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Test for Hormones: Overview
Hormone testing for sex hormones such as estrogens, progesterone, testosterone, DHEA, LH, FSH, prolactin and binding globulins (SHBG) is an important step in determining hormone abnormalities that may be causing or contributing to symptoms. Deciding which of these tests to perform requires your doctor's assistance and understanding of the nature of your complaint.
Function
Blood, saliva, and urine tests are available. An advantage of salivary testing in women is that samples can be taken and frozen over a period of time and then collectively tested for hormone levels and patterns. Salivary testing is not useful for follow-up testing when transdermal hormone creams are used: reported values are falsely elevated.Instructions
24-hour urinary testing is a good method of determining hormone levels, both initially and for follow-up. Timing of the test in relation to the menstrual cycle is important for accurate and usable results with regard to estrogens and progesterone levels. Your doctor can advise you when it is best collect the sample.References & Further Information
Testing information is available at Great Smokies Diagnostic Laboratories as well as many other sites such as Meridian Valley Laboratory.Test for Hormones can help with the following:
Aging
Premature/Signs of Aging
| Early reduction in quantity or bioavailability of multiple hormones hastens the aging process. The hormones most likely to be involved include estrogens, progesterone, testosterone and DHEA. |
Hormones
Low Melatonin Level
| Saliva testing is currently the most widely avaible test and several laboratories offer it. |
Andropause/Male Menopause
| Hormone testing and replacement will help to reduce symptoms and prevent the consequences associated with premature hormone reductions seen in male menopause. |
Hirsutism
| Blood, saliva or urine tests may be arranged to make sure that the hirsutism is not due to excessive male hormone levels. |
Low Sex Drive
| Midlife is a time when sex desire decreases for many women. Inevitably, in most men also, sex drive decreases with age. This is often due to declining hormone levels, especially testosterone. Hormone replacement is particularly effective at this time for restoring libido. |
Immunity
HIV/AIDS
| Several studies have shown that testosterone levels are generally lower and that testosterone administration alleviates fatigue and depression in men with HIV/AIDS. In one study, 80% of men reported significant improvements in their energy levels. [General Hospital Psychiatry, July 1998] |
Lab Values
Low Total Cholesterol
| A chronically low serum cholesterol level can be an unsuspected problem. Since cholesterol is the precursor to the adrenal and sex steroids, low levels may mean an insufficient supply of raw material for hormone production. When there are indications of hormone insufficiency, appropriate lab testing should be conducted. |
Laboratory Test Needed
Reproductive
Menopausal Issues
| Checking primarily for estrogens and progesterone at this time of life, with subsequent hormone balancing, can provide both immediate and long-term benefit. |
Polycystic Ovary Syndrome (PCOS)
| The most worrisome consideration in PCOS is the presence of an androgen-producing neoplasm. It is for this reason that a measurement of total testosterone and DHEA is recommended. |
Endometriosis
| Estrogen excess or progesterone deficiency may contribute to the severity of the symptoms. |
Erectile Dysfunction (ED, Impotence)
| Testosterone is the major hormone produced by men, but does not directly affect a man's erectile ability as much as it does libido or sexual desire. Men with low testosterone, however, have shown improvement in ED with hormone replacement. A clinical trial of testosterone for all types of erectile dysfunction is not recommended. When considering lab testing, a full panel of tests should be considered such as DHEA, testosterone (total and free), DHT, sex hormone binding globulin (SHBG), estradiol, luteinizing hormone (LH), follicle-stimulating hormone (FSH), prolactin (best taken at 9am to avoid diurnal variations), progesterone and a PSA test for prostate cancer. Testosterone replacement, preferably applied to the skin or by injection, typically ranges from 25-100mg of natural testosterone per day usually given in two divided doses. DHEA has been reported to be low in some men with erectile dysfunction. In one double-blind trial, 40 men with low DHEA levels and ED were given 50mg of DHEA per day for six months. Significant improvement in both erectile function and interest in sex occurred in the men assigned to DHEA but not in those assigned to placebo. No significant change occurred in testosterone levels or in factors that could affect the prostate gland. [Urology 53: pp.590-5, 1999] |
Skin-Hair-Nails
Male Hair Loss
| There have been several reports that supplemental DHEA has accelerated hair loss in susceptible men and women. Hormone level testing is advised prior to hormone use. |
Female Hair Loss
| There have been several reports that supplemental DHEA has accelerated hair loss in susceptible men and women. Hormone level testing is advised prior to hormone use. |
Tumors, Malignant
Breast Cancer
| Testing for estrogen, progesterone and testosterone may help to properly evaluate breast and ovarian cancer risk. Some estrogens, as well as testosterone, may aggravate the risk whereas progesterone has a protective effect. There are additional estrogenic tests that can be done to evaluate breast cancer risk. There is considerable and increasing research concerning the 2/16-alpha hydroxyestrone ratio. A very recent human study states: "2-hydroxyestrone levels and 2/16-alpha hydroxyestrone ratios were significantly lower, while 16-alpha hydroxyestrone levels were higher in breast cancer patients." The 2/16-alpha hydroxyestrone ratio appears to be a very significant predictive factor of breast cancer. Many laboratories are offering these tests now. |
KEY
May be useful:
may help with
Moderately useful:
often helps with
Very useful:
is highly recommended for
Last updated: Apr 25, 2013