What Blood Tests Are Done To Check Hormone Levels

What Causes A Hormonal Imbalance

The causes of hormonal imbalances vary according to the specific hormone involved. However, in general, they are due to changes or dysfunctions of a hormone-producing gland. For instance, a thyroid gland that isn’t functioning correctly may produce too much thyroid hormone, accelerating your bodys metabolism or could produce too little. Thyroid dysfunction can be caused by autoimmune diseases, thyroid nodules, medications or, rarely, thyroid cancer, among other potential causes. Imbalances in male or female sex hormones, such as estrogen, progesterone and testosterone, can be caused by age-related changes, such as menopause and andropause, as well as genetic disorders, stress, nutritional issues, or medications. Excessive stress, poor diet, aging and certain medications can contribute to imbalances in cortisol and other adrenal hormones.

There are many different underlying causes that can result in a hormonal imbalance. Each cause relates to different glands and hormones and, does impact your body differently. Many diseases and other conditions can result in a hormonal imbalance.

Diabetes

Diabetes is characterized by an inability to properly use the insulin hormone. An insulin imbalance can lead to other related hormonal imbalances as well such as disrupting estrogen, testosterone, thyroid, progesterone, and cortisol.

Hypothyroidism or Hyperthyroidism

Congenital Adrenal Hyperplasia

Cushing Syndrome

Addison’s Disease

Turner Syndrome

Prader-Willi Syndrome

Pancreatitis

Bioavailable Testosterone With Oestrogen

Most of the testosterone attaches to two proteins: albumin and sex hormone binding globulin . Some testosterone is free, which means it is not attached to proteins. Free testosterone and albumin-bound testosterone are also referred to as bioavailable testosterone. This is the testosterone that is actually available for use.

The free testosterone can help give more information when total testosterone is low. Increased levels of testosterone can indicate polycystic ovary syndrome . This condition can cause:

• Infertility
• Blood sugar problems
• Extra hair growth, especially on the face

Testosterone levels are usually measured prior to commencing HRT treatment and the levels are checked during treatment to ensure that each woman receives the correct dose.

Oestrogen replacement is safe and effective in the treatment of menopausal symptoms and preventing osteoporosis but the combination of oestrogen and testosterone is better, particularly in those women who have had a premature menopause or have had their ovaries removed. It should also be considered in women who continue to experience symptoms of loss libido, depression, mood swings headaches and tiredness despite taking oestrogen.

Prior to any blood test request, your doctor will need to know about any medicines, herbs, vitamins, and supplements you are taking.

What Is A Hormonal Imbalance

A hormonal imbalance occurs when your hormones are not produced at the proper levels. You can have many different types of hormonal imbalances. Sometimes, the imbalance means a deficiency in the given hormone while in other times, there might be an overflow. The kind of hormone that is imbalanced will play a major role in determining how the sign and symptoms will manifest and what would be the associated risks involved.

Though there are a few common life transitions that can cause a hormonal imbalance, such as menopause or pregnancy, you can struggle with such a problem at any point in your life. Both men and women can experience hormonal imbalances. Children, adolescents, adults, and the elderly may also find their hormones out of balance.

Because hormones and their functionalities are so varied, there’s no one single way to detect a hormonal imbalance. A wide range of issues can indicate that something is amiss with your hormones. This is one of the reasons why your best bet is to get tested occasionally, especially when you start developing uncommon symptoms.

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What Tests Are Included In This Package

Luteinising hormone

Luteinising hormone plays a key role in reproduction. Mid-cycle, your LH levels increase which triggers your ovaries to release an egg ovulation. If your LH levels are too high or low you might have irregular periods and have trouble getting pregnant. High LH levels can be a sign that youre menopausal or have PCOS.

Follicle-stimulating hormone helps your ovaries to function normally and plays a key role in egg production and ovulation. Your FSH levels naturally increase as you age high levels can be a sign that you’re menopausal. If your FSH levels are too high or low you might have trouble getting pregnant.

Testosterone

Testosterone is a sex hormone that’s important for your sex drive, bone and muscle health, mood, and cognitive function. Your levels gradually drop as you age this process speeds up around perimenopause and menopause. If your levels are out of range you might feel tired, have a low sex drive, and have low mood.

SHBG

Sex hormone-binding globulin binds with certain hormones and transports them in your blood. When these hormones are bound to SHBG your body can’t use them. This helps regulate how much is available for your body to use. If your SHBG levels are too high or low it can cause affect your testosterone and oestradiol levels.

