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Hormonal Imbalance Testing Overview

In order to gauge your current state of health, our clinic will often request copies of your last two years of medical testing and will often recommend further testing as needed.  Our clinic does request some testing that is not commonly performed in more "mainstream" medical clinics.  24-hour heavy metal testing with provoking agent, neurotransmitter analysis, food sensitivity testing, comprehensive stool testing and Candida antigen testing are commonly recommended by our medical staff. 

What to Expect on Your First Visit:

Your first office visit will typically last 45-60 minutes. Your doctor will review your intake form with you and gather a detailed medical history.  A partial physical exam is usually performed and medical records are often requested from your primary care physician and/or other doctors.  Specialty laboratory testing may be recommended.  Most clients are offered an initial protocol consisting of nutritional supplementation, and dietary and life style recommendations.

First Visit: Blood Test

The blood test assesses and identifies any issues with your kidneys, liver, and blood sugar, as well as other key factors such as blood cholesterols. The results are explained to you so that you will have a fuller understanding of your blood chemistry, and be able to take control.

You will be required to fast for 14 hours before the test. Water may be drunk freely, but not tea, coffee, juices or other beverages. Appointments are normally arranged for mid-morning so that food and drink can be consumed up to 8pm the previous evening. On the day of the appointment, any prescribed medication should be taken with water as normal.

It is recommended that you bring food to eat after the blood sample has been taken. Diabetics should advise the clinic, and separate arrangements will be made.

First Visit: Urine Analysis

A urine analysis establishes exactly how the kidneys are functioning. You will be required to collect urine over a period of 24 hours. This should be as near the date of the blood test as possible, but must not include the 14 hour fasting period prior to the appointment. For example, if your appointment is at 10am Friday, urine collection should start Wednesday, 8 a.m. and continue until Thursday, 8 a.m. Fasting commences Thursday at 8 p.m. and continues until after your appointment on Friday, 10 a.m.

The first urine of the day should be excluded. All subsequent urine for the next 24 hours should be collected in clean plastic containers. Avoid contaminating the sample by urinating before defecating, and by not putting any foreign objects (i.e. toilet paper) in the container. The specimen should be kept refrigerated during the 24 hour collection period. Containers should be clearly labeled with your name and brought to the clinic at the time of your appointment. You are encouraged to drink fluids during the 24 hours.

First Visit: Resting ECG for Doctors Report

The electrocardiograph (ECG) determines the condition of the heart and measures its actions and the pulse.

The doctor in charge reports any findings in his medical notes.

Specific Hormonal Imbalance Testing:

A hormone will only act on a part of the body if it fits. A hormone can be thought of as a key. Its target site, such as an organ, has specially shaped locks on the cell walls. If the key fits the lock then the hormone will work. The endocrine glands get feedback from the body so they can adjust the hormones and keep them at the right levels.

  • Hormone Level Testing-Testosterone

As a man, in order to maintain masculine characteristics, you need a steady flow of testosterone, or androgens. This hormone is responsible for the normal growth and development of male sex organs, and the maintenance of secondary sex characteristics. Without enough of it, you can feel anxious, depressed, become intellectually muddled, and develop a low sex drive. Also, low levels of testosterone may result in a decline in muscle mass and strength, and an increase in upper body and abdominal fat.

What is a hormone level test for testosterone?

It measures the level of male hormone (androgen) in the blood. Testosterone affects sexual features and development. In men, it is made in large amounts by the testicles. In both men and women, testosterone is made in small amounts by the adrenal glands; and, in women, by the ovaries.

Indications and Contraindications

Hormone level testing for testosterone is used to evaluate male and female conditions such as:

  • Precocious puberty
  • Infertility
  • Tumor marker for ovary and testicle tumors
  • Ambiguous sex characteristics
  • Decreased sex drive
  • Erectile dysfunction
  • Delayed puberty
  • Irregular periods for women

How do you prepare for the test?

There is no fasting required for this test.

How does it feel? How long will it take?

The test is a painless procedure that usually lasts about three minutes or less. Some patients may feel a slight stinging pain while the needle is being inserted into the vein in the arm to draw blood. After the test, a small amount of throbbing might occur at the needle site.

Expected effects after the test

Normally, there are no major effects after the test. Commonly, patients may feel a little sore and slight bleeding may occur at the needle site. Bruising or swelling may occur.

Special instructions after the test

After drawing the blood, the needle site will be covered with a bandage. Apply pressure for several minutes. If the site becomes swollen, apply warm compresses a few times a day. You may resume your regular diet and your daily activities after the test.

Interpretation of Results

Normal Findings

Normal levels of testosterone fall between 3-10 ng and 10-35 nmol/L (SI units). Levels in the same man vary according to time of day, season and exercise.

Normal levels of testosterone in women are less than 1 ng/mL (SI units).

