Why doesn't my GP just order all the markers?

Public-payer panels are constrained by reimbursement codes and turnaround pressure. Specialists order the full set; GPs are often gate-kept by the system, not by skill or willingness.

Are at-home assays as accurate as venous draws?

For the markers in a fertility panel — total + free testosterone, FSH, LH, SHBG, prolactin, estradiol — finger-prick assays processed in ISO 15189 labs correlate closely with venous draws when properly stabilised. Sample timing matters more than collection method.

Should I share my at-home result with my GP?

Yes. A printable PDF is easier to discuss in twelve minutes than a vague concern. Most GPs welcome a numbered baseline; a small minority will dismiss it. Either reaction is data.

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DiagnosticsHealthcareHormonesPractical

What your GP actually measures — and what they almost always skip

If you ask a GP for a fertility-relevant blood panel, you'll usually walk out with one or two numbers, sometimes none. Here is what a typical primary-care order looks like, and why it tends to under-deliver.

Niko Hems

Co-founder, FutureKit · MSc Longevity Science

Published 2026-04-27

KEY TAKEAWAYS

What to remember before reading on.

1
A typical primary-care 'low T workup' often consists of a single total testosterone draw — sometimes nothing fertility-related at all.
2
FSH, LH, SHBG, prolactin and estradiol are the markers that turn a number into a diagnosis. They are routinely skipped in GP panels.
3
Cost and time pressure, not malpractice, drive most of these gaps. A GP visit is twelve minutes; a hormone work-up is a different conversation.
4
If you want a complete picture, ask for it explicitly — or run an at-home panel that includes all six markers by default.

I'm not a clinician. I'm a co-founder writing from the side of the table where you, the reader, are sitting — the one trying to make sense of what tests to ask for and why you're not getting the answer you expected. What follows is my read of the standard pathway, drawn from how it has played out for friends, founders, and customers I've spoken with. Take it as a map, not medical advice.

The standard primary-care pathway

If you walk into a GP office in Germany, the UK, or most of continental Europe and say "I think my testosterone might be low," the most common workup looks like one of three things:

Reassurance. "You're 33. Eat well, sleep more. Come back in six months."
A single total testosterone draw. No SHBG. No FSH. No LH. The result either lands above the reference cutoff (no further action) or below (a referral to an endocrinologist, which can take three to six months).
A focused panel. Total testosterone, sometimes SHBG. Occasionally LH and FSH if the GP is fertility-aware. Rarely all six markers in one go.

None of these are failures of the doctor. They're consequences of a system where a primary-care visit is twelve minutes, the reimbursement code for "fertility workup" doesn't exist in most public schemes, and a "complete" hormone panel needs a separate referral.

But all of them tend to under-deliver against what you actually want to know.

What gets skipped, and why it matters

Three markers, in particular, tend to be missing from a typical GP panel. Each one changes the answer.

SHBG. Without SHBG, your free testosterone is uncalculable. Two men with identical total-T can have very different bioavailable fractions. SHBG is a cheap test; its absence is the single biggest "your normal-looking number is misleading" trap.

FSH and LH. These tell you whether the brain is signalling correctly. A low total testosterone with high LH is a different problem — and a different decision — from a low total testosterone with low LH. A panel without these two markers can't distinguish between primary and secondary hypogonadism. That distinction is often the difference between "TRT" and "find the upstream cause."

Estradiol. Often missed because it's framed as a "female hormone." It's not — it's downstream of testosterone via aromatase, and it's a major driver of libido, mood, bone density and the feedback loop. Estradiol is the marker most often missing from a self-described "men's health" panel.

If you want a self-test for whether your panel is complete: count the markers. Six is the floor for a fertility-relevant readout.

What I'd ask for, walking into a GP today

If I were trying to use the public system to get a useful baseline:

Be specific. "I'd like a complete male hormone panel: total + free testosterone, SHBG, FSH, LH, prolactin, estradiol. Drawn before 10 am. Fasted." Writing this down before the visit is the difference between getting four markers and getting six.
Ask for the printout. You want the actual numbers, not a pass/fail summary. The same value can be normal in one assay and borderline-low in another; you need to be able to look it up.
Don't wait six months for normal symptoms. If you're already taking the time to see a GP about this, take the panel seriously. A twelve-month "watch and wait" is appropriate for some questions and not others.

If the GP can't or won't order the full set, the next-best move is an at-home panel that includes all six markers by default. The cost difference is usually small — and the markers are the same markers a private specialist would order.

What we built, and why

The FutureKit Hormone Panel 01 was designed to fix exactly this gap. Six markers, one finger-prick sample, processed in an ISO 15189-accredited German lab, results read by a physician within 3–5 working days.

I'm not pretending this is a substitute for an endocrinologist when one is needed. It isn't, and we say so on every page that says so. But for the question most men actually have — what's my baseline, and is anything obviously wrong? — the panel answers it without the gatekeeping.

If you've already had a GP visit and walked out with a single number, you've already discovered the gap. The question now is what to do about it.

Sources cited: ESHRE guideline group (workup of male and couple infertility) — full entry on /science.

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