Feeling depressed, anxious, tired or having trouble losing weight?
Is your memory a little foggy or are you lacking the ability to concentrate?
Can’t sleep at night and always getting sick....
Many of us in the quantified self, direct access healthcare community are looking for cost effective, actionable, real world applications of home based testing options to evaluate our symptoms that can be evaluated by a qualified healthcare practitioner to help treat the underlying cause of the problem. Specifically, many are interested in learning about hormone imbalances, which can cause things like adrenal fatigue, weight gain, low libido, anxiety or depression.
Men, if you are reading this article and are about to hit the close tab….STOP!
Both men and women make and need hormones for optimal body function. We all have certain hormonal balances that need to be kept in check. You may even be asking yourself, “how do I know if I need a test to check my hormones and if I do, how much is this going to cost?”
Did you know that for around $175 you can learn:
- why you are fatigued and tired
- why you can’t sleep
- why your immune system may not be working as well as it could
- if you are at risk for an adrenal imbalance
This is all possible from the privacy of your own home… and in most cases without a doctor’s order! In many cases the tests are non-invasive and only require your saliva or a small sample of blood….
Did you know that your blood only results ordered by your doctor may not tell you what you need to know about your symptoms and the underlying cause?
When choosing a home based hormone testing company, you will see that there are several on the internet offering many, many testing choices, methods and packages. Doing your research into the right testing company is vital and thankfully for you, we’ve done the leg work. I’ll direct you to two companies that I feel are the best in the business later in this article.
For now, let’s learn more about hormones!
This article will not only point you in the right direction to purchase your home-based hormone testing kits, but will also offer you some insight into why you may be feeling:
- have a low sex drive
- a low sex drive
The Endocrine System: What is it and why is it important?
The endocrine system is comprised of glands responsible for the production and secretion or certain hormones within men and women. The hormones produced by the endocrine system and released into the bloodstream to control things like breathing, metabolism, reproduction, sensory perception, movement, sexual development and growth.
Glands of the endocrine system include:
- Pituitary gland
- Pineal gland
In the perfect world, the endocrine system would constantly work like a well-oiled machine but in reality, that is not always the case. For many reasons, the endocrine system may not function correctly due things like stress, and thus hormone production and levels may become altered which can lead to certain diseases.
Several organs within the body also affect how the endocrine system functions and hormone production. Certain organs within the body themselves also produce, store and distribute hormones including the:
- Small intestines
For the purpose of this article, we will be focusing on some common testing panels used for evaluation of male and female sex hormones which when unbalanced can wreak havoc on the body, leading to a cascade of unwanted symptoms.
Let’s talk sex…hormones that is.
What are sex hormones anyway? Well, simply stated both men and women have certain hormone levels that keep their body in perfect hormonal harmony. The key sex hormones we will be discussing within this article are:
Estrogens are present in both men and women, but at different levels with different effects on the body. Estrogens are well known for their role in female characteristic development. They are vital for female secondary sex characteristics (breasts, pubic/underarm hair and menstrual cycle regulation), however they also play a vital role in men. In men, estrogens are responsible for libido, erectile function and sperm production.
We’ll tell you how to test your estrogen levels later in this article!
The three types of estrogen that are produced by the body include:
- Estrone (E1): While estrone is the weakest form of estrogen, it is reported to be present in body tissues like fat and muscle. In menopausal women, this is the only estrogen circulating through the body.
- Estradiol (E2): In women, the steroid estradiol produced in the ovaries, is the strongest estrogen in the body and responsible for a multitude of gynecologic problems, some of which include endometriosis, fibroids and endometrial cancer. In men, E2 is produced by the testes in smaller amounts resulting in men having naturally lower levels of circulating E2. Menopausal women also have low levels of E2 as compared to pre-menopausal women.
Other organs and tissues produce E2 including the adrenal glands and tissues including fat.
- Estriol (E3): Estriol is produced at maximal amounts in women during pregnancy and is noted to be the natural waste product of estradiol.