In prepubescent boys and girls, normal levels of testosterone are 0.05-0.2 ng/ml (SI units)

Abnormal Findings

Increased levels of testosterone can indicate the following conditions:

Males:

    • Hyperthyroidism
    • Testicular tumors
    • Encephalitis
    • Pinealoma
    • Congenital adrenal hyperplasia

Females:

    • Ovarian tumor
    • Adrenal tumor
    • Congenital adrenocortical hyperplasia
    • Polycystic ovaries

Decreased levels of testosterone in males indicate the following conditions:

    • Hepatic cirrhosis
    • Primary and secondary hypgonadism
    • Hypothalamic disease
    • Pituitary disease
    • Klinefelter’s syndrome

Notes

Testosterone levels in men usually decrease with age. They gradually begin to fall from the age of 40 and decrease by approximately 0.3% per year. It has been estimated that up to 20% of men over 60 will experience a decline in androgen production that is significant enough to warrant a diagnosis of androgen deficiency.

It is necessary to draw blood for testing testosterone levels early in the morning when testosterone levels are at their highest.

  • Hormone Level Testing-Estrogen

Estrogens are responsible for female sexual development and function, such as breast development and menstrual cycles. In women, estrogens are produced mainly in the ovaries and in the placenta during pregnancy. Small amounts are also produced by the adrenal glands. In men, small amounts of estrogens are produced by the adrenal glands and testicles. Small amounts of estrone are made throughout the body in most tissues, especially fat and muscle.

What is a hormone level test for estrogen?

It measures the level of the three estrogen hormones (estradiol, estriol, and estrone) in a blood or urine sample.

  • Estradiol is the most commonly measured type of estrogen for women who are not pregnant. The amount of estradiol in a woman's blood varies throughout her menstrual cycle. After menopause, estradiol production drops to a very low but constant level.
  • Estriol levels are usually measured during pregnancy. It is produced in large amounts by the placenta, the tissue that links the fetus to the mother. Estriol can be detected as early as the 9th week of pregnancy, and its levels increase until delivery. Estriol can also be measured in urine.
  • Estrone may be measured in women who have gone through menopause to determine their estrogen levels. It also may be measured in men or women who might have cancer of the testicles, ovaries, or adrenal glands.

Indications and Contraindications

Hormone level testing for estrogen is used to evaluate conditions such as:

  • Hypopituitarism
  • Menstrual problems (amenorrhea)
  • Fertility problems in females
  • Tumor markers for estrogen-fed tumors
  • Ovarian tumors
  • Birth defects
  • Males with gynecomastia (feminization, e.g. enlargement of the breast)

How do you prepare for the test?

No fasting required.

How does it feel? How long will it take?

The test is a painless procedure that usually lasts about three minutes or less. Some patients may feel a slight stinging pain while the needle is being inserted into the vein in the arm to draw blood. After the test, a small amount of throbbing might occur at the needle site.

The 24-hour urine test involves collection of urine passed during the next 24 hours. Please see below for instructions on how to easily collect the urine sample.

Expected effects after the test

Normally there are no major effects after the blood or the urine test. In blood testing, patients may feel a little sore and slight bleeding may occur at the needle site. Bruising or swelling may also occur.

Special instructions after the test

After drawing the blood, the needle site will be covered with a bandage. Apply pressure for several minutes. If the site becomes swollen, apply warm compresses a few times a day. You may resume your regular diet and your daily activities after the test.

Instructions for collecting urine

The first urine of the day should be excluded. All subsequent urine for the next 24 hours should be collected in clean plastic containers. Avoid contaminating the sample by urinating before defecating, and by not putting any foreign objects (i.e. toilet paper) in the container. The specimen should be kept refrigerated during the 24 hour collection period. Containers should be clearly labeled with your name and brought to the clinic immediately after the 24 hour period. You are encouraged to drink fluids during the 24 hours.

Interpretation of Results

Normal Findings

      Estradiol

 

Normal Result (blood test)

Normal Result (24 hour urine)

Child <10 yrs

< 15 pg/ml

0-6 µg/24 hr

Adult male

10-50 pg/ml

0-6 µg/24 hr

Adult female (pre-menopause)

20-450 pg/ml

0-10 µg/24 hr

Adult female (post-menopause)

≤ 20 pg/ml

0-4 µg/24 hr

     

 

Estriol (increasing estriol indicates normal fetal growth)

 

Normal Result (blood test)

Normal Result (24-hour urine)

Male/ Child <10 yrs

N/A

1-11 µg/24 hr

Adult female (pre-menopause)

N/A

0-14 µg/24 hr

Adult female (post-menopause)

N/A

0-11 µg/24 hr

Pregnant: 1st trimester

< 38 ng/ml

0-800 µg/24 hr

Pregnant: 2nd trimester

38-140 ng/ml

800-12,000 µg/24 hr

Pregnant: 3rd trimester

31-460 ng/ml

5,000-12,000 µg/24 hr

Total Estrogen

 

Normal Result (blood test)

Normal Result (24-hour urine)

Male/ Child <10 yrs

N/A

4-25 µg/24 hr

Adult female (pre-menopause)

N/A

4-60 µg/24 hr

Adult female (post-menopause)

