Hormone Testing: What To Check And Why
Questions about hormone testing are common among my patients and on social media. Women want to know which hormones they need to check and why. They also want to know what hormones and other biomarkers can be tested at home. In this video and accompanying article, I cover the biomarkers that I check for myself and my patients approximately once per quarter. Note that not all biomarkers I discuss below have been validated for blood spot testing versus the gold standard of a blood draw for serum testing, which is what I use for treatment decisions. Still, one can infer trends and screen for problems to investigate further. My highest recommendation is to perform serum testing for all treatment decisions, though that may be difficult during quarantine and lockdown. I created this video to show the blood spot test that I am performing in lockdown, even with the caveat that it is not considered the gold standard for all tests mentioned in this article.
What Is A Hormone Imbalance
The symptoms of a hormone imbalance are wide-ranging and can occur at any age, so if youve noticed changes to your blood pressure, menstrual cycle, sleep, weight, mood or general health, or if it feels like something is out of whack or you simply dont feel right, its worth talking through your concerns with a doctor.
If you suspect you have a hormone imbalance here are some of the signs to look out for, and what to expect from a diagnosis and treatment.
Hormones are produced by endocrine glands around the body. These glands include the pineal and pituitary , thyroid , adrenals , pancreas , and the ovaries. Hormones have an impact on multiple aspects of bodily function and play a part in amongst others growth, hunger, weight and reproduction, as well as moods and our ability to cope with stress.
While women can expect hormonal fluctuations throughout their lives periods, pregnancy and menopause are three prime examples a hormone imbalance occurs when the endocrine glands stop working properly, or when theres too little or too much of one or more hormones. The consequences can range from irritating, to distressing, to life-threatening.
Dr. Nyjon Eccles, a leading Integrated Medicine Physician and expert in natural medicine, runs The Natural Doctor Clinic in London.
What Are The Different Types Of Hormones
Endocrine glands are located throughout the body. These glands include the:
- Hypothalamus: controls thirst, hunger, sleep, sex drive, moods, body temperature, and the release of other hormones
- Parathyroid: controls calcium
- Ovaries, in women: controls female sex hormones
- Testes, in men: controls male sex hormones
There are several different types of hormones in the body. When you have a hormonal imbalance, you may have a problem in one of more of these glands. The specific hormone that’s imbalanced will determine the signs and symptoms that you experience as a result. Some of the major hormones found in the body include:
- Estrogen: controls sex drive in both men and women, and regulates the menstrual cycle in women
- Progesterone: influences the body’s changes through pregnancy
- Testosterone: controls sex drive in both men and women
- Cortisol: controls stress
- Melatonin: control’s the body’s circadian rhythm and sleep cycles
- Serotonin: controls sleep cycles, appetite, and mood
- Growth hormone: controls the reproduction of cells and their subsequent growth
- Leptin: controls appetite, signaling when you’re full
- Ghrelin: controls appetite, signaling when you’re hungry
- Insulin: responds to sugar in the bloodstream
If your hormones are well-balanced, you will thrive. An imbalance, however, is something you cannot afford to ignore.
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Which Test Should I Choose
i-screen offers a number of hormone tests, and it can be confusing to decide which test is right for you.
- If you believe you have a sex hormone imbalance, then i-screens Female Hormone Check can verify this
- If you think your thyroid may be to blame, then a Thyroid Check or Advanced Thyroid Check is a good place to start
- Or if cortisol could be the problem, then i-screens Adrenal Fatigue Check can provide further insight
If your blood tests or saliva tests do reveal that you have a hormone imbalance, then our team of qualified doctors can recommend how you can take steps to improve your health and wellbeing.
If you need further guidance on which test is right for you, then contact us and one of our medical professionals will be in touch to work through your symptoms.
The Best Way To Test Thyroid Function
The standard thyroid test, done by your doctor, usually only includes Thyroid Stimulating Hormone , and if that is in the normal range then you are told that your thyroid is fine. But TSH is only the message from the brain to the thyroid, so the TSH test is not actually testing thyroid function, and while the TSH levels are important, if you have the symptoms of low thyroid function then it is important to get a comprehensive thyroid test.
Also, the reference range for TSH is very broad which is what most doctors look at, but the optimal range is between 0.5 and 2.5, or even less than 2.
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Is Blood Testing The Best Way To Check Your Hormones
In todays blog, were going to go through what blood testing is good for, what its not good for and how you can use the results to help you cure your hormonal acne.
Blood testing is great to pinpoint a few different things.
The number one thing is pathology. Thats diseases. Its when things have gone seriously wrong in your body or you have a major hormone imbalance. Blood testing is great for picking these things up.
Blood testing is also great for identifying nutritional deficiencies. Things like vitamin and mineral deficiencies, which well look at some results in a minute and see what they look like.
But when we think about hormonal acne and PCOS though, blood testing is only going to pick up hormone imbalances if theres a big problem. But, the one area blood testing is always good for it is when we want to look at baseline hormone levels.
