcorp $1,099 or BioReference $1,099. Your price depends on your state and the laboratories near you. Enter your ZIP code to see them.

What’s included

• Testosterone, total and free, with SHBG (standard): Total testosterone, sex hormone-binding globulin (SHBG) and albumin, the proteins that carry testosterone in the blood, and free testosterone calculated from them.
• Dihydrotestosterone (DHT): Dihydrotestosterone, a hormone made from testosterone.
• Progesterone: Progesterone, a hormone made mainly by the ovaries, with smaller amounts from the adrenal glands.
• Prolactin: Prolactin, a hormone made by the pituitary gland.
• LH: Luteinizing hormone, a pituitary hormone that signals the ovaries or testes.
• FSH: Follicle-stimulating hormone, a pituitary hormone that signals the ovaries or testes.
• DHEA sulfate: DHEA sulfate, a hormone made mainly by the adrenal glands.
• Insulin-like growth factor 1 (IGF-1): Insulin-like growth factor 1, a hormone made mainly by the liver.
• Cortisol, morning: Cortisol, a hormone made by the adrenal glands, in a sample drawn between 7 and 9 a.m.
• PSA, total: Total prostate-specific antigen, a protein made by the prostate.
• Thyroid panel with TSH: Total thyroxine (T4), the main hormone the thyroid releases; T3 uptake, an indirect measure of the open binding sites on the proteins that carry thyroid hormone in the blood; a free T4 index calculated from the two; and thyroid-stimulating hormone (TSH).
• Total T3: Total triiodothyronine, both the protein-bound and free forms.
• Free T4: Free (unbound) thyroxine, the main hormone the thyroid releases.
• Free T3: Free (unbound) triiodothyronine, the active form of thyroid hormone.
• Reverse T3: Reverse T3, an inactive form of triiodothyronine, measured by mass spectrometry.
• TPO antibodies: Antibodies to thyroid peroxidase, an enzyme in the thyroid gland.
• Thyroxine-binding globulin (TBG): Thyroxine-binding globulin (TBG), the main protein that carries thyroid hormone in the blood.
• Lipid panel: Total cholesterol, HDL cholesterol and triglycerides, with calculated LDL cholesterol, non-HDL cholesterol and the cholesterol-to-HDL ratio.
• Apolipoprotein B (ApoB): Apolipoprotein B, the main protein on LDL and other cholesterol-carrying particles.
• Lipoprotein(a): Lipoprotein(a), an LDL-like cholesterol-carrying particle that a standard lipid panel does not report.
• C-reactive protein, high-sensitivity (hs-CRP): C-reactive protein, a protein the liver releases during inflammation, measured with a high-sensitivity method.
• Fibrinogen: Fibrinogen, a protein made by the liver that helps blood clot, measured by its clotting activity (the Clauss method).
• Homocysteine: Homocysteine, an amino acid the body processes using vitamin B12, folate and vitamin B6.
• Trimethylamine N-oxide (TMAO): Trimethylamine N-oxide (TMAO), a compound the liver makes from substances gut bacteria release from foods such as red meat and eggs.
• Hemoglobin A1c: The percentage of hemoglobin with glucose attached, which reflects average blood sugar over about the past three months.
• Insulin: Insulin, the hormone that signals cells to take up glucose from the blood.
• C-Peptide: C-peptide, a small protein fragment the pancreas releases in equal amounts with insulin.
• Leptin: Leptin, a hormone made by fat cells that helps regulate appetite and energy balance.
• Gastrin: Gastrin, a hormone made in the stomach that signals it to release acid.
• Amylase: Amylase, an enzyme that helps digest starch, made mainly by the pancreas and salivary glands.
• Lipase: Lipase, an enzyme that helps digest fat, made mainly by the pancreas.
• Complete blood count (CBC): Red cells, white cells with a breakdown by type, and platelets, plus hemoglobin, hematocrit and red-cell size.
• Comprehensive metabolic panel (CMP): Glucose, sodium, potassium, chloride, carbon dioxide, calcium, the kidney tests BUN, creatinine and eGFR, total protein, albumin, bilirubin and the liver enzymes ALP, ALT and AST.
• Gamma-glutamyl transferase (GGT): Gamma-glutamyl transferase, an enzyme found mostly in the liver and bile ducts.
• Cystatin C with eGFR: Cystatin C, a protein filtered by the kidneys, with an estimated filtration rate (eGFR) calculated from it.
• Parathyroid hormone (PTH): Intact parathyroid hormone (PTH), a hormone made by the parathyroid glands that helps control blood calcium, without a calcium level.
• Creatine kinase (CK) with isoenzymes: Creatine kinase (CK), an enzyme found mainly in skeletal muscle, heart muscle and the brain, with a breakdown into its forms (CK-MM, CK-MB and CK-BB), which those tissues make in different proportions.
• Lactate Dehydrogenase (LD) Isoenzyme Panel: Total lactate dehydrogenase (LD), an enzyme found in most of the body's tissues, with a breakdown into its five forms (LD1 to LD5), which different tissues make in different proportions.
• Vitamin D (25-hydroxy): 25-hydroxyvitamin D, the main form of vitamin D circulating in the blood.
• Vitamin B12 and folate: Vitamin B12; serum folate
• Methylmalonic Acid: Methylmalonic acid, a byproduct of protein and fat breakdown, formed from a compound the body processes using vitamin B12.
• Iron and TIBC: Iron; total iron-binding capacity; calculated iron saturation
• Ferritin: Ferritin, the body's iron-storage protein.
• Magnesium, red blood cells: Magnesium inside red blood cells.
• Zinc, red blood cells: Zinc, an essential mineral, inside red blood cells.
• Copper: Copper, a trace mineral, most of which is carried in the blood by a protein called ceruloplasmin.
• Copper, red blood cells: Copper, a trace mineral, inside red blood cells.
• Estradiol, sensitive (LC/MS): Estradiol measured by liquid chromatography with mass spectrometry (LC/MS), a method designed for low levels.

Before your draw

Fasting required.

Fast for 9 to 12 hours before your draw; water is fine. The insulin, C-peptide and gastrin tests need a fasting sample, and the lipid panel is best done fasting. If you are on testosterone therapy, test when your clinician tells you to relative to your dose. If they have not said, or you are not on therapy, book a morning appointment, ideally before 10 a.m., for the testosterone and cortisol tests. Skip hard training, especially heavy lifting, for at least 48 hours before your draw, since exercise raises creatine kinase. Note if you take creatine. If you have an infection or are unwell, consider rescheduling your draw. If you take insulin or other diabetes medicine, ask your clinician how to take it while you fast. Don't stop your usual medicines unless your clinician tells you to. If you take biotin (vitamin B7), including in hair, skin and nail supplements or multivitamins, have your blood drawn at least 8 hours after a usual dose, or at least 72 hours after a high dose. If biotin was prescribed, ask your clinician before stopping it.