ABC of testing for hormonal balance - part 2: Specific testing

It is important to know how to check correctly all of your hormones. Before you move to specific testing of your hormones don´t forget to check the ABC of testing for hormonal balance- part 1: Foundation of hormonal balance.

Some hormones will show their optimal levels through a blood test and some of them are better to test through dry urine sample (The Dutch Panel) or saliva. The ideal situation is to use the combination of both blood test and The Dutch panel or saliva, to get more comprehensive results and understanding. Your doctor should evaluate your symptoms also to be able to establish which test might be necessary.

It is important to understand how your hormones work to know what steps to take in their testing and in which order so you can fix your hormonal imbalance.

You should be testing the following:

• Sex hormones: DUTCH PANEL (more comprehensive) AND BLOOD TEST

- Estrogens and their metabolites (Dutch Panel only)

- Progesterone

- Testosterone, free testosterone and bioavailable testosterone

- Androgens and DHEA

- Follicle- stimulating hormone (FSH)

- Luteinizing hormones (LH)

- Sex biding hormone globulin

To feel ok you need to have estrogens in balance with progesterone. Make sure you test well all your hormones before you start any replacement hormone therapy. If you are in perimenopause test on day 19-22 of your cycle.

• Thyroid: BLOOD TEST

- TSH (not enough to test only TSH)

- Free T4 (not enough to test only T4)

- Free T3 (crucial to test T3)

- TPO and TGB antibodies (important for detecting Hashimoto disease which is the

most undetected illness; indicators of an autoimmune attack on the thyroid gland).

What do you need to know about Thyroid testing? It´s not enough to test TSH and T4. It´s crucial to also test for free T3 which is the active form of thyroid hormone. Other very important things your doctor should be looking at are the Antibodies which are the indicators of an autoimmune attack on the thyroid gland. You can have your TSH and T4 at normal levels, yet if your antibodies are high or your free T3 is not at an optimal level, you could have problems with your thyroids. Thyroid problems are 10x higher in women than men. Is the most misdiagnosed disease.

• Adrenal hormones: DUTCH PANEL O SALIVA

If you are under chronic stress you might have a problem with your primary stress hormone called cortisol which, after some time, starts to steal from pregnenolone which is the precursor of progesterone, so you start to lack progesterone and as a result, you suffer the estrogen dominance. That´s why you need to test for:

- Free cortisol pattern

- Cortisol and its metabolites (only DUTCH PANEL)

For a full picture of the cortisol, test 4 times a day.

• Neurotransmitters and their metabolites: DUTCH PANEL

Nerve cells in the brain communicate with each other through neurotransmitters. You have probably heard about one of the best-known: serotonin. This chemical messenger affects moods and is linked to depression, anxiety, and obsessional states. Estrogen’s role in a balanced mental state is to maintain the orderly firing of several neurotransmitters in the brain, including acetylcholine, dopamine, norepinephrine, and serotonin.

Estrogen, the body’s natural mood stabilizer and antidepressant, is necessary for the production of serotonin.

Due to this link between estrogen and serotonin, women are especially susceptible to mood disorders when they experience a drop in estrogen levels (such as during pre-menstruation). Estrogen levels rise, serotonin levels rise, a woman’s mood is improved. It happens monthly, for example, when menstruation begins. During pregnancy, high levels of estrogen can improve mood. But right after the baby is born, estrogen levels drop off, reducing the amount of serotonin in the mother’s brain. Sometimes this is the catalyst for post-partum depression.

The same drastic dropping off of estrogen happens during perimenopause, increasing the likelihood of depression and anxiety. The lack of some of the mentioned neurotransmitters is also an indicator of hormonal imbalance.

• Organic acid (oxidative stress): DUTCH PANEL

This will indicate the state of the functioning of your mitochondria which is responsible for Cellular respiration and numerous bodily processes, included processes of your hormonal system:

1. Cellular energy production

2. Calcium homeostasis

3. Cell growth

4. Cell death

5. Oxidative radical regulation

6. Nerve conduction

7. Synthesis of bio-molecules

8. Role in disease

9. Metabolism

• Melatonin: DUTCH PANEL

Many people suffer sleeping problems and the production of their melatonin is compromised. If you don´t sleep well and enough, you will have hormonal problems. The production of melatonin happens between 8 pm- 2 pm so if you don´t get good quality of sleep in this time interval, your body will be lucking melatonin.