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The 7 Hormones You Should Be Testing

September 18, 2017
hormone testing, naturopathic doctor toronto

Listen up, I love discovering why you’re experiencing your symptoms. 

It’s true – it makes me feel like Sherlock Holmes.

Because once I figure out why your symptoms are happening, I can treat the root cause so they can disappear!

Sometimes it can be easy to figure out the root cause (ex. you’re laying awake at night because you drink coffee at 6pm). And sometimes it can be more difficult (ex. your period is irregular and you don’t know why). This is probably where you defer to Dr. Google, and have at least 5 different supplements in your online shopping cart. 

Just because the cause isn’t clear, it doesn’t mean that it’s impossible to discover. In these situations, I refer to lab testing to see how your body is functioning at a chemical and cellular level. 

When it comes to your period, I often recommend hormone testing. Hormones are complex, and the way my hormones might be interacting with each other, may be different than yours. And we won’t know what is going on until we look at them. 

So should you investing in testing? Yes. 

Symptoms associated with hormonal imbalance

Hormones can affect your health in so many ways including:

Test these hormones:

1. Estrogen

You have 3 types of estrogen: estradiol, estrone and estriol. Estradiol is the main hormone of your menstrual cycle, especially in the first half. Estrogen is mainly produced by your ovaries, adrenal glands, and fat cells (but in smaller quantities). 

How estrogen works

There are SO many things that estrogen does! Including: controlling vaginal moisture, enhancing sex drive, preventing UTIs and urinary incontinence. And it also has effects on your brain, nervous system and skin. 

When to test estrogen

Day 3 (ex. 3 days after your period starts) or day 21 (with progesterone)

Why you should test estrogen

If you experience: abnormal vaginal bleeding, inability to become or stay pregnant, irregular cycles or menopause. 

Optimal Lab Range

Follicular Phase: <165 pmol/L

What it means

HIGH estrogen happens because of: early puberty, ovarian or adrenal tumour, hyperthyroidism, cirrhosis, and drugs. May increase during perimenopause as FSH rises.

LOW estrogen happens because of: menopause, PCOS, ovarian dysfunction, low pituitary hormones, eating disorders, extreme endurance exercise. 

2. Progesterone

Progesterone is the other main hormone in your menstrual cycle, especially in the luteal phase! When ovulation happens, progesterone is produced! It’s mainly produced by your ovaries, but also the adrenal glands. When fertilization doesn’t happen, your progesterone levels drop and signals the start of your period.  

How progesterone works

Progesterone promotes urination, improves sleep, supports mood, and works with the thyroid to stimulate metabolism. 

When to measure progesterone

Day 21 (or 7 days after ovulation)

Optimal Lab Range

Over 18 ng/mL (57nmol/L). Levels higher than 16 nmol/L strongly suggest that ovulation has happened.

What it means

HIGH progesterone because: luteal phase of the menstrual cycle, ovarian cysts, overproduction by the adrenal glands, adrenal tumours, or congenital adrenal hyperplasia. 

LOW progesterone because: No periods, decrease in ovarian function, miscarriage, threatened abortion. 

3. Testosterone

Yes, this is a male hormone but you have it too! It’s made in your ovaries and adrenal glands. And as you age, you’ll notice a decrease in testosterone.

How testosterone works

This hormone is usually low and is associated with sex drive, bone density, muscle mass and strength.

When to measure testosterone

Anytime during the cycle. Be sure to measure free and total testosterone for a better idea. 

Optimal Lab Range

Free testosterone: 8-25 pmol/L 

Total testosterone: 0.8-2.08 pmol/L 

Don’t forget to test

DHEA-S and SHBG (sex hormone binding globulin)

What it means

HIGH testosterone is associated with a common condition called Polycystic Ovary Syndrome (PCOS), congenital adrenal hyperplasia or an ovarian/adrenal gland tumour. Women who are also taking forms of estrogen, may have higher testosterone levels.

LOW testosterone is associated with fatigue, loss of muscle mass and strength, low libido, lack of motivation, and lowered mood.  

4. Cortisol

Known as your stress hormone, cortisol is produced by your adrenal glands.

How cortisol works

Cortisol helps your body adapt to daily stressors. But if you keep on experiencing stress, your adrenal glands might get tired and stop producing it. 

Best type of test

This is a test that benefits from saliva or urine testing, because you’re able to visualize your body’s cortisol pattern throughout the day, and how your body is handling stress.  

When to test

Anytime you want. Best to do 4-point testing to get an idea of what your curve looks like.

What it means

Excess cortisol can cause havoc in your body and interfere with your other hormones including thyroid hormones, testosterone and progesterone. 

5. Thyroid Stimulating Hormone (TSH)

Your thyroid is incredibly important your metabolism and how your body functions! It controls how regular your menstrual cycle is, your fertility, weight, energy, heart rate and more!

How TSH works

TSH is your body’s barometer, and tells you if your thyroid gland is working properly (basically how T3 is working in your pituitary). 

