Do I Have a Hormone Imbalance? Lab Tests to Take
Published: May 2023
Staying healthy as we age seems like a battle we’re (slowly) losing. As we leave our 30s, 40s and 50s behind, most of us notice subtle shifts in our bodies; our energy levels aren’t what they used to be, our patience runs short, our muscles don’t feel as strong, and managing a healthy weight can feel like a lost cause—even after cutting out processed foods and refined sugars.
So, what’s changed? Besides the obvious telltale signs of aging—more gray hairs, laugh lines and wrinkles—the reason why you’re not feeling like your usual self could be a hormone imbalance.
Yes, that’s correct: hormonal imbalances can (and do) impact your sleeping patterns, metabolism and mood! That’s because your hormones help regulate everything from growth and development to how your organs work, how hungry you feel, your libido, and even how your body responds to stress and injuries.
A hormone imbalance—too much or too little of any given hormone—can adversely affect your health. Hormone testing is a proactive way to keep your hormones in check, giving you a starting point to improve your health and enjoy a long and fulfilling life at every age.
Why do hormone levels change over time?
It's natural for hormones to fluctuate as you go through your day. There's a rhythmic pattern of hormone production, storage and release that supports different biological processes that keep you kicking and thriving. For example, as bedtime approaches, your pineal gland will release melatonin, signaling your body that it's time for restful shuteye.
The pituitary gland signals different glands throughout the body that oversee the production and release of specific hormones. For example, the pituitary gland releases luteinizing and follicle-stimulating hormone (FSH) to signal the ovaries or testes that regulate the release of sex hormones, such as estradiol (a form of estrogen), testosterone and progesterone.
For us women, these hormones (which essentially are chemical messengers that "tell" the body what and how to function) sway throughout the day and during different phases of our menstrual cycle, impacting how we feel—yeah, that's right, we don't feel "hormonal" for nothing!
There are also life milestones with an expected change in hormone status: puberty, pregnancy and menopause. Health conditions like polycystic ovary syndrome will also impact the delicate hormonal balance. For example, the luteinizing: FSH ratio is skewed in women with this condition, and in men, elevated FSH levels could indicate reproductive impairment.
But as we age, the balanced seesaw of production and release of these vital chemical messengers progressively becomes less efficient and results in a peak of some hormones and a decrease of others. Low testosterone levels, for example, can indicate high estrogen; you may feel wiped out by the end of the day, have a lower-than-usual libido, or feel "off."
General symptoms of a sex hormone imbalance
For men, low energy levels and libido, a depressed mood, or a decrease in muscle mass could be an indication of low testosterone levels.
For women, hormone levels vary monthly and during different life stages like pregnancy, perimenopause, menopause and post-menopause. In general, however, a hormonal imbalance in women could be an indication of low progesterone or estrogen or an imbalance between the two. For example, low estrogen and high progesterone or vice versa.
Some symptoms women may experience during a hormonal imbalance are:
- Night sweats and hot flashes
- Sleep disturbances
- Mood swings
- Depression and anxiety
- Vaginal dryness
- Unexplained weight gain or weight loss
- Pregnancy can bring about skin concerns like blemishes and other imperfections
A lab test can help both men and women identify if a hormonal imbalance is present.
What are hormone lab tests?
Hormone testing is a type of health test that empowers you to understand your biology and health better. It removes the guesswork about what's going on, allowing you to design a wellness plan that addresses the cause of your hormone-related health concerns rather than wondering if what you're feeling is "normal" or symptoms of a hormone imbalance. Hormones can be tested using a saliva sample, a blood sample or a urine sample.
When should you have hormone levels checked?
Bottom line: If you're healthy and not going on hormone replacement therapy (or you're post-menopausal), getting yearly hormone testing is an excellent way to stay on top of your health. Regularly keeping up with your hormone status can help you hack your biology and address hormonal imbalances to improve sleep and metabolism, maintain muscle and bone mass, manage energy levels and how you respond to stress and immune challenges, and much more.
What is the best hormone lab test?
There's no perfect way to test hormones; results depend on your unique biology. Each type of lab test offers different information about the ratio and balance of your hormones. The type of hormone test you need will depend on factors such as age, gender and the condition you're experiencing.
Physicians may order a blood and a urine test to thoroughly cover their bases. For example, if you're a woman in your 40s, and you're experiencing perimenopausal symptoms such as lack of concentration or inexplicable fatigue, hot flashes, or inability to have restful sleep, your healthcare provider may suggest doing both lab tests at the same time to have a more comprehensive insight into your body's hormone metabolism. The same may apply if you're a man in your 40s or 50s trying to improve testosterone levels.
