Dr. Sara's Top 8 Hormone Tests: Find Your Blind Spots + Track Your Progress
If you read O Magazine as avidly as I, you know that December features a story on the quantified self, called Beyond Measure. Author Catherine Price describes the Hawthorne Effect, which is the phenomenon that we behave differently when watched, or put another way: when your yoga teacher gazes at you in class, your sun salutations are suddenly more graceful, heartfelt and buoyant. I agree with this observation, and would add that what you measure tends to improve. When you measure and find where your are off-base, you are immediately compelled to up your game.
I’ve been asked by my beloved tribe on the current Mission Ignition (next one is January but we just announced early-bird pricing right here) to rank order the tests that I’ve discussed and most favor for my concierge integrative medicine patients.
Here’s a brief list.
1. Blood panel to ask your doctor to order:
VAP cholesterol [extensive – includes subtypes of LDL and HDL plus lipo(a), VLDL], ferritin, TSH, free T3, reverse T3, cortisol, DHEA
if overweight: leptin, insulin. IGF-1 (growth hormone)
If infertile: free, bioavailable and total testosterone, progesterone day 21-23, fasting insulin and glucose.
2. If your doctor won’t order these tests, consider going to CanaryClub.org to order them yourself and test at home. I especially like their blood spot test because the little thyroid hormones are very stable when dried on their test cards, and I suspect more stable than sitting around all day in a test tube at a lab. If you can afford it, I recommend the Advanced Plus Hormone Profile.
3. Omega-6/Omega-3 ratio. It costs only $150 and is offered from Metagenics. You can also get this done as part of the NutrEval (#5 below). If you are having new symptoms of ADD in perimenopause, get this test. Omega 3s are one of the most proven supplements we have yet most people don’t optimize their level.
4. Complete Hormone Profile. If your doctor is the more open-minded type, check this Genova test. It will tell you about your adrenals, both short-and long-term, and inform you of your estrogen metabolism – that is, do you have a modifiable tendency toward breast cancer or not?
5. Let NutrEval rock your world. For those of you who really love to measure everything, and want to know where your nutritional deficiencies are… this will rock your world http://www.gdx.net/product/10051 The cost is reasonable for people with insurance who qualify for Genova’s Pay Assured program at $169. Add on Vitamin D for $5.
6. Mercury, anyone? I commonly see women with fatigue, hair loss, weight gain, low sex drive and underperforming thyroids. I encourage them to test for mercury from Mercout.com
7. Telomeres, My Telomeres. For those soul sisters who delight in quantifying biological age, the best marker is your telomeres, the cute little caps on your chromosomes that keep your chromes from unraveling and are similar to shoelace caps. I encourage people to test at Spectracell.com
8. Neuroendocrine fun and games. Finally, for women in perimenopause with the usual suspects of more stress/irritability/waning libido & focus, one of my favorite tests is the Neuroendocrine 3 panel (9505) from Neuroscience. This tests looks at the intersection of your hormones with your neurotransmitters. Very satisfying, and it generates a personalized amino-acid balancing protocol. Excellent for women trying to get off anti-depressants, sleeping pills or anxiety medication.
Is that an overwhelming list? Then schedule a wellness session with me and we’ll prioritize and customize for you. Or just start at the top end and work your way down slowly and methodically, asking yourself if the information is helping your process toward becoming as vital as you desire. I didn’t even get to the stool analysis and food sensitivity testing!
In Beyond Measure, Catherine Price adds a further twist that is appropriate to the extreme self-tracker: will my measurements improve my behavior, and would I go nuts in the process? Price ended up where we always try to be, on the middle path, collecting enough information to learn, grow, and stretch ourselves and our health, but not so much that it becomes addictive or gets us to check out from love and life. The secret is to use these tests is to proceed in a meaningful way that best combines your values, genetic tendencies, current health, lifestyle and blind spots.
Most of us need help with the latter.
Please share this list with every person you love, so they can get a taste of what’s possible with testing. I find it enriches dramatically your commitment to robust health.
I live in Canada and am really interested in starting this process. What are my options in terms of requesting the tests from the US?
Lorraine, I would suggest blood work as a start. Next, you may want to contact these labs directly and see what they offer for our fabulous cousins to the North. Genova diagnostics is gdx.net and phone 800.522.4762. CanaryClub.org and Spectracell.com. Surely there must be some similar labs in Canada – if you hear of any reputable labs, please share them, and perhaps other readers can do the same! All the best, Dr. Sara
If one is a night owl and gets up in the morning between 10 a.m. – 11 a.m., would one then do corisol levels at that time instead of 8 a.m. to get an accurate reading.
Yes! Closer to 10am, but the likely reason for being a night owl is high cortisol at night.
Hi Dr. Sara,
I’m so glad I found you! You are such an amazing resource for us women who know we need something more from our doctors, but are not sure just what that ‘more’ really is. Thank you.
I’m curious, as far as the progesterone test goes, what do you recommend for someone who doesn’t know her cycle? A little background on me: I never had a regular cycle and decided to begin the birth control pill in my teens. Obviously, this regulated me, but when I went off it at the age of 26, I didn’t see my period after that for another 33 months. I became a strict paleo eater, but nothing happened until I introduced maca root (literally within 2 weeks after adding this to my diet I menstruated). Anyway, I have since stopped taking it, as it definitely gave me more of a booty than I had wanted (no joke), and my cycle still comes but it’s very intermittent (sometimes 6 weeks, sometimes 8, sometimes 4). How might I approach a progesterone test?
Thank you for such valuable insight.
Jessica, have you seen a clinician for your irregular cycle? I can’t give you medical advice without a full history and physical, but that’s what I’d recommend as a next step! Sounds like you’re not ovulating, and I don’t enough about you to know why that is happening. Good luck! Dr. Sara
Dr. Sara…yes, I did see a doctor a few years ago. After an ultrasound, she diagnosed me with PCOS (at the time I was 5’5″, 116lbs. but now am up to 130). After telling me I had a very thin uterine lining (i.e. no ‘build-up), she wanted to put me back on the pill simply to get a period (which from my understanding would not have been a ‘true’ cycle anyway???). I refused, as I wanted to do something naturally. Hence, I began a strict paleo diet and a year-and-a-half after that I added maca and finally something happened. I do have a physical at the end of the month and am planning on asking for the blood panel tests. However, I didn’t know what a good time in the month would be for someone like me to have her progesterone test done, as I don’t seem to have a clear ovulation cycle.
Thank you again for such excellent information:)
Sara – thanks for the inspiration to be deliberate and thoughtful in taking care of myself and for reposting these tests! I am doing an annual executive physical at a clinic but as you know, they do not look at the full picture.