This month I have been interviewed for a few different summits and podcasts, all on the topic of hormone balance.
One of the main questions that I was frequently asked was, in my experience, what is the best way to test hormones?
As a practitioner trained in Functional medicine lab analysis, I see that there are limitations to the standard blood tests, as well as the limitations in the standardized allopathic analysis.
I also recognize that testing hormones is just one piece of the puzzle.
This is because most hormones are metabolized by the microbiota in the digestive tract, and in the liver.
The key word in that last sentence is ‘metabolized’….
In order to get a clear snap shot, I prefer to look at the hormone metabolites, as well as liver health, and markers for infection & inflammation.
In addition, to truly analyze root cause, a comprehensive microbiota and microbiome analysis is important.
I will address these other tests in separate articles, but for now I want to talk about hormone metabolites.
What are Hormone Metabolites?
In their active form, hormones act as chemical messengers to control, facilitate, or trigger various processes in the body.
As active hormones complete their work and new hormones are produced, active hormones need to be cleared from the body via the urine.
Because steroid hormones don’t dissolve well in water, they can’t pass straight into the urine.
Instead, they must be broken down in the liver and kidneys to form water-soluble metabolites that can be excreted. Certain metabolites can be harmful if they are produced in excess
Since hormone metabolites leave the body through urine, the best method to test these important markers are in a home urine kit.
My preferred lab kit to present an accurate snap shot of hormone metabolites is the DUTCH complete (the Dried Urine Test for Comprehensive Hormones)
Just as the name describes, this is a dried urine test, in which you urinate on a strip four times a day to collect data on the diurnal hormonal rhythm.
This test is comprehensive, by including all three estrogens, progesterone, testosterone, melatonin, pregnanediol, androsterone, DHEA, and many more including the important and impactful stress hormones, cortisol and cortisone.
I also appreciate that the DUTCH complete includes neurotransmitter metabolites, such as dopamine, nor-epinephrine/epinephrine, oxidative stress/DNA damage, plus nutritional organic acids (such as Vitamin B6, B12, and Glutathione metabolites).
What about Stress Hormones?
One of the largest pieces of the puzzle for the epidemic of hormonal imbalance falls on the role of stress hormones.
Our biological mechanism of fight-flight-freeze, in actually triggered by our second brain, also called our primal brain, located in our gut.
The ‘messengers’ that signal us into this sympathetic response are the stress hormones.
The continuous flood of stress hormones, can upset the balance of the entire endocrine system, leading to a cascade of hormonal imbalance.
How about thyroid tests?
Thyroid hormone is not included in the DUTCH, and I do believe a ‘universal’ thyroid panel, available through blood markers, is essential.
The thyroid is like the canary in the coal mine, presenting symptoms before the other endocrine glands.
We should include thyroid in the HPA axis….it should be hypothalamus-pituitary-adrenal-thyroid axis, HPA-T axis.
Thyroid hormones, just like the other hormones, are metabolized by the gut and the liver, plus are affected by stress and the HPA axis.
With an epidemic of thyroiditis and many thyroid disorders, many people are told to test their thyroid hormones, however are limiting the a couple markers, namely TSH and T4.
In order to get the full picture of thyroid health, one should test the thyroid antibodies, the active (or free) thyroid hormones, the total thyroid hormones (both T3 & T4), the thyroid hormone uptake and hormonal reversal markers.
All of these can be done through a blood test, which makes it easy to monitor the levels as you treat accordingly and work towards balance.
These tests, just like the DUTCH, can be ordered by a Functional medicine practitioner, Naturopath or Integrative healthcare provider. All of whom can properly analyze the results for you.
Other factors to consider….
- Heavy metals block hormone receptors, plus disrupt liver function and hormone metabolism. A comprehensive heavy metal test can pinpoint body burden and direct your proper detoxification methods.
- Chronic infection not only burdens your immune system, located in your gut (over 90% of our immune system is directed by our microbiota), it also locks our body into the flight-fight-freeze response. Stimulating our primal brain to initiate the stress response.
- Liver congestion or ‘liver stagnation’ is the most essential and typical diagnosis in Chinese medicine when there is hormonal imbalance. Thousands of years ago, our wise ancestors understood that the liver is key for hormonal health. Now we know that liver metabolizing many of the hormones, so caring for the liver and promoting liver function is key to hormonal health.
- Microbial extinction is one of the lesser known factors to consider. Many of the microbes in the Western microbiota are on the endangered species list, and with our depleted ecosystem we are missing essential microbes that metabolize hormones
Try not to get overwhelmed
It truly can be overwhelming to go down the rabbit hole of revealing root cause, starting with all the tests and detailed analysis, and then the personal effort to reset your health.
However, the sensation of overwhelm creates additional stress, which leads to more imbalance.
It is essential to work with a skilled and well-rounded practitioner, to guide you through your personalized journey.
In my two decades of practice I have concluded that simply focusing on physical health is not enough to end the cycle of suffering and health struggles.
As Ayurveda, the mother of all medicine, teaches us that true healthcare must address the mind, body and consciousness of each person.
We are much more than just our physical form, and the sooner we include comprehensive care for the whole person, mind/body/spirit, the sooner we will be able cease this epidemic of chronic disease.
Remember to keep it simple
I always remind my clients that the body wants homeostasis, and traditional naturopathy and ancestral medicine provide numerous tools to assist the body in completing this task.
Whether it is eating seasonally, sun exposure, exercise, breathing, a diet high in fiber, proper detoxification, rest, human connection, laughter, meditation, plant medicine, there is a unique combination for every person to tip the scales back into balance.
One very simple addition to your diet would be seed cycling. If you want to learn more about seed cycling and how it can support hormonal balance, I put together a FREE Ebook with recipes. Check it out here, and enjoy!
Wishing you microbial wellness!