Hormone Balance

Here is a simplified track for helping you understand what types of hormone imbalances you may have.  It can help you determine whether you need to see your doctor and receive testing.

Ask these 7 Questions:

1- If you are female, do you have symptoms that occur prior to menses and are relieved after menses or do you have irregular menses?  (PMS)

2-Do you have postmenopausal symptoms?

3-If you are male, are you experiencing decreased energy and libido?

4-When did your symptoms start?

5-How do you feel when you wake up?

6-How well do you sleep?

7-How is your energy?/Are you on Synthroid?

Premenopausal Question #1

If you have symptoms related to your cycle then you should test your ovarian function. Regardless of the symptoms, if the symptom occurs at certain times during the 28 day menstrual cycle on a consistent basis the hormone imbalance is either the problem or exacerbating the problem.  The most likely times during a woman’s life where she may experience imbalance of these hormones is during the transitional stages of her life.  The stages of transition are puberty, perimenopause and menopause.  This is when women are transitioning in and out of the reproductive stage of her life.

The Female Hormone Panel  (FHP) measures 11 samples over the month to provide the Estrogen to Progesterone ratio in the Follicular and Luteal phases of the cycle.  This allows treatment individualized for the physiology and specific needs. This allows treatment individualized for the physiology and specific needs.

Postmenopausal Question #2

The Post Menopausal Panel (post-M) measures the free (active) components of all the necessary sex hormones and precursors.  This allows for diagnosis and safe prescribing of bio-identical hormones  to maintain the proper Estrogen to Progesterone ratio.  In the proper ratio there is a balance of the proliferation on the breast cells and the uterine lining.  There is also an importance to the ratio of testosterone to estrogen and progesterone.  All three hormones (estrogens, progesterone, and testosterone) are normally prescribed for Bio-identical Hormone Replacement.

Male Question for energy and libido #3

The Male Hormone Panel and the female panels address the level of active testosterone.   The full  androgen pathway is measured including:  DHEA-the precursor for both male and female hormones and an anti-stress hormone, Androstenedione- a weak male hormone and precursor, DHT- responsible for prostate enlargement and thinning of hair, Progesterone- keeps in check excessive DHT, Estrone- the so-called undesirable estrogen which leads to breast and prostate problems but is still necessary in males to balance the androgens.  This test is for you if you are having:

                Impaired libido

                Erectile dysfunction

                Baldness

                Fat accumulation around the waist

                Poor cholesterol panel

Questions  #4, 5 and 6   How do you feel when you wake up?  How well do you sleep?  When did your symptoms start? 

These questions may be used to reveal the stressors in a person’s life.  The stressors can be past or worry for the future.  Cortisol and dehydroepiandrosterone (DHEA) are steroids that help the body manage stress.  The Adrenal Stress Index (ASI) is a saliva take-home test that measures the stress hormones at 4 times throughout the day as well as the DHEA.  Because insulin and cortisol are linked, insulin is measured pre and post meals.  And the immune system function is screened for gliadin (wheat) sensitivity since this is a common cause of inflammation and ongoing stress to the adrenals.

This Adrenal Stress Index may be needed if you experience:

                Weight gain

                Fatigue

                Insomnia

                Brain fog

                Depression

                Mood swings

                Hair loss

                Skin problems

                Poor immune function

                Intolerance to cold

                Craving carbohydrates or salt

Question # 7   How is your energy/are you on Synthroid? 

Energy and weight concerns are often manifestations of suboptimal  thyroid, however, this is a diagnosis which is still often missed.  Advanced  thyroid testing includes free T3 and T4, TSH and thyroid antibodies.  Interpretation of the results must always include patient symptoms and signs.  Treatment is controversial but I favor using natural approaches over the use of synthetic T4 (Synthroid).  Mild cases of hypothyroidism may only require nutritional support with iodine, selenium, zinc and other micronutrients as determined by functional testing.  More severe cases will require repletion with natural thyroid.  Follow-up evaluations are done periodically to ensure optimal levels of free T3 and free T4 are maintained and that anti-thyroid antibodies are not produced. 

For further information about thyroid see: www.about.com/thyroid. 

Another often overlooked hormone is human Growth Hormone.  This important hormone is called the “repair hormone”.  Low levels are often found in chronic fatigue states and chronic pain/stress.  We optimize this hormone by various nutritional and lifestyle interventions.  Rarely, injections of human Growth Hormone are prescribed.  Benefits include slowed signs of aging such as improved lean muscle mass, strength and vigor.