Here are the ins and outs of each diagnostic option:
Blood testing:
Considered the gold standard for measuring hormones, this type of health test has a well-established reference range, is relatively inexpensive, readily accessible through blood draw centers, and reveals the association between the symptoms you're experiencing and your hormone levels. Blood tests measure free hormones (actively circulating throughout the body) and total levels of hormones. For men, annual blood tests help measure prostate-specific-antigens (PSA) levels, a crucial marker for managing prostate health.24-hour urinary panel:
Most healthy adults can get a clear understanding of their hormone profile with a blood panel. But for particular cases, more information is needed to paint a full picture of what could be infringing on their health. Here's where a urinary panel can be helpful. While blood testing is a piece of your wellness puzzle that provides a single snapshot of the time of day you take it, a urinary panel provides the average hormone status over 24 hours (you will need to collect urine samples at different intervals in a one-day period), revealing daily hormonal fluctuations. It also tests for more hormones and their metabolites (broken down hormones), providing different information than blood or saliva testing because it measures the hormones the body is excreting.Saliva testing:
Saliva testing can be a good alternative if you're not a fan of needles or collecting urine samples for an entire day. It measures free hormone levels and provides a way to chart hormonal changes over time (think of the changes during your menstrual cycle). You can collect information about the peak and bottom of your hormone levels through multiple samples.
How do I know which hormone lab test to take?
The type of lab test (or tests) you take depends on whether you need an initial read-out on your hormone status (to get a baseline) or need a comprehensive insight of your hormone status due to specific hormone-related conditions or symptoms you may be experiencing.
Pro tip: A Life Extension wellness specialist can help you determine which test is best for you.
5 popular hormone tests
Chances are, you've been getting some of these tests for years; you're probably familiar with the thyroid stimulating hormone (TSH) test which provides insight into whether your thyroid gland, which produces thyroid hormones, is functioning normally. Many doctors order a TSH test as part of a whole battery of tests done every year when you go in for your annual physical.
But did you know that this test really just scratches the surface—and that there are many other options that will give you a deeper dive into your health status? Here are five examples of lab tests that measure different hormones—maintaining youthful levels is essential for enjoying a fulfilling life, especially during those golden years.
1. Hormone urinary metabolite test
As you go through your day, hormones are released into the bloodstream and reach their target tissues (fulfilling their purpose, so to speak). They're then metabolized by hormone-specific enzymes to be replaced by a new batch of hormones. A urinary metabolite test reveals how your body is metabolizing hormones. In other words, this at-home test gives you in-depth insight into how hormones like estrogen, progesterone, or testosterone are produced, metabolized and excreted from the body. Your doctor or a Life Extension wellness specialist can help you understand the results.
2. Basic male hormone panel
A basic hormone panel for men provides information on blood levels of sex hormones concerning men and reveals potential prostate issues. The panel tests for DHEA-S levels, which are fundamental in hormone balance, immune function, energy, mood and muscle and bone mass maintenance. The basic panel test also measures estradiol, a form of estrogen that's also present in men. High levels of estradiol are associated with excessive abdominal fat, enlargement of the prostate and an increased risk for heart disease.
Your test results will also reveal free and total testosterone levels, which help maintain bone density, fat distribution, muscle strength, sex drive, mood, energy, sperm production and much more. And lastly, this basic hormone panel also screens for prostate-specific-antigens (PSA) levels, which are exclusively produced by prostate cells and are biomarkers of prostate health and function.
3. Basic female hormone panel
A basic female hormone test also evaluates levels of reproductive hormones like DHEA, which, as we mentioned earlier, is important for hormone balance, immune function, energy, and mood and is essential for maintaining muscle and bone mass, especially as we age. Your results will show DHEA-sulfate (DHEA-S) levels; it's a form of DHEA that's more stable in the blood than DHEA. Measurement of DHEA-S is preferable to DHEA.
The test also evaluates estradiol levels in the blood. This primary female sex hormone is a form of estrogen responsible for regulating your menstrual cycle, skin elasticity, bone strength, bladder and vaginal health. You'll also get insight into free and total testosterone—yes, we have testosterone, too, and it regulates our libido, bone and muscle mass, heart health, mood, and overall sense of well-being. Healthy testosterone and estrogen levels can help reduce sleep disturbances, hot flashes, night sweats and vaginal dryness. And lastly, the test also evaluates progesterone levels, which is necessary for balancing the effects of estrogen. A hormone imbalance between estrogen and progesterone is associated with weight gain, sleep disturbances, anxiety, depression, osteoporosis and more.
4. Comprehensive male hormone panel
As the name suggests, a male comprehensive hormone panel test evaluates a wide variety of hormones in addition to those covered in a basic panel test, giving you a more thorough insight into what's happening behind the scenes. In addition to analyzing your levels of reproductive hormones, it also tests for pregnenolone, sex hormone binding globulin (SHBG), cortisol levels and thyroid hormones like TSH, free T3 and free T4. The test results also reveal general health markers, such as a complete metabolic panel with lipids and a complete blood count.