In women, this is at the beginning of your menstrual cycle . This is when its good to use a blood test because you can get your baseline hormonal values and see if theres any significant dysfunction there.
At baseline, the hormones you want to look at are FSH, LH, Estradiol and Progesterone . At the beginning of your cycle, the progesterones always going to be low, which is why you see it quite a low in the above results. This is because progesterone doesnt come up until after you ovulate. So early in your cycle ovulation hasnt occurred yet so it will naturally be low.
Androgen Excess And Hormone Imbalance
There are other forms of hormone imbalance too like those that arises from excess androgens in PCOS. Usually you can check these hormones when you check the others. You would not want to check when you are menstruating because the production of these hormones is going to be lowest at this time. These hormone levels may be much higher later on in the cycle. Specifically the hormones that are important to look at and understand how they are funneling through the body are dhea, dhea sulfate, total and free testosterone, sometimes dihydrotestosterone and definitely hydroxy-progesterone.
Keep in mind not all insurances are going to pay for all these lab tests. In this case it may make more sense to do a urine test. These test provide a full hormone profile of all these hormones plus others. By looking at all these you can see which enzymes are up regulated and turned on and which ones are turned off based on the relative levels of the different hormones.
For example, you may do a dhea level and it looks really low but your dhea sulfate is really high. This suggests the enzyme between dhea and dhea sulfate is working relatively good and the the enzyme that breaks dhea sulfate into androstenedione is moving much slower. This is where you get the clues to understand what you need to do to fix the imbalance or create balance.
If you want a customized plan on checking and treating your hormone imbalance, click in the link below to get started.
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The Skin Health Tests
The symptoms: Acne, along with constipation and a low libido, are all signs that you might be suffering from a hormonal imbalance that topical skin products just wont touch.
The hormone: Oestradiol is a form of oestrogen produced in the ovaries.
What will it tell you? High oestradiol is linked to higher than normal levels of oestrogen, or oestrogen dominance, which upsets the normal balance of hormones and can lead to symptoms such as acne, constipation, low libido, depression, as well as an increased risk of oestrogen-driven womb and breast cancer.
Blood Tests For Hormone Levels Q& A
Here at the Marion Gluck Clinic, we place a focus on giving you the very best experience and precise, personalised care. We are often asked questions about the blood tests that are required for treatment at the clinic. We sat down with Dr Ghazala Aziz-Scott, one of our hormone doctors, to help answer your most frequently asked questions about blood tests for hormone levels and hormone balancing therapy.
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Stimulation And Suppression Hormone Testing
We use tests called stimulation and suppression tests to evaluate a hormone imbalance. We give you hormones and other substances that either start or stop your production of certain hormones. We then evaluate how your body responds.
Common types of stimulation and suppression testing include:
- Growth hormone response to glucagon: We inject a hormone, glucagon, into muscle tissue and measure growth hormone levels over four hours. This test helps us confirm or rule out adult growth hormone deficiency.
- Cortisol response to cosyntropin: We give you cosyntropin, which acts like ACTH . ACTH is a hormone produced in the pituitary gland that stimulates the adrenal glands to produce cortisol. We measure cortisol levels every 30 minutes for one hour. This test helps us confirm adrenal insufficiency.
- Glucose tolerance test: We give you a sweet drink, which should lower levels of growth hormone. We measure levels of growth hormone in the blood every two hours. This test helps us confirm acromegaly.
- Cortisol response to dexamethasone: You take a pill at night that should block cortisol production. The next day we take a blood sample to measure cortisol levels. This test helps us confirm or rule out Cushing’s syndrome.
- Metyrapone suppression test: You take a pill at night that should block cortisol production. The next day we take a blood sample to measure cortisol and ACTH levels. This test helps us confirm or rule out adrenal insufficiency.
Where Should I Get A Hormone Balance Test
Hormone balance tests can be performed in a variety of settings. Many people first get their hormones tested by their primary care doctor or gynecologist. Others prefer to go straight to a lab facility. While both of these methods can garner accurate results, we recommend getting your hormones tested by a hormone health specialist. These practitioners will have the training and experience necessary to determine which tests are right for you and are experts at both interpreting your results and providing treatment.
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How To Get Your Hormones Tested And What To Do Next
Last updated on by Alisa Vitti
So, youve been feeling less than great lately maybe the first sign was irregular or heavy and painful periods, or maybe it was some weight gain and acne either way, you know something is wrong and you want to feel better. Youre thinking it might be hormone-related. What now?
Many women take a trip to their OBGYN and ask for a hormone test. This is a great first step towards treating your health issues. But the results can be confusing and concerning without a little background information and preparation. Knowledge is power! Theres no need to be mystified.
Remember: no result received is static, the diagnosis you get can and will change with the right kind of treatment.
Thyroid Testing With Urine
You can also test thyroid function using a 24-hour urine sample, this is not commonly done due to the inconvenience of collecting a 24-hour urine sample, but it is a good option for anyone who has a phobia with needles or has another reason why they cannot do a blood test.