When to measure TSH

Morning of day 3

Don’t forget to test

Pair TSH with thyroxine (T4), triiodothyronine (T3) and reverse T3 should be tested alongside TSH to get a solid picture of how the thyroid is functioning. 

Optimal Lab Range

1.0-2.0 miU/mL

What it means

LOW TSH is indicative of hyperthyroidism. 

HIGH TSH is indicative of hypothyroidism.

6. Follicle Stimulating Hormone (FSH)

Follicle stimulating hormone is produced by your pituitary gland and it helps your follicles grow. 

How FSH works

This hormone stimulated your ovary in preparation for ovulation. As you age, FSH becomes the predominant pituitary hormone. 

When to test FSH

Morning of day 3

Don’t forget to test

LH and estradiol

Optimal Range

<6 pg/mL is ideal

What it means

FSH is usually higher than LH.

HIGH: Levels will rise during perimenopause, as your pituitary gland tries to get your ovary to release a follicle.  

LOW: High leptin levels may inhibit FSH causing poor follicular development and preventing ovulation. FSH may also be low if you have PCOS.

7. Lutenizing Hormone (LH)

How LH works

Lutenizing hormone is produced by your pituitary gland as high amounts of estradiol are being released from the dominant follicle. A surge of LH trigger’s your egg maturation, and causes it to be released from the follicle. This tells your body that ovulation is ready happen.  

Using ovulation tests is a good way to see the LH surge. You can also pay attention to other ovulatory signs like the slight increase in body temperature (thanks to progesterone) and egg-white cervical fluid. LH and FSH should be equal, if it’s not, you may have PCOS.

When to test LH

Morning of day 3

Don’t forget to test

FSH and estradiol

Optimal Range

<7 miU/mL

What it means

HIGH: indicative of PCOS, especially a LH to FSH ratio greater than 2:1 is sign of PCOS.

Bonus Tests

Ferritin

It’s never a bad idea to test your ferritin levels. Ferritin is the storage form of iron. If you’re experiencing heavy periods, you may actually be deficient iron which can cause it’s own array of unwelcome symptoms. 

Optimal Range

60-80ng/mL

Looking for a quick chart to refer to? You can download the healthy hormone guide here!

Tips for your visit with a ND

Type of Test

Blood/Serum

This is your standard blood test performed in a laboratory. Use this option to test FSH, LH, estradiol, progesterone, testosterone, TSH and most of the bonus tests. Serum measures your active and inactive hormones as a total – aka. you cannot see each one separately. 

Saliva

This is specialized at-home test where saliva is used to monitor excesses or deficiencies within your body, as well as look for patterns (ie. diurnal patterns of cortisol). Saliva testing allows us to look at ‘free’ hormones (not bound by proteins), and expands our clinical picture with respect to your condition.

Preferred: baseline of cortisol pattern. 

Urine

Urine testing provides an average of your hormone levels and assesses their metabolites (ex. understanding if we are clearing the estrogens). Currently, there are 2 types of urinary tests: the first where you are collecting urine in liquid form, and the second where you are collecting dried samples of urine.

Good for: understanding estrogen and cortisol pathways and how they detoxify within the body.

Urine will not tell you your overall levels within the body.  

Reading the Results

Normal vs. Optimal

If your numbers fall within the normal levels, that’s great right?

But what happens when everything looks normal, but you still feel like crap?

Turns out that while your numbers can be normal, they can also be optimal! And this is the place where you shouldn’t be noticing any symptoms. 

I want you to feel fantastic, I do that by looking at your lab work and determining if it’s optimal (rather than normal). Making sure that your numbers are optimal allows me to work on your longterm health, so that your symptoms don’t turn into anything serious. 

Next Steps

Naturopathic Prescription

Based on your hormone results, I create a custom treatment plan that will help you feel your best! Sometimes this might mean that I take away your espresso for a few weeks, or make you go for a walk at lunch. Or it might mean I have you come in for acupuncture for a couple of months. It’s different for everyone. 

But, do you know what’s the same? You don’t need to consult Dr. Google anymore and find out what you should be taking for every single symptom you have. I’ve got you covered.  

Your homework

Once we go through your results and the treatment plan, it’s up to you to take the next steps. 

But don’t worry, because you’re not doing it alone! I’m a car, call, or email away and am happy to provide whatever resources you need. Even if it’s a recommendation for a personal chef. 

Once you have your plan, it doesn’t mean that I don’t want to see you ever again. In fact, I’ll likely tell you to come back in a month and tell me what worked and what didn’t. I want to be sure that the plan is fitting your lifestyle, eliminating your symptoms and getting to the root of the your problem. If we need to make some tweaks, so be it! 

Are you ready?

If you’ve been suffering with unwanted symptoms for years, if you want to get pregnant, or if you generally just want to feel fantastic – here’s your permission slip to finally invest in yourself.

Hormone testing will give us some answers, but it’s up to you to take that first step and book an appointment. You deserve to live your best life, and I am going to help get you there. 

Looking for a quick chart to refer to? You can download the healthy hormone guide here!

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