In women, estrogens are vital in maintaining a normal menstrual cycle and aiding in reproduction. For example, in women estrogen is responsible for the:
- stimulation of an ovarian follicle (egg)
- stimulation of normal vaginal growth, wall thickening, maintenance of normal vaginal pH and for vaginal lubrication
- normal fallopian tube development and function; normal levels of estrogen promote the growth of health muscular development of the fallopian tube which helps transport the egg and sperm cells during the process of fertilization
- maintenance of the uterine lining and normal muscular stimulation and contractions
- regulation of flow and consistency of uterine secretions which aids in healthy fertilization
- breast development, nipple pigmentation and cessation of lactation (milk flow)
Estrogen is also responsible for normal feminization of the female body including:
- the development of smaller bones and a wider set pelvis
- hip and thigh fat storage
- insulin sensitivity and slower growth rates during puberty
- hair growth patterns
- growth of a smaller voice box and shorter vocal cords
- suppression of oil secretion in the skin
The role of estrogen doesn’t stop there. Estrogen is a hormone which also interacts with many other parts of the body for normal body function including:
- temperature regulation and enhanced effects of “feel-good” hormones in the brain
- promotion of skin thickness and collagen production
- improvement of bone strength and prevention of bone loss
- cholesterol regulation
Ladies- listen up! There may be lifestyle or medical reasons for unbalanced estrogen levels.
There may be a one or more causes to altered estrogen levels that can be caused by certain medical conditions or lifestyle choices some of which include:
- ovarian failure
- underactive pituitary gland function
- pregnancy, miscarriage, menopause, perimenopause, puberty
- polycystic ovarian syndrome (PCOS)
- eating disorders like anorexia nervosa
- strenuous exercise
- medication use
- high blood pressure or diabetes
- ovarian or adrenal gland tumors
What happens to the body when estrogen levels are unbalanced?
When estrogen levels are unbalanced women may report experiencing a multitude of unwanted symptoms, some of which may include:
- altered menstruation with or without bleeding abnormalities
- hot flashes/night sweats
- benign breast (fibrocystic changes) or uterine masses (fibroids)
- mood swings
- premenstrual syndrome (PMS)
- weight gain
- low sex drive
- depression and/or anxiety
- dry skin
Men…don’t think you’re off the hook here!
Some men may experience unwanted and troublesome symptoms when estrogen levels are unbalanced including:
- erectile dysfunction (ED)
- prostate cancer
- gynecomastia (enlarged breasts)
- excess belly fat
- low sex drive
Ladies! High levels of estrogen could be negatively affecting your health. Read more to see how.
Elevated levels of estrogen in women can have a negative impact on your health and increase your risk for certain diseases, some of which may include:
- breast cancer (especially post-menopausal)
- endometrial cancer
Men with excessive levels of estrogen can be at risk for certain diseases, some of which may include:
- blood clots
- heart attack
- coronary atherosclerosis and peripheral artery disease
- prostate cancer
- male breast cancer
Like estrogen, progesterone is a hormone found in both men and women, however, its function is different in each sex. In women, progesterone is vital for healthy reproductive function. Progesterone has a number of responsibilities in the female body, some of which may include:
- preparation and maintenance of the uterine lining for implantation
- prevention of egg release during pregnancy
- prevention of multi-egg fertilization
- fetal development, lactation and pelvic wall muscle strength
- breast development
- important player in the hormonal cascade as it is known to work with estrogen and testosterone levels
Progesterone in men is also important and not only a female sex hormone. Males need progesterone to:
- develop sperm
- maintain an erection and sex drive
- regulate estrogen and testosterone levels
- maintain bone and joint health
What happens to the body when progesterone levels are unbalanced?
When progesterone levels are unbalanced women may report experiencing a multitude of unwanted symptoms, some of which may include:
- headaches or migraines
- mood changes
- anxiety and/or depression
- low sex drive/libido
- hot flashing
- menstrual cycle irregularities such as abnormal uterine bleeding, infertility and/or irregular/missed periods
Because estrogen and progesterone need to work in a harmonious balance, unbalanced levels of progesterone may trigger estrogen dominance and lead to some of the estrogen related symptoms discussed in the section above.
Note: Women who are pregnant may experience symptoms caused by low progesterone levels including vaginal spotting, abdominal pain, breast tenderness, fatigue, low blood sugar and vaginal dryness. Given the importance of progesterone on a healthy pregnancy, if you are pregnant, these symptoms need to be discussed with your obstetrician or midwife immediately.
