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 Cushings 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.
Whats The Outlook For A Hormonal Imbalance
If you have a hormone imbalance, there are various treatments to help bring your hormones back to appropriate levels and restore balance.
Depending on the underlying cause of the imbalance, as well as the specific hormones in question, treatments can vary, but there are ways to manage symptoms and bring hormone levels back to normal.
If theres an underlying condition causing the hormone imbalance, long-term management of the condition will help ensure hormonal balance.
Hormone levels change and fluctuate over time they dont remain static. Its important to be aware of your bodys symptoms.
Talk with your health care provider about any changes you might notice, especially after giving birth or while going through perimenopause.
Free Thyroxine And Free Triiodothyronine
Thyroid binding globulin is a protein that transports thyroid hormone & makes it so your body can’t use it. When thyroid hormone is bound it is measured via blood test as Total T4 & Total T3.
Your cells use Free T4 & Free T3. This is why we measure both of these markers in addition to TSH.
Your T4 is inactive and T3 is active. T3 is involved in your mood, menses, metabolism, and gut motility.
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Which Hormone Tests Should I Ask For
Which tests you undergo will depend on your symptoms and preferences.
On the other hand, you might simply be interested in a general hormone health check even if you dont have any specific concerns or symptoms of a hormonal imbalance. This can be useful to establish a baseline that helps you identify hormonal changes in the future or detect asymptomatic health conditions.
Regardless of whether you have specific concerns or just want an overview of your current hormonal health, your healthcare practitioner can help you determine which tests are most appropriate for your situation.
A Quick Summary Of Hormones
Hormones serve as chemical messengers in your body, carrying signals to different areas of your body and affecting vital functions like metabolism and growth. These chemicals are produced by the endocrine system and contain information that helps instruct different organs and tissues throughout your body about how to function.
When these chemicals are out of balance, it can lead to:
While this sounds like a bunch of medical jargon, each hormone has an important purpose in the reproductive system.
AMH is released by cells around your follicles and is the best predictor of your ovarian reserve or egg count. FSH is responsible for starting ovulation, while estradiol is a sex hormone produced by your ovaries. LH is the hormone that keeps your cycle regular and is produced by your pituitary gland.
Testing for thyroid health is also necessary since the gland can often be the root of pregnancy issues. Low levels of TSH and untreated hypothyroidism can interfere with ovulation, impairing fertility. Thankfully, TSH and fT4 can be adjusted with medication when thyroid disease is present.
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How Are Hormonal Imbalances Treated
Treatment for a hormonal imbalance will depend on whats causing it.
If you have lower-than-normal hormone levels, the main treatment is hormone replacement therapy. Depending on which hormone is deficient, you may take oral medication or injection medication.
For example, if you have low thyroid hormone levels , your provider can prescribe synthetic thyroid hormone pills. If you have growth hormone deficiency, youll likely have to take injections of synthetic growth hormone.
If you have higher-than-normal hormone levels, there are many treatment options depending on the cause. Options include medication, surgery, radiation therapy or a combination of any of these.
For example, if you have a prolactinoma, a benign tumor that causes excess prolactin , your provider may prescribe a medication to shrink the tumor or you may need surgery to remove it.
What Types Of Hormonal Imbalance Are Most Common In Women
Women most commonly experience imbalances in their thyroid, testosterone, and estrogen hormone levels. In fact…
- 1 in 8 women will have issues related to thyroid imbalance â like hyperthyroidism or hypothyroidism â at some point in their lives.
- 1 in 10 women have polycystic ovary syndrome , which is often linked to higher testosterone levels.
Though hormonal imbalance is pretty common, there are many treatment options out there .
Also Check: How To Help Estrogen Levels
Hormone Testing For Women
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Functional Hormone Imbalance Tests
Hormone levels are continuously changing throughout the day thus blood may not always be the perfect reflection of whats going on.
You may be able to relate to this by being told everything is normal and youre good to go from your doctor, yet you still feel like junk!
Its no fun leaving the doctors office confused, discouraged, and unheard because youve been told your lab work is all normal despite feeling the complete opposite.
This is where specialized functional lab testing can be useful.
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When Is The Best Time To Test Hormone Levels
If youre struggling with a hormone imbalance, testing your sex hormones can help you understand where the issue is rooted. Evaluating estrogen, progesterone and testosterone can be helpful in understanding which hormones are driving your symptoms.
Hormone levels arent static throughout the monthand this is why so many women get within range blood test results.
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:
- 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.
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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.
When Thyroid Levels May Be Tested
You may need a thyroid hormone test if you have symptoms of either an underactive thyroid or an overactive thyroid .
Hypothyroidism symptoms include:
| Pituitary disease |
If results start out with low TSH and high thyroid hormones and then reverse with further testing, it indicates thyroiditis, which is inflammation of the thyroid gland.
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Ask A Laboratory Scientist
This form enables patients to ask specific questions about lab tests. Your questions will be answered by a laboratory scientist as part of a voluntary service provided by one of our partners, American Society for Clinical Laboratory Science. Please allow 2-3 business days for an email response from one of the volunteers on the Consumer Information Response Team.
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Commonly Asked Questions About Female Hormones
What is the lifelong role of estrogen in female health?
Most people think estrogen is primarily responsible for reproduction, but it also helps with bone, skin and cardiovascular health. In addition, it affects thyroid hormone production. During menopause, estrogen levels decline along with the production of progesterone and testosterone. Hormone replacement therapy , which means replacing lost hormones by re-introducing them into the body, is often suggested to offset the positive benefits of estrogen and can be helpful in reducing common symptoms of menopause. But some studies show that artificial doses of estrogen carry risks and have been linked to cancer, dementia, strokes and arthritis. Never assume that hormone replacement therapy is the right thing to do without consulting your healthcare provider.
