The more we know, the better positioned we are to succeed. Even though symptoms of hormone imbalance can be very informative of the underlying hormonal situation in a woman’s body, assessing the actual hormonal terrain can allow us to be much more precise with treatment plans. Hormone testing is an invaluable way to get specific insights into the underlying mechanism of a woman’s symptoms.
When women come into our naturopathic practice we offer them 4 options for hormonal assessment:
If you know the language, and if you’re listening well, the body is very good at giving us hints about what’s going on underneath the surface. Depending on what the symptoms are, and when in your cycle they’re happening, we can often very precisely nail down the root cause of your health concern. Using tools like basal body temperature testing, and possibly ovulation predictor test strips are a cheap and easy way to really fine tune our understanding of your hormonal cycling. And because naturopathic doctors (aka naturopaths) mostly use gentle interventions, we can often start a simple treatment plan and see how the body responds to help guide the deepening of the plan.
Many times however, it is best to get some objective data via lab testing to be 100% sure that we are on the right track.
Serum hormone testing is the standard for assessment for most family physicians and OBGYNs. It is the best form of testing when working in collaboration with a patient’s other care providers.
A typical female hormone panel would include estradiol, progesterone, LH, FSH, testosterone, DHEA, and prolactin. It’s important that estradiol and progesterone are tested 1 week after ovulation (day 21 of a 28 day cycle, or 1 week after a positive at-home OPK test), and that the others are tested on day 3 of the cycle. This is also a good opportunity to test other markers that could indirectly impact hormones, or cause symptoms that mimic a hormonal imbalance like a full thyroid panel (TSH, T4, T3, and possibly thyroid antibodies), iron/ferritin, B12, vitamin D, blood sugar and fasting insulin, and inflammatory markers.
Blood hormone testing usually costs about $100, and is often covered under your extended health care plan.
Hormones circulating in the blood can be viewed as what’s passing by the village, as oppose to what the cells are actually utilizing (what’s actually in the houses). Salivary hormone testing gives us more of a tissue measurement of the hormone values, and as it’s easily collected at home, we have the added benefit of collecting multiple samples. Serial sampling is ideal for cortisol hormone testing, as there is a circadian (daily) rhythm and being able to measure cortisol levels at multiple points across one day gives a very useable data set with which we can specifically tailor a targeted treatment plan addressing each observed imbalance.
Salivary hormone testing usually costs about $200-300, and is often covered under your extended health care plan.
Dutch hormone testing is the Cadillac of hormone testing. Not only does it test for a broader range of hormones, but by testing the hormone metabolites it helps us determine not just the what but also the why of hormone imbalance.
A complete Dutch test assesses your 3 types of estrogen (estrone, estradiol, estriol), your progesterone, your androgens, testosterone and DHEA, as well as melatonin and cortisol. Samples are taken 4 times in one day, so that we get an accurate view of your daily cortisol circadian rhythm.
Dutch hormone test reports are very extensive and are presented pictographically for ease of understanding, but once your results are in, your naturopath will thoroughly comb through each item with you and translate that into actionable plan sections so that you can finally achieve hormonal balance.
The Dutch test costs about $400, and is often covered under your extended health care plan.
It’s hard to heal when you don’t actually know what’s going on, and lab testing can be the most direct route of knowledge acquisition when it comes to your health.
Naturopathic doctors offer an accessible entry point to a more in depth investigation of what’s going on underneath the hood. We are a means by which you can learn more about your own body. It’s your body, you should be able to get the information about it that you’d like to know.
We will give you the run down on your suite of testing options, and help you understand what is warranted, what is relevant, what is necessary, what is not needed, and what is bonus. It’s up to you to decide what route we take.
Some patients need to know the numbers and they’d like to be tested through and through. Others just want the basic testing, and still others prefer trying gentle dietary and lifestyle interventions to let their symptoms point them towards health.
It’s totally a choose-your-own-adventure, with your naturopath guiding you, but where you steer the ship.