Thyroid function

A basic thyroid profile measures Thyroxine , the main hormone produced by your thyroid, and thyroid-stimulating hormone a hormone that regulates your thyroid.

Oestrogen

When Is The Best Time To Test Your Hormones

Dr. Jolene Brighten is a prominent leader in womens medicine and award winning naturopathic physician. She is an international speaker, clinical educator, medical advisor within the tech community, and considered a leading authority on womens health. Dr. Brighten is also part of the MindBodyGreen Collective and a faculty member for the American Academy of Anti Aging Medicine. Her work has been featured in the New York Post, Forbes, Cosmopolitan, Huffington Post, Bustle, The Guardian, and ABC News.

Part of this post originally appeared on the Dr. Jolene Brighten blog on August 1, 2020, and has been reposted with permission.

I get a ton of questions from women who are confused about their hormones. When youre trying to figure out why you feel so crappy every month, it can be frustrating trying to get access to the appropriate tests. It can be even more frustrating to suffer terrible symptoms and yet have no diagnosis because your bloodwork comes back normal. Part of the problem is you simply dont know when is the best time to test hormone levels. In this article, Im outlining some of the more common testing recommendations I make for women in my medical practice.

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Sexually Transmitted Disease Tests

Many sexually transmitted diseases can be diagnosed using a blood sample. These tests are often combined with urine samples or swabs of infected tissue for more accurate diagnoses.

The following STDs can be diagnosed with blood tests:

Blood tests arent always accurate right after contracting an infection. For an HIV infection, for example, you may need to wait at least a month before a blood test can detect the virus.

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What Is A Follicle

This test measures the level of follicle-stimulating hormone in your blood. FSH is made by your pituitary gland, a small gland located underneath the brain. FSH plays an important role in sexual development and functioning.

• In women, FSH helps control the menstrual cycle and stimulates the growth of eggs in the ovaries. FSH levels in women change throughout the menstrual cycle, with the highest levels happening just before an egg is released by the ovary. This is known as ovulation.
• In men, FSH helps control the production of sperm. Normally, FSH levels in men do not change very much.
• In children, FSH levels are usually low until puberty, when levels begin to rise. In girls, it helps signal the ovaries to make estrogen. In boys, it helps signal the testes to make testosterone.

Too much or too little FSH can cause a variety of problems, including infertility , menstrual difficulties in women, low sex drive in men, and early or delayed puberty in children.

Other names: follitropin, FSH, follicle-stimulating hormone: serum

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Use Your Symptoms As Your Guide

For more serious cases and symptoms, hormone testing can be very helpful. But for most women who experience the normal, if unpleasant, fluctuations of hormones during perimenopause and menopause, hormone tests are not generally needed â nor will they offer many answers. The best way to measure your hormones during perimenopause and menopause is to evaluate your symptoms. Take our quick hormonal profile to see how your symptoms rate.

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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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How To Test Your Hormones At Home

My gold standard is a blood draw for serum testing, but its hard to get a blood draw during a pandemic! There are convenient, reliable alternatives for many biomarkers. In the video, I talk about the blood spot test from ZRT Labs. I also love the dried urine test for hormone metabolism and to follow certain hormones in my patients on bioidentical hormone therapy. Occasionally I will run saliva tests but only for limited indications.

Where Can I Get Blood Work Done

There are different locations that offer laboratory services that include blood work. Most hospitals contain a laboratory that you can visit to get tests done. Some laboratories will have walk-in options. Others may require an appointment.

Additional locations for blood testing may include:

• Private laboratories. Hospitals may use private labs to offload some testing from their own laboratories, or in cases when a specialized test is needed. Often, health insurance plans will require you to use a specific laboratory that is in their network for the test to be covered.
• Point-of care. This describes situations when you may need to get a blood test wherever you are receiving medical care. In routine scenarios, this typically

Results may take anywhere from a few hours to a few days to become available. Heres an overview of how long some common tests may take:

• complete blood count : 24 hours
• basic metabolic panel: 24 hours
• complete metabolic panel: 24 to 72 hours
• lipid panel: 24 hours

Timing can depend on the specific lab where you get tested, and how many tests you get done at once. If you order multiple tests, you may not get the complete results until all of the tests are completed.

Sometimes a lab will only release results to your doctor, who reviews them and then releases them to you.