N/A

4-60 µg/24 hr

Pregnant: 1st trimester

N/A

0-800 µg/24 hr

Pregnant: 2nd trimester

N/A

800-5,000 µg/24 hr

Pregnant: 3rd trimester

N/A

5,000-50,000 µg/24 hr

Abnormal Findings

Increased levels indicate the following conditions:

    • Ovarian tumor
    • Testicular tumor
    • Adrenal tumor
    • Development of female secondary sex characteristics
    • Precocious puberty
    • Hyperthyroidism
    • Hepatic cirrhosis
    • Pregnancy of twins/triplets

Decreased levels indicate the following conditions:

    • Failing pregnancy
    • Turner’s syndrome
    • Hypopituitarism
    • Hypogonadism
    • Menopause
    • Anorexia nervosa
    • Stein-Leventhal syndrome

Notes

Inform your physician if you are menstruating, pregnant or are using contraceptives.

  • Hormone Level Testing- Progesterone

Progesterone is a female hormone produced by the ovaries during release of a mature egg from an ovary (ovulation). Progesterone helps prepare the lining of the uterus (endometrium) to receive the egg if it becomes fertilized by a sperm. If the egg is not fertilized, progesterone levels drop and menstrual bleeding begins.

What is a hormone level test for progesterone?

It measures the amount of the progesterone in the blood.

Indications and Contraindications

A hormone level test for progesterone is used to evaluate conditions such as:

  • Infertility
  • Ovulation
  • Difficulty in becoming pregnant or a difficult pregnancy
  • High-risk pregnancies
  • Adrenal gland disorders

How do you prepare for the test?

No fasting is required.

Your physician might require you to discontinue medications containing estrogen and progesterone for one month.

How does it feel? How long will it take?

The test is a painless procedure that usually lasts about three minutes or less. Some patients may feel a slight stinging pain while the needle is being inserted into the vein in the arm to draw blood. After the test, a small amount of throbbing might occur at the needle site.

Expected effects after the test:

Normally there are no major effects in doing the progesterone test. In some cases, patients may feel a little sore and slight bleeding may occur at the needle site. Bruising or swelling may occur.

Special instructions after the test:

After drawing the blood, the needle site will be covered with a bandage. Apply pressure for several minutes. If the site becomes swollen, apply warm compresses a few times a day. You may resume your regular diet and your daily activities after the test.

Interpretation of Results

Normal Findings

Normal Range

Female: 1-14 days (menstrual cycle)

< 50 ng/dl

Female: 15-28 days (menstrual cycle)

300-2500 ng/dl

Child: up to 15 years

< 20 ng/dl

Male adult

10-50 ng/dl

Female adult (postmenopausal)

<40 ng/dl

Pregnancy: 1st trimester

725-4400 ng/dl

Pregnancy: 2nd trimester

1950-8250 ng/dl

Pregnancy: 3rd trimester

6500-22900 ng/dl

Abnormal Findings / Other findings

Increased levels of progesterone can indicate the following conditions:

    • Pregnancy
    • Molar pregnancy
    • Ovulation
    • Adrenocortical hyperplasia
    • Ovarian cysts

Decreased levels of progesterone indicate the following conditions:

    • Possible miscarriage
    • Toxemia of pregnancy
    • Preeclampsia
    • Fetal death
    • Amenorrhea
    • Ovarian hypofunction

Notes:

During pregnancy, the placenta also produces high levels of progesterone, starting near the end of the first trimester and continuing until the baby is born. Levels of progesterone in a pregnant woman are about 10 times higher than they are in a woman who is not pregnant.

Some types of cancer cause abnormal progesterone levels in men and women.

The Right Diagnosis and Treatment for Hormonal Imbalance

Once your comprehensive review is completed, our doctors and our team of medical professionals will evaluate your diagnosis. At this point, our doctors will spend one on one time with you to interpret and explain your results. Together you will explore your goals and discuss your treatment plan options. These treatment plans can be implemented using multiple modalities such as medications, hormones, diet, supplements, behavior and lifestyle changes, and alternative therapies. Our doctors will prescribe a preventative and comprehensive treatment plan that is tailored to your needs and fits into your lifestyle.

Patients Medical’s Personal Approach to Hormonal Imbalance

Our doctors and our team at Patients Medical will regularly monitor your progress and track the effectiveness of your program making adjustments if necessary. Our goal is to support you and advise you every step of the way.

We work in conjunction with your existing doctors. Any gaps between specialists are filled to ensure we support your overall health and well-being. While we treat serious medical conditions such as Alzheimer’s, Diabetes, Parkinson’s, Multiple Sclerosis, anxiety, depression, and heart disease, the primary objective of our staff is prevention and early detection of disease.

Start Your Road to Health with Patients Medical

Be informed, inspired and transformed with your own personal holistic consultation at Patients Medical. For those that can make the journey, we are happy to welcome new patients to our medical center in New York City. Call us at 212-794-8800. We are here to listen and help.

We are located at: Patients Medical PC, 800 Second Avenue, Suite 900 (Between 42nd & 43rd Street), Manhattan, New York, NY 10017.