Author: Salma Alsibai, RD. LD.
What are hormones and Why are they important?
Hormone are chemical messengers that influence everything in our bodies, from bone health, brain health, cognitive function, digestion and gut health to fertility, appetite and cardiovascular health. They are produced by our bodies in precise amounts to keep us healthy. However, when our hormone levels drop or exceed what is deemed normal for us specifically, it can cause a whole host of symptoms.
Tools that we can use to help assess our hormonal health include taking a look at the signs and symptoms we consistently experience, lab tests, functional tests and menstrual cycle data.
Signs & Symptoms of hormonal imbalance include:
- Irregular or absent periods
- Infertility
- Menstrual migraines
- PCOS
- Endometriosis
- Breast tenderness
- Acne
- Low libido
- Weight loss resistance
- PMS
- Mood swings
- Loss of lean muscle mass
- Acne
- Estrogen dominance
- Luteal phase defect
- Low Progesterone
- Heavy or painful periods
Lab Tests
There are a number of blood tests that let us know when our bodies aren’t functioning at their best and can alert us to hormonal imbalances before they become severe.
Blood Sugar Balance
- Fasting Plasma Glucose: FPG tests show us the state of our blood sugar at a single point in time. The blood sample is usually drawn in the morning after an 8 hour fast.
Normal value: <99 mg/dL
- HbA1C: The hemoglobin A1C blood test also takes a look at our blood sugar values, but gives us a better idea of general blood sugar balance as it shows us an average of the past 3 months.
Normal Values: below 5.7%
- Homeostatic Model Assessment for Insulin Resistance: HOMA-IR uses fasting glucose and fasting insulin levels to calculate the body’s level of insulin sensitivity or insulin resistance. The equation used is fasting insulin (microU/L) x fasting glucose (nmol/L)/22.5. A high value is indicative of insulin resistance, while a low number means that your body is responsive to small amounts of insulin.
Values: <1: Insulin Sensitive
> 1.9: Early insulin resistance
> 2.9: Significant Insulin Resistance
Thyroid Panel is a group of tests that evaluate thyroid gland function.
- Thyroid Stimulating Hormone: TSH hormones produced by the pituitary gland and regulates the balance of thyroid hormones (T3 & T4). Elevated TSH levels are indicative of thyroid hormone deficiency, while low TSH levels are indicative of thyroid hormone excess. (Normal range: 0.40 – 4.50 mIU/mL)
- T4: Thyroxine measurement (Normal range: 5.0 – 11.0 ug/dL)
- Free T4: measures thyroxine levels that are not bound to protein, giving a more accurate measurement. (Normal range: 0.9 – 1.7 ng/dL)
- T3:Triiodothyronine measurement (normal range: 100-200 ng/dL)
- Free T3: measures triiodothyronine levels that are not bound to protein, giving a more accurate measurement. (Normal range:2.3-4.1 pg/mL)
Hormone Panel tests: when looking at hormone levels in the blood, it is best to take samples during 2 different periods of a womens’ menstrual cycle (for example day 3 and 22) to get a better picture as hormone levels fluctuate throughout the cycle.
Estrogen: In the first half of a womens’ cycle, the follicular phase, estrogen levels gradually increase until they reach their peak at about 14 days into the cycle. This estrogen peak is typically what triggers ovulation. Once ovulation occurs, estrogen levels drop and are at their lowest during menstruation. Typically, women\’s estrogen levels decrease as they age, with a dramatic drop once menopause occurs.
Progesterone: During the second half of the menstrual cycle, the luteal phase, the ovaries release progesterone. Progesterone works to stabilize the uterine lining, stimulate the thyroid gland and support pregnancy. Generally, progesterone makes us feel good and is known as the anti-anxiety hormone.
Follicle Stimulating Hormone: Produced by the pituitary gland during the follicular phase of the menstrual cycle, alongside estrogen, in preparation for ovulation. Levels continue to rise if pregnancy is achieved, but drops if it has not.
Testosterone: Produced by the ovaries and Adrenal glands, and needed in small quantities for women to support metabolism, muscle mass maintenance and libido.
Functional Tests
Functional tests are not typically done in traditional labs, but can be ordered as mail-in test kits from many online labs. Although they can be slightly costly, they do provide detailed insight into our health.
HTMA: Hair, Tissue and Mineral Analysis
HTMA is conducted to look for micronutrient deficiencies and imbalances by using a hair sample. Mineral ratios are indicators of adrenal function, thyroid function, carbohydrate metabolism, and your body\’s overall ability to handle stress.The benefit of an HTMA test over a typical blood draw, is that the hair sample allows us to look at 3 months of tissue activity, while a blood draw represents a single moment in time.
DUTCH: Dry Urine Testing for Comprehensive Hormones
The Dutch test allows us to not only study hormone levels but also the metabolites that result from hormone metabolism. This provides insight into the metabolic pathways the body is using and what end products are resulting.
Menstrual Cycle Data
Part of advocating for our health is knowing our body, this is why it\’s so important that women track their menstrual cycles. Thankfully, this has been made easier by the use of free “period tracker” apps. Tracking your cycle includes taking note of when your cycle occurs, how long it typically is, how often it occurs, and noting when symptoms tend to flare. Symptoms can include anything from acne, menstrual migraines, changes in bowel movements, mood swings and increased or decreased appetite.
Some women may benefit by taking this a step further and tracking their basal body temperature (BBT). BBT is the oral body temperature taken first thing every morning, before even speaking or sitting up in bed. For women struggling to conceive, tracking their BBT can help pinpoint when ovulation occurs, as our BBT increases about half a degree shortly after ovulating.
For women who are not trying to conceive, but simply want to improve their hormonal health, tracking BBT can prove to be useful as well. This is because knowing whether or not ovulation is occurring tells us a lot about our hormonal health. Its also a great way to get quick feedback on whether the lifestyle and dietary changes that are being implemented are having their desired effect.