The thyroid urine test does not measure TSH but it does measure free T4 and free T3 and the results correlate well with blood testing. Another advantage of urine testing is that you can also test selenium, iodine, and tyrosine which are the cofactors in making T4 and helping with T4 to T3 conversion.
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Estrogen Testing: How To Test Estrogen Levels At Home
Estrogen plays a major role in womens health and is one of the primary sex hormones in females. Beyond its main responsibilities of controlling the menstrual cycle and supporting pregnancy, estrogen also has a role in bone formation and managing cholesterol.
Estrogen levels that are out of whack for your particular stage in life can result in both unwanted symptoms and can be dangerous to your health long-term, making it incredibly important to keep the estrogen levels balanced and within healthy ranges.
Whether you are trying to conceive or simply maintaining good health, estrogen is a crucial hormone to track and test. In this post, we will look at how estrogen testing works, which tests you can do at home, and how to interpret the results.
Why Do I Need An Estrogen Test
You may need an estradiol test or an estrone test if you:
- Are having trouble getting pregnant
- Are a woman of childbearing age who is not having periods or having abnormal periods
- Are a girl with early or delayed puberty
- Have symptoms of menopause, including hot flashes and/or night sweats
- Have vaginal bleeding after menopause
- Are a boy with delayed puberty
- Are a man showing female characteristics, such as the growth of breasts
If you are pregnant, your health care provider may order an estriol test between the 15th and 20th week of pregnancy as part of a prenatal test called a triple screen test. It can find out if your baby is at risk for a genetic birth defect such as Down syndrome. Not all pregnant women need to get an estriol test, but it is recommended for women who have a higher risk of having a baby with a birth defect. You may be at a higher risk if you:
- Have a family history of birth defects
- Are age 35 or older
- Have a viral infection during pregnancy
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Treatment Of Womens Hormonal Imbalance
In most cases, female hormones balance can be improved or corrected with treatment. Often, changes in diet and lifestyle are sufficient to improve female hormonal imbalance and offer some protection against its potential health complications. Among the common changes recommended are:
- Weight control
- 30 minutes of exercise daily, including resistance and aerobic exercise.
- Dietary changes that include replacing processed, fatty and sugary foods with lean proteins, low-fat dairy and a wide range of fresh fruits and vegetables.
- Limit alcohol consumption
- Eliminate tobacco consumption
Female hormonal imbalance that cannot be resolved with lifestyle changes is most commonly treated with hormone replacement therapy. Conventional HRT uses hormone drugs to normalize levels of estrogens or progesterone in the system, while bioidentical hormone replacement therapy enhances hormone levels as needed with plant-derived supplements. HRT has been associated with health risks with long-term use, so women considering this treatment should discuss risks and benefits carefully with their doctors.
How Is Low Testosterone Diagnosed What Treatments Are Available
Most healthcare providers will measure their testosterone levels by having a blood test, doing a physical exam and having the patient describe his symptoms. Finally, they may order additional tests to rule out other possible diagnoses.
Testosterone is sometimes prescribed for men with low testosterone. Almost all hormone supplements and testosterone treatments are available in different forms, including lozenges, patches, gels and creams.
Because of the limited knowledge regarding this condition, challenges in having a proper diagnosis, as well as the possible side effects of treatments, HRT should not administer for men without proper testing, retesting and consultation with a healthcare provider to discuss the pros and cons. One may want to consider an endocrinologist who specializes in hormones.
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What Are The Signs And Symptoms Of Low Estrogen In Men
In men, male menopause may result from too little estrogen in addition to lower testosterone levels, at least according to some recent studies. Diminished libido, strength and energy are the main symptoms. However, testosterone levels tend not to fall as sharply in aging men as estrogen does in women who are post-menopausal. Further research is needed to determine if changes that come with aging are due to hormonal declines and if so, which hormones are the culprit.
Preparing For Hormone Testing At Cedars
We explain the tests you need and answer any questions you may have.
Here’s what to expect:
- Stop certain medications: We let you know whether to stop taking drugs such as oral steroids or estrogen supplements before your test.
- Visit one of our labs: You go to a Cedars-Sinai lab and provide a blood, urine or saliva sample. If you need stimulation or suppression testing, we let you know in advance how long you’ll need to stay.
- Collect samples at home: If we need samples over a period of time, you may be able to perform testing at home. We give you special containers for collecting saliva or urine samples and detailed instructions on how to handle them.
- Receive more than one form of hormone testing: Blood testing is one way we evaluate hormone imbalances. We may recommend additional tests, including stimulation or suppression tests, to learn more about what’s causing the imbalance.
- Undergo other forms of testing: For problems such as tumors or a possible cancer diagnosis, we use imaging to learn more about their size, location and nature.
Have Questions or Need a Second Opinion?
To make an appointment or refer a patient, call us or send a message to the Endocrinology care team.You can also have us at your convenience.
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