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More Information About Hormone Testing

Hormone levels change as you agesome change throughout the day. We use hormone testing to detect and evaluate hormone imbalances that may be making you sick. We often conduct hormone testing using a blood sample, but some tests require urine or saliva samples.

We frequently test levels of:

• Estrogen and testosterone
• Adrenal gland hormones, such as cortisol
• Growth hormone, prolactin and other pituitary gland hormones
• Thyroid hormones, such as thyroxine

Causes And Symptoms Of Hormonal Imbalance

When the endocrine system is functioning smoothly, its precise and timely release of hormones works to promote optimal health and function. The glands in this system assist in nearly every critical bodily function. So, if there is a problem with one or more glands, hormonal imbalance can occur, causing a variety of problems, some more serious than others. These changes can be detected by undergoing a hormone imbalance test, which is an opening door towards getting the right kind of treatment to address your hormonal imbalance symptoms.

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What Are The Most Common Endocrine Disorders

There are many different types of endocrine disorders. Many of the most common disorders relate to improper functioning of the pancreas, thyroid, adrenal and pituitary glands. In the United States, the most common endocrine disorder is diabetes. More than 29 million Americans have diabetes, but nearly one-third are unaware that they have it.

Other endocrine disorders include:

• Polycystic Ovary Syndrome

Hormone Testing For Women

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Blood Tests For Infertility

If youre a woman who is 35 years old or younger and have been unable to conceive after one year of unprotected intercourse, or after six months if youre over 35, you and your partner should have afull physical and medical evaluation with a Reproductive Endocrinologist, a doctor who specializes in infertility diagnosis and treatment.

Several blood tests are available to determine if you, your partner, or both of you have a problem that is causing infertility.

Do All Patients Need Blood Tests For Hormone Levels

Dr Aziz-Scott: Although treatment is bespoke to you, patients will follow a similar patient journey, and in the initial consultation, blood tests for hormone levels are required for all patients. In some cases, women may come to the clinic with blood tests conducted externally by their GP, or another healthcare professional.

We do see patients that have had a Dried Urine Test for Comprehensive Hormones . The DUTCH test is a urinary assessment of hormones and can provide a great deal of useful information about the different hormone systems in the body. It is very useful in assessing how estrogen is metabolised and this is a very important factor to consider once you are on BHRT as certain estrogen metabolites can be toxic and increase breast cancer risk.

Depending on a patients individual situation, we may be able to work with DUTCH test results, but serum blood hormone levels are the gold standard of testing to provide an accurate baseline. Many clinics offer finger prick tests, but we opt for serum blood tests as these are less likely to provide erroneous results and unnecessary additional costs if repeats needed. Once we begin treatment, the monitoring process is also much more efficient with serum blood tests.

Your Marion Gluck Clinic doctor will advise you of the tests required during your consultation and will explain the options for how you can have blood drawn.

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How To Check Hormone Levels With A Pelvic Exam

Pelvic exams dont directly check hormone levels, but they do give your doctor valuable insight into your bodys ability to produce sufficient hormones. Doctors will check the testicles for abnormalities in size or any internal lumps or growths that may be cause for concern.

Female hormone testing usually involves a pap smear and a wellness check to assess reproductive health issues that may contribute to or be caused by inadequate hormone production.

Lumps may require a punch biopsy or a needle biopsy. Your doctor will send a sample to a lab for analysis to determine the nature of these lumps, such as to confirm they are not tumors. Its important for your doctor to ascertain that these lumps dont present a serious threat to your overall health.

The Pill And Your Thyroid

Its important to note that the pillâs role in elevating TBG, Sex Hormone Binding Globulin & Cortisol Binding Globulin is well recognized. In fact, it is how researchers can verify who is & isnât actually taking the pill in clinical trials.

Itâs also listed in prescriber handbooks as a change we expect to see in labs. When TBG goes up, total thyroid hormone levels go up and free thyroid levels can go down.

Now, if you thought that total thyroid hormone was what the body utilized & that is all you measured then you might think, thyroid function is improved on birth control. However, FREE thyroid hormone is what you use, and not bound thyroid hormone .

This is why I test thyroid hormones in my patients before they start the pill and we continue to monitor symptoms & labs to ensure it is working best for them. Yes, some of my patients decide to use the pill for birth control or other reasons and I support them in doing that.

From the research, it appears progesterone, progestin, & topical estrogen do NOT elevate TBG. It is oral estrogen that influences the increase in binding proteins.

If you want a deep dive into the Birth Control-Thyroid Connection, then you can read all about it in this article.

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