Ladies! There may be a true medical reason for your unbalanced levels of progesterone!
Progesterone levels may be abnormally low in women due to several medical conditions, some of which may include:
- preeclampsia in late pregnancy
- ovarian dysfunction
- amenorrhea (no periods)
- ectopic pregnancy (pregnancy in the fallopian tubes)
Some women may experience higher than normal levels of progesterone due to certain medical conditions, some of which may include:
- ovarian cysts
- pregnancies that are not viable
- certain ovarian cancers
- adrenal gland dysfunction, cancer or congenital adrenal hyperplasia (CAH)
Men…stay tuned….you may have low progesterone too!
As we discussed, men also produce and need progesterone to maintain optimal health. Progesterone is an important hormone in men, as it is converted into testosterone and is responsible for the neutralization of estrogen. When men have lower than normal levels of progesterone, they may experience symptoms of feminization and estrogen dominance discussed above, as well as other symptoms including:
- low sex drive and/or erectile dysfunction
- hair loss
- weight gain
- bone and muscle loss
- breast development (gynecomastia)
Low progesterone levels in men can lead to certain medical conditions including:
- prostate cancer
- bladder neck obstruction called prostatism
Keep reading to learn about progesterone level testing!
Ladies! Stay put…testosterone isn’t just for men!
Like estrogen and progesterone, testosterone is a hormone found in both men and women, however, its function is different in each sex. Testosterone is responsible for the development of male characteristics in the human body. In men, testosterone is maintains libido, bone mass, fat distribution, muscle mass, maturation of sperm cells and the production of red blood cells; it is a hormone that is normally lowered as part of the aging process.
Testosterone is also an important hormone in women, however balance is vital. Like in men, testosterone is responsible for libido and bone/muscle mass in women and is also a vital part of the reproductive cycle.
Testosterone levels may be found to be abnormal in men due to several medical conditions which may include:
- testicle injury or infection
- certain medications
- pituitary tumors
- elevated prolactin levels
- type 2 diabetes
- kidney/liver diseases
- certain genetic abnormalities leading to diseases like Klinefelter syndrome, Prader-Willi syndrome, hemochromatosis, Kallman syndrome, and myotonic dystrophy
Women too may have altered levels of testosterone due to certain medical conditions including:
- low DHEA levels
- adrenal insufficiency
- ovary removal
- certain medications like estrogen therapy
- early onset menopause
- polycystic ovary syndrome (PCOS)
- congenital adrenal hyperplasia
- ovarian tumors, for example Sertoli-Leydig tumors
What happens to the body when testosterone levels are unbalanced? Let’s talk symptoms…
Men with lower than normal levels of testosterone may experience a variety of unwanted symptoms, some of which may include:
- lowered sex drive
- erectile dysfunction
- lower than normal sperm counts
- breast enlargement (gynecomastia)
- lowered body hair, muscle strength and mass and increased levels of body fat
- mood swings
- testicle shrinkage
Women with abnormally high levels of testosterone may experience a variety of unwanted symptoms, some of which may include:
- changes in the menstrual cycle
- male pattern baldness
- voice deepening
- enlargement of the clitoris
- decreased breast size and/or changes in body shape
- increased muscle mass
- increased skin oil production
- increased facial hair growth
- uterine fibroids
- low sex drive
- mood changes
Women with abnormally low levels of testosterone may experience a variety of unwanted symptoms, some of which may include:
- changes in libido and sexual satisfaction
- muscle weakness
What is DHEA and why is it important?
DHEA or dehydroepiandrosterone is produced by the adrenal glands of both men and women and is an important player in the production of other hormones like estrogen and androgens. While DHEA levels are reported to peak at age25, as a person ages normally, they experience a steady decline in DHEA.
Certain medical conditions may contribute to lowered levels of DHEA, especially in those over 30 year old, some of which may include:
- type 2 diabetes
- adrenal deficiency
- kidney disease
- use of certain medications including insulin, opiates, corticosteroids and danzol
When DHEA levels are low, some people may experience symptoms like
- concentration difficulties
- diminished level of overall well-being
Note: Higher than normal levels of DHEA may be caused by certain tumors and adrenal gland disorders and lead to the early onset of sexual maturity.