5. Comprehensive female hormone panel
As with the male comprehensive panel, the female hormone comprehensive blood test evaluates additional sex hormones, not just progesterone, but also pregnenolone and SHBG. You'll also get insight into your cortisol levels, thyroid hormones like TSH, and free T3 and free T4 hormones (all produced by your thyroid gland). The test provides a complete metabolic panel, which includes a lipid profile (fats like triglycerides and cholesterol) as well as a complete blood count.Is hormone testing the same for men and women?
Not really, no. Men's hormones don't fluctuate as often as women's do in their reproductive years, and unlike women, they can take their test any day of any month. Non-pregnant women in post-menopause also can have blood tests done any day of the month—but for those who still have a monthly cycle, test timing is key.
This is because women's hormones change daily and from month to month when they are in their childbearing years. The pituitary gland and adrenal glands regulate levels of important hormones for women. For example, the pituitary gland secretes follicle-stimulating hormone (FSH) and luteinizing hormone, which are vital for ovulation; the adrenal glands secrete hormones like cortisol that help cardiovascular function. Being aware of these changes is essential for getting results. In fact, you will need to take the test during a specific time in your cycle, depending upon which test you take, so keep track of your dates of ovulation and menstruation. Always speak with your healthcare provider about when is the best time of day (and month) to take these tests.
Pro tip: If you're taking birth control or are undergoing hormone replacement therapy, your results will be different than if you were not taking hormone medications. Birth control medication can impact the results of a lab hormone test; people who are doing hormone replacement therapy should speak with their doctors about the best time to test.
What do hormone lab tests show?
Hormone tests give you a peek into the inner workings of your biology and can help you detect hormonal imbalances—too little or too much of a hormone or group of hormones—that could be impacting your health. Testing your hormones can also help you determine if your ongoing hormone replacement therapy is working. For example, your results will reveal if your estrogen levels are within normal range after undergoing bio-identical hormone therapy.
Are expensive hormone tests worth the price?
Hormone lab tests make you the knight in shining armor of your wellness journey, but they can get pricey, especially if your doctor hasn't ordered them for you. So, use them as a strategic wellness tool.
If you're a healthy man or woman in childbearing years, or a healthy postmenopausal woman (or a man in your 60s and up), annual lab tests allow you to track your hormone numbers to keep them at optimal levels and live your best life. However, if you're addressing a specific hormone-related concern, or want to improve levels of specific hormones, then you'll want to do a series of periodic tests.
How to periodically test your hormones
Start with a baseline:
The first test helps you understand your hormone profile. It gives you a starting point to know what you need to address. Maybe you need to level out the progesterone-to-estrogen ratio or increase testosterone levels.Get a follow-up lab test:
The little things we do every day directly impact how our body produces, metabolizes and excretes hormones. Speak with your doctor, but on average, wait about three to six months before you do a follow-up test. This gives your body enough time to adjust to any changes you're making, like adding cruciferous vegetables (such as broccoli, cabbage and brussels sprouts) to your meals and eliminating processed and refined foods and sweets, getting regular exercise, or hormone replacement therapy. It takes time for the body (and hormones) to find balance, so be patient with yourself.
Pro tip: Be consistent with the type of hormone test you do. Don't do a blood test one time and a urine test the next. You will not get comparable results because they measure hormones in different ways.Dive deeper when necessary:
If the follow-up tests don't show the desired results or there's no symptomatic improvement, then you can opt for other types of lab tests to get a clearer understanding of how your hormones are working.Discuss your results with a professional:
Always speak with your doctor to discuss your lab test results and the possible game plan to make lifestyle changes and address any imbalances. Remember: hormone lab testing is not a "one size fits all" approach; results, follow-up tests and whether you need to do other lab tests depend on everyone's unique experience, symptoms and biology.
Pro tip: When you purchase a lab test with Life Extension, you get free consultations with our wellness specialist.
References
- Campbell, Miles, Ishwarlal Jialal. "Physiology, Endocrine Hormones." StatPearls. September 2022. https://www.ncbi.nlm.nih.gov/books/NBK538498/
- Gnocchi, D, et al. "Emerging Role of Thyroid Hormone Metabolites." Acta Physiol. July 2016. https://pubmed.ncbi.nlm.nih.gov/26748938/
- Orlowski, Michelle; Manbeer S. Sarao. "Physiology, Follicle Stimulating Hormone." StatPearls. May 2022. https://www.ncbi.nlm.nih.gov/books/NBK535442/
- "Anatomy of the Endocrine System." Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/wellness-and-prevention/anatomy-of-the-endocrine-system