What is Puberty? Hormones that control puberty
Puberty is the time in life when children begin to show changes through hormone secretions that indicate they are about to become adults physically. In girls, the most obvious sign of puberty is the onset of menstruation. It can happen anywhere between the ages of 9 17, with a median age of 12. The menses, or monthly cycle, is interrupted during pregnancy and typically ends when the ovaries stop secreting steroid hormones a stage known as menopause.
What are the hormonal milestones in a females life?
What Causes Hot Flashes?
Why do I feel so different during my monthly cycle?
Why dont men have monthly cycles?
How Do You To Test For Sibo
SIBO is diagnosed using a hydrogen/ methane test, the same breath test used to diagnose FODMAP malabsorption, but it uses glucose.It is a simple, painless and non invasive test. Bacteria in the colon produce either hydrogen and / or methane gas when ingested sugars are not completely absorbed into the small intestine. The gas is absorbed into the blood stream from the bowel and travels to the lungs where it is breathed out, allowing detection by an analyser.
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What Do I Test If I Dont Have A Period
If your period has stopped showing up , this is what is called amenorrhea.
- Primary amenorrhea is when you havent gotten your period by age 15 or 16.
- Secondary amenorrhea is when you have had a period, but now its gone.
If your regular period is missing for three or more months, or your irregular period is missing for six or more months, this is considered secondary amenorrhea.
Often, doctors will try to prescribe the birth control pill as a means of treating amenorrhea. If you begin birth control you will not be able to test FSH, LH, estradiol or progesterone accurately.
The Endocrine Society guidelines clearly advocate against the use of the pill in women with functional hypothalamic amenorrhea solely to restore a period or even improve bone mass. They also recommend educating patients who are currently using the pill that it may mask these issues.
Why Hormonal Imbalance Blood Testing Makes Sense
Hormones are chemicals that are produced by glands in the endocrine system and play a critical role in regulating bodily functions. Hormones naturally fluctuate as you age, and some hormonal imbalances are to be expected as you transition through various stages of life.
However, hormonal imbalances can also occur at any time and may be indicative of an underlying disease or disorder. Below, learn all about hormones, hormonal imbalances, common endocrine disorders and hormonal testing.
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When To Test Progesterone
Progesterone levels are highest 5-7 days following ovulation, which is within our luteal phase . This is why testing is recommended days 19-22 of a 28 day cycle.
Even though were commonly told that women ovulate like clockwork on day 14 of their cycle, unfortunately, this isnt always the case. Its a great idea to track your basal body temperature and evaluate your cervical mucus to get an idea of when and if you are ovulating. Or you can use over-the-counter LH strips which can help you dial in the day you ovulate.
Ive got a whole article devoted to this practice, but the general idea is pretty simple, but can take some time. When you ovulate, your body temperature rises and your vaginal discharge becomes the consistency of stretchy egg whites. If you keep an eye on these changes to your body, theres a pretty good chance you can approximate when youre ovulating.
For a lot of women, this will mean that testing for progesterone should happen on roughly day 19-22 of their cycle. Again, this recommendation could change if youre not ovulating day 14 of your cycle which is actually pretty common, or if your typical cycle is shorter or longer than 28 days. Track your cycle for a few months before and talk to your doctor so that they can tell you the best day to test progesterone.
If you feel confused, talk to the provider ordering your test.
When Should I See My Healthcare Provider About A Hormonal Imbalance
If youre experiencing new, persistent symptoms, its important to talk to your healthcare provider. They can order tests to help determine the cause of your symptoms.
A note from Cleveland Clinic
Hormones are complex and powerful chemicals. If one or more of them goes out of whack, it can cause certain symptoms that make you feel like youre not in control of your body. If you have new and persistent symptoms, its important to talk to your healthcare provider. They can order some tests to see if a hormonal imbalance or another condition is the cause. The sooner you reach out for help and treatment, the sooner youll be able to feel like yourself again.
Last reviewed by a Cleveland Clinic medical professional on 04/04/2022.
References
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Professional Testing At Home
DIY hormone testing kit results are not sufficient to be prescribed hormone replacement therapy. If you do have a hormonal imbalance that requires hormone replacement therapy, you will have to get an evaluation done by a healthcare professional who can prescribe your treatment. A house call doctor can offer professional testing services in the comfort and privacy of your home.
To conduct an in-home hormone imbalance test, a healthcare professional will come to your home to conduct a health screening and blood draw and prepare the sample for testing. They will submit the collection to a lab for processing. Because house call doctors often have working relationships with specific labs, results are often available earlier than you may get from an at-home DIY kit.
Once the sample has been processed, you will have a follow-up appointment either in your home or via telehealth with a health expert to help you interpret the results and answer any questions you have.
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.
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What Is A Hormone Imbalance Test
A hormone imbalance test detects whether your endocrine glands are producing the right amount of each hormone. Tests vary depending on the hormones being tested.
Some tests are designed to detect imbalances respective to gender, so you should consult with your healthcare provider to ensure you are using the correct test. You should also inform your provider about any hormone-altering medications you may be currently taking so that they may be considered when reviewing results.
- Blood tests detect cortisol, estrogen, testosterone, and thyroid levels.
- Saliva tests detect estradiol, progesterone, and testosterone.
- Ultrasounds are used to determine if there is an issue with a particular gland in the body. This test is often used to examine ovaries, the pituitary gland, testicles, thyroid, and uterus. X-rays or MRI may be used in subsequent tests to further identify issues. Doctors also may conduct a biopsy of a gland to make a diagnosis.
- Sperm counts and pap smears can help identify issues with glands such as lumps, cysts, or other abnormalities that may impact hormone levels and cause an imbalance.