Do You Need Hormone Tests?


If you suffer from symptoms such as fatigue, mood swings, anxiety, PMS, weight gain, brain fog, hot flushes, low libido insomnia or depression then you could be suffering from hormone imbalances.

While it’s important for any health practitioner to take your history and symptoms into account to determine correct protocol, certain functional hormone tests can give you a real head start.

What are the benefits of testing?

  • It removes the guesswork. Even though we can get a good idea of what’s going on from your symptoms, it’s good to have the backup of a physical test so you know for certain that something isn’t where it should be. You can put a protocol in place that laser targets that specific imbalance.
  • You get quicker and more effective results, after all, that’s what everyone is after!
  • It helps you stick to the programme – it’s all well and good being told that there is a problem, but seeing it on paper makes it REAL.
  • It gives you a baseline to measure your progress

Which hormone tests?

Cortisol. Chronic stress is at an epidemic level in our modern day lives and this can take a toll on our adrenal output. A cortisol imbalance over the long term can have serious implications on your health including cardiovascular, hormones, digestion, neurological and immune function. Your doctor may test your cortisol levels but it is not a standard test. If your doctor suspects very low or very high levels, he may order a blood test that measures your cortisol levels in the morning. Your GP may be looking for abnormally low levels, which could indicate a serious condition called Addison’s Disease. They are not looking to measure how well your adrenals are coping over the course of your day. ‘Adrenal fatigue’ or cortisol imbalance is not a recognised condition in conventional medicine, but it can be a risk factor for many chronic conditions.

Private testing options include a urine test which analyses samples over 4 points of the day. This test not only shows your active cortisol levels, but also your metabolised cortisol, effectively looking at a much larger percentage of the cortisol in your system. From this, you can see if you have a cortisol imbalance and then put the appropriate protocols in place.

Thyroid. Your thyroid hormone is vital for every cell in the body to make the energy required for it to do its job – whether that’s making your heart beat, your muscles work or your brain function properly! You may have been tested and told you were ‘normal’. There are three problems with standard thyroid hormone tests.

A very wide reference range: The reference ranges for thyroid hormones are very wide. That means that you could be ‘normal’ even though you are at the lowest end of the scale. Unless you dip under the threshold you won’t get any treatment. This is known as ‘sub-clinical’ hypothyroidism and there is much debate about how or even whether it should be treated.

It’s not the whole picture: The standard initial test for thyroid will sometimes only measure TSH levels. Often T4 is measured though not always in its free form (fT4). It’s really important to know your free T4 and free T3 levels but these won’t necessarily be measured if your TSH is ‘normal’. This testing process only looks at a small part of the Hypothalamus-Pituitary-Thyroid axis and doesn’t take into account what may be happening further down the chain (e.g. if your T4 is not converting to T3, you have low active hormone).

No interest in the root cause: If you have low thyroid function, it is vital to know if it is autoimmune related. Around 80% of thyroid disease cases are autoimmune Hashimotos or Graves disease. Autoimmune thyroid conditions have a different etiology than other thyroid issues, and so require a different protocol of treatment. Many people are just put on Thyroxine, not knowing they have an immune disorder and how to treat it. As an alternative, a full thyroid hormone blood test panel includes TSH, fT4, fT3 plus TG and TPO antibodies. That way, if there is a problem you can see where in the chain it’s likely to be occurring and put in place the right dietary and supplement protocol to address it.

SEX HORMONES. Blood tests for sex hormones are often hard to come by and not particularly reliable as they only show a snapshot of your free hormone levels. If you are in peri-menopause (this can occur anytime between the ages of 35-52) and experiencing symptoms then your doctor may test your FSH (Follicle Stimulating Hormone) and LH (Luteinizing Hormone) levels. If they are raised then it can indicate lower levels of oestrogen and progesterone, indicating that you may be in peri-menopause (but chances are that you know that if you are experiencing symptoms). HRT is often recommended when actual sex hormones have not been tested.

As an alternative, one of the best sex hormone tests available is a test involving 4 simple urine samples taken in the luteal phase of the menstrual cycle (or anytime for post-menopausal women). This test will show not only show your sex hormone levels but also their hormone metabolites. This gives you a much more accurate picture of how hormones are actually performing, and crucially how they are being detoxified and eliminated. This is very useful to know whether HRT will actually be of benefit (or risk!) and also key to understanding the unique behaviour of hormones in the body and potential risks of further conditions.

NUTRIENT LEVELS. As we age our nutrient levels can go down just at the very time that our need for them goes up. There are many reasons for this including a poor diet, stress, digestive imbalances, alcohol, medications, toxins and general aging. It is important to identify any nutrient deficiencies when you have ongoing unexplained symptoms. Some vitamins and minerals can be tested through your GP, however often not as thoroughly as may be needed.

An alternative is to go for a more comprehensive blood test, which looks for a wider range of nutrients that can have a big effect on common symptoms such as fatigue, mood swings, brain fog and will test for B12 (active, not blood levels), Vitamin D, Ferritin (iron stores), Folate and Magnesium.

The Problem with ‘normal’

Many people report that they have had hormone tests done by their doctors and have been told they are ‘normal’. What often occurs with these results is that they have fallen into the ‘normal’ range, but at the very low end.

There’s a huge difference between someone with optimal TSH (thyroid stimulating hormone) and someone with a level that is just within range. Or Ferritin levels at the bottom of the range, when you need optimal levels to support hair growth, energy levels and immune function.

You want to be at OPTIMAL levels not ‘normal’ levels! It can make a huge difference to your wellbeing.

To learn more about hormone testing