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Hormones and Hormone Testing

Updated: Mar 25

Young women are frequently known to report symptoms relating to low libido, absent periods, depression, anxiety, obesity, heavy periods, panic attacks, PMS, PCOS. excessive body hair, lumpy breasts amongst other symptoms which are hormonal in nature.


The more mature woman can also report the same symptoms and present to their practitioner additional menopausal symptoms including insomnia, hot flushes, vaginal dryness, insomnia and loss of concentration and/or memory.


For men both young and old, they can present with symptoms relating to extreme fatigue, osteoporosis, loss of libido and generally not feeling well. And, whilst these symptoms seem quite ubiquitous and can be related to a number of conditions, once hormones are balanced, there can be a complete resolution of symptoms. Fatigue in particular can be due imbalanced hormones and can include treatment which can include DHEA, vitamin D, testertone and thyroid hormones.

Many women can breeze through menopause, whilst others can experience the opposite and can go through quite a distressing time with a number of hormonal deficiency symptoms which can severely compromise their quality of life.

One treatment that can be used is Bio-identical hormone replacement therapy which involves using plant derived hormones that are biologically identical to the hormones that your own body makes.

In functional medicine, one of the mantras, is that we are unique and what should be taken into consideration is that one’s response to hormones is unique and depends on many factors, including gut health, stress levels, your genetic makeup and nutritional status. It is also essential that one considers how all of your body’s hormones interact with each other, before taking any form of hormone replacement therapy. A thorough medical history and physical examination, along with laboratory testing to establish your hormone levels is essential.


Serum (Blood) Hormone Testing Serum is ideal for testing peptide hormones such as FSH, LH, prolactin, fasting insulin and thyroid hormones. It is also used to measure binding globulins such as sex hormone binding globulin (SHBG) and cortisol binding globulin (CBG). For many other hormones, testing them in the blood gives us only the total hormone level and does not distinguish between bound (inactive) hormones and those that are free (active). Additionally, serum hormone testing gives us only a ‘snapshot’ of your biochemistry. It is difficult to determine if the level of hormone represents a peak, a valley, or a moment of transition from one to another. Lastly, serum hormone tests do not allow for measurement of hormonal metabolites.


Salivary Hormone Testing Saliva collection allows for multiple collections over a day or month which provides a more detailed picture of hormonal fluctuations. Saliva can only be used to evaluate steroid hormones, including estrogens, progesterone, testosterone, DHEA, and cortisol. Salivary measurements are greatly affected by the use of exogenous hormones therefore it is pertinent to be aware of any current hormonal prescriptions prior to testing.


Urine Hormone Testing Urine testing is an effective way of analyzing hormone metabolites. Generally, urine is collected for 24-hours to obtain a complete picture of the number of metabolites excreted. Samples are affected by dehydration or excessive fluid intake therefore both must be avoided during the sample period. Additionally, previously diagnosed liver or kidney disease likely will exclude urine hormone testing as a viable option.

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