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Let's Talk Hormone Testing
In the last blog post we discussed the different steroid hormones produced in the body and what happens when they are not in balance. Hormonal imbalances may manifest in a variety of different ways including but not limited to:
- Weight gain
- Insomnia
- PMS/mood swings
- Anxiety
- Painful periods
- Irregular periods
- Infertility
- Acne
- Hair loss
- Food cravings
- Breast tenderness
- Bloating
- Low libido
- Fatigue
Based on symptoms we can often figure out that there is an imbalance in some hormones. However, the next step is to figure out exactly WHICH hormones are not in their optimal ranges and WHY.
Naturopathic Doctors treat the root cause, most people already know this. Sometimes it is easy to figure out the root cause (ex. insomnia post 6 pm coffee) and sometimes it can be a bit more challenging (ex. painful periods and hormone imbalances). When the cause is not crystal clear, I refer to lab testing to get a better idea of what is happening in the body at a chemical and cellular level. I am a firm believer in testing, not guessing. The simplest way to understand what is happening with your hormones is testing them.
Hormones are a dynamic system which means they are being produced, being utilized and then being cleared from the body. Since hormones follow this pattern, the way in which we test for hormones needs to also follow this dynamic pattern so as to best represent this system. When it comes to hormone testing, it can be done in three ways: serum, saliva or urine.
Serum Testing:
Serum (blood) hormone testing is most commonly used amongst all healthcare professionals. Bloodwork is most accurate for pituitary hormones like LH, FSH, prolactin, TSH and metabolic hormones like insulin, leptin, ghrelin and thyroid hormones. However, bloodwork only provides you with a snapshot in time. Bloodwork does not differentiate between bound and free hormones, which can be misleading as free hormones are the active ones. It also doesn’t give you insight into how the hormones are being metabolized or cleared from the body.
Saliva Testing:
Saliva testing allows you to assess the 24-hour trend in hormones. It tests both free and bound sex hormones. Cortisol is heavily concentrated in saliva and therefore is best tested using salivary testing. Saliva testing does not however, measure hormone metabolites.
When hormones circulate throughout the body they are metabolized by the liver and broken down into their respective metabolites. Each of these metabolites have their own physiologic effect. These metabolites cannot be tested in blood or saliva. This is where urine testing comes in!
Urinary Testing:
Urine hormone testing is the newest form of hormone testing and allows us to look at both sex (estrogen, progesterone, testosterone) and adrenal (Cortisol) hormones. Urine testing allows you to get an in-depth look at your overall hormone production, hormone metabolism and hormone clearance. Some hormone metabolites are more active than their primary hormone. It is these metabolites that give us a better picture of overall health and wellness. For example, estrogen has three pathways it can follow in order for it to be metabolized and eliminated from the body. The first pathway is protective and allows for healthy detoxification of estrogen. The second pathway can increase the chances of DNA damage and the third pathway can increase breast tenderness and moodiness. Therefore, it is important to not only understand estrogen but to also understand how estrogen is being broken down in the body.
It gives us more insight into how efficiently our hormones are being used in the body. Urinary hormone testing gives you a wealth of information about your hormonal state of health. It gives you a complete picture of your sex hormones, adrenal hormones, stress tolerance, sleep hormones, vitamin deficiencies and signs of oxidative damage.
In my practice, I use the Comprehensive Hormone Insights (CHI) test which is a urine test that measures sex and adrenal hormones and their metabolites over a 24-hour period. It also provides insight into the diurnal variation of cortisol levels.
Why would I do the CHI Hormone Test?
When things in life are running uber smoothly, you tend to focus on all the good things. Now, when life throws a curve ball at you, like a relationship gone sore, or losing a job, you start to feel it, in fact it starts to take over your thoughts and other areas of your life and overall happiness. Hormones work in the same way. When they are balanced you don’t notice, but when they are out of balance, it’s hard to ignore. The CHI test can be a great tool to help you discover and understand the potential source of the hormone imbalance. Once we figure out the source of the problem, we can better address treatment.
The CHI test can give your insight into your:
Imbalances in sex hormones (estrogen, progesterone, testosterone, DHEAs, DHT along with all their metabolites)
How well your body, specifically your adrenals are dealing with and tolerating stress (cortisol and cortisone) in relation to the diurnal pattern
Sleep hormone imbalances (melatonin)
DNA damage and oxidative stress
What Does the Chi test Involve?
It’s easy! It comes in a kit with everything you need and can be mailed directly to your home! The kit consists of a instruction pamphlet, a requisition form, ice pack, urine tubes and a return label. All you need to do is collect 4 urine samples (2 hours after waking, dinner time, before bed, next morning) in a 24-hour period and then mail them off!
What happens with the results?
Results take about 2 weeks. We use this information to understand how well your hormones are being used in the body. Once we can connect the dots of your test to explain why you’re feeling the way you are feeling, we can create a treatment plan that is unique to you. A treatment plan can involve, lifestyle adjustments, dietary changes, stress management techniques, supplements, injections and/or Intravenous nutrient therapy.
So, if you’re struggling with weight gain, sleep disturbances, PMS, irregular periods, painful periods, anxiety, depression, irritability, acne the CHI test may be what you need to pinpoint exactly where you may need a little extra support.
To share along my journey, I just mailed in my CHI test, so stay tuned for when I share my results!