So at this point you may be saying “Now what? How do I test for these abnormalities and what do I do next?”
Obviously, it is vital that you speak with a qualified healthcare provider about ANY abnormal symptoms you may be having because as you can see, the cause of these hormonal imbalances can be caused by potentially life threatening and serious conditions.
For many of us in the quantified self, direct access healthcare community, we are looking for answers to the most common question…what is causing my symptoms?
A simple internet search will lead you to companies who test hormones using various methods like saliva testing and/or spot blood testing but here at CompendiumDX we have narrowed down the search to two trusted labs, ZRT and EverlyWell.
Both companies test for hormone imbalances using saliva and small amounts of blood. ZRT also tests urine depending on the test requested.
So why no tubes of blood?
According to ZRT, testing saliva and blood spot may be a more reliable way to test the hormone levels within the tissues and are “highly accurate methods for assessing oral, topical, vaginal, injectable and pellet hormone delivery. However, saliva is not accurate for troche or sublingual hormone therapies because these deliver high amounts of hormone locally to the salivary glands – giving a false-high determination of whole body exposure to the supplemented hormone.”
They go on to explain that serum (whole blood) testing for evaluation of the effect of supplementation with topical hormones may underestimate how much of the hormone is being delivered to the actual tissues within the body. Therefore, they explain that blood spot testing, which is taken from the finger, gives better insight into the hormone levels within the tissues. ZRT further explains that because there is not a significant elevation in serum hormone levels following topical hormone dosing, saliva testing may offer a more accurate assessment of the amount of available to the tissues.
When it comes to taking the test into the loo for a urine sample, ZRT explains that urine testing “Urinary hormone testing is the only way to see how the body is metabolizing hormones. Both saliva and urine can be used for measuring diurnal cortisol levels; but urinary free cortisol output reflects an average of the time since the previous urine void (hours), while saliva provides an instantaneous assessment at the time saliva was collected (minutes)”.
Did you know that you may be able to order home based hormone testing without a prescription?
You heard that right!
Each state within the United States has certain regulations under CLIA (Clinical Laboratory Improvement Amendments) regulations which determine the need for a prescription for these types of services. A state that allows Direct Access Testing (DAT), do not require a prescription for these type of testing services, however there are states that do have these requirements.
EveryWell tests do not require a prescription for testing, however they do not currently service residents of New York, New Jersey, Maryland and Rhode Island. ZRT requires a prescription from residents of California and notes that there are restrictions for Maryland and New York State residents with online orders.
Once you determine the need or desire for home based hormone testing, it is best to speak with a representative from the company with shipping and prescription questions.
What tests are available to test my hormones?
If you are considering saliva and/or blood spot testing, we recommend visiting ZRT and EverlyWell’s websites for additional testing information to choose a test which meets your individual needs or you can speak with your healthcare provider for testing type recommendations.
There are many options to performing the tests at home; determining which company to use is a personal decision based on many factors including location, cost, specimen collection methods and testing needs.
We have complied a short list of a handful of the many hormone tests which are available for testing as a sample of some of the services offered. Click on the test for more information!
Hormone Trio (ZRT)
Testosterone Test (EverlyWell)
Men’s Health Test (EverlyWell)
Blood Spot Testing
Hormone Trio (ZRT)
Female Blood Profile I (ZRT)
Female Blood Profile II (ZRT)
Male Blood Profile I (ZRT)
Male Blood Profile II (ZRT)
Saliva and Blood Spot Combo
Women's Health and Fertility(EverlyWell)
Fertility Profile (ZRT)
Speaking with a qualified healthcare provider is essential in determining your personal risk for hormone imbalances which can be causing uncomfortable physical and emotional symptoms. Certain hormone imbalances may be caused by minor issues or more potentially serious health conditions that need further evaluation by a healthcare provider.
Maintaining hormonal balance can help with unwanted symptoms like depression, anxiety, weight gain, low libido, vaginal dryness, erectile dysfunction, menstrual irregularities and infertility to name a few. Home based saliva, blood spot and combination testing may be a useful tool for you and your healthcare provider to determine the best course of treatment for symptoms and disease prevention.
Speak with your healthcare provider to see if home based hormone testing is right for you and how they can help to best interpret your results!
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