Please click on the test links given below to see more detail, collection instructions, sample reports etc...
There are simply loads of different hormone tests you can do and it really depends what you are looking to find out. To be honest, I am going to make this easy for us and recommend only a couple. What we want is useable, practical information to help see what is going on in this complex area of hormones!
Two key tests:
I can still happily do any of the tests we've done for years and have kept them most on for you, but nowadays I am favouring the DUTCH Complete with or without Cycle Mapping.
Well, put simply, I think you get a lot more or similar info using this easier-to-do dried urine test for less money on doing the separate tests.
There is more help for those with irregular cycles, on HRT, the pill etc and for men. It covers everything we're likely to need to know clinically to help you get well, including adrenals and the metabolites (you can read more about that here on the Adrenal page), sex hormones (oestrogen, progesterone, testosterone) and their metabolites, a monthly cycle (in Cycle Mapping one) and clues on methylation, oestrogen dominance (important for women and men), oestrogen breakdown, androgen and DHEA issues, liver phase 1 and 2 clearance, organic acid markers for B12, B6 and glutathione deficiency, an oxidative stress check and three key markers for mood issues, fatigue and hypersensitivity.
It's more cost up front, I'll grant you, but much better value in the long run. The only downside is the complexity of the reports!
You can learn all about the DUTCH tests on their site here. And see the various sample reports here. The DUTCH Complete checks adrenals, sex hormones (oestrogen, progesterone, androgens inc testosterone and DHEA), plus all the other markers as described above. If all you want is adrenals, see the Adrenal Tests here. The DUTCH Complete with cycle mapping checks all of that plus a monthly cycle pattern of the oestrogen and progesterone for women having cycles. The DUTCH Plus is the Complete using saliva samples plus CAR (cortisol awakening response) that can sometimes show a developing adrenal problem even if the normal cortisol samples look OK.
Here are the DUTCH Collection Instructions as a PDF and here is a series of videos if you are more complex cycle-wise or on meds/supplements. If your cycles are long, short or irregular, see the extra guidelines here. If you are on HRT, check if the DUTCH is viable or not for you here; it depends on the form you are taking. Note the Mirena coil contains synthetic progesterone which is not detected by the DUTCH tests; everything else is tested fine but don't rely on it to show progesterone correctly.
Samples are returned to the UK lab and drop-shipped to the US for you. Any questions, check the DUTCH website, their FAQ or email me. Note that if you mess up your samples, a new test kit costs a further amount - about £12 currently - so just be aware of that.
An alternative, slightly cheaper option for a salivary adrenal and hormone test is the Genova One Day Hormone Check. This a urine test that measures the usual 4 cortisols and DHEA for adrenals, plus a snapshot of oestrogen, progesterone, the ration between them (for oestrogen dominance) and testosterone.You can see a sample report here and collection instructions here. Just bear in mind that when you take your sample matters for women - to interpret the results, you need to know roughly if you were in the luteal (Day 15- 28 usually) or follicular (day 1-13 usually) phases, for example. Ovulation occurs usually on Day 14 roughly. These timings vary a lot so use them as guidelines only!
Genova has a Guide to which samples are best for which hormones here.
Why is it useful to test adrenals as well as hormones then?
This kind of testing can be very useful because your adrenals are partly responsible for the production of the sex hormones, especially as we get older (take note pre-menopausal women) so, if the hormone levels are struggling, it is often because the adrenal output is too low or dysfunctional somewhere, if you see what I mean. Correcting the adrenals and HPA axis generally often improves oestrogen and progesterone levels.
Also, the adrenal test will check DHEA levels too which has a direct impact on progesterone and testosterone production. So, if your DHEA was high, this could explain why you are progesterone dominant or producing a lot of male hormone. Obviously, it all gets a lot more complex than that - this is hormones after all! - but you get the general gist. I've kept the Rhythm Plus on for you as I know many of you like that one.
You can get much more complex tests including Hormonal Health, which measures levels in blood and is particularly useful for PCOS and others needing to see free androgens, SHBG etc.
You can see a list of all the different Genova hormone tests here. Just ask if you need something and use a Lab Test Request.
You can do a much simpler One Day Progesterone/Oestrogen Test if you need to. This can be useful if you need a snapshot eg. to check hormone treatment progress or check luteal phase hormone production, or if you are no longer having periods.
As a sufferer of PCOS myself, I have found it incredibly difficult to get the correct tests. No more: I have now listed both the full and short PCOS Profiles from TDL. They cover pretty much everything I talk about in my PCOS ebook here. You can see what is covered in each here along with collection instructions etc:Short Profile and Full Profile. Note both are blood tests and the full profile needs to be centrifuged (see theFAQ for how to do this).
For women no longer having periods, I would say the the DUTCH Complete test above, which includes a check of the good and bad oestrogen ratios for risk of hormonal cancers like breast or ovarian, for example. I encourage everyone past menopause to have it.
Combine that preferably with a bone resorption/osteoporosis marker test to see if you are breaking down bone faster than you should be (this shows problems much earlier than a DEXA scan).
Alternatively, you can do simple tests like the One Day Progesterone/Oestrogen Test or, Testosterone only test. I really still like Genova's Menopause Plus Profile too, especially as the report is so easy to follow!
If all you want is to check is for oestrogen dominance, use the One Day test. If you want to see the levels of the good and bad oestrogens to assess cancer risk, for example, you would do the Oestrogen Metabolism Test.
For men, things are a lot simpler (as always with hormones!). Again, do the DUTCH Complete. This includes DHEA, which is so important for men as it is the pre-cursor for making testosterone and male hormones in general. Ergo: if DHEA and testosterone are low, you have your answer - boost the DHEA, or in more complex cases, see what else might be going on.
Alternatively, you can simply do a Testosterone only test. This can be used for women too.
In addition, there is the very useful Male Hormonal Health blood test which includes a PSA and SHBG check and the Genova Complete Hormones which gives a comprehensive break down of the various hormonal metabolites.
Adding Neurotransmitters. Sometimes it can be useful to see what your levels of the brain neurotransmitters are with hormones eg serotonin for PMDD, PMS with mood issues or adrenaline or GABA for anxiety etc. In this case, have a look at the Neurotransmitters section. If doing the DUTCH Complete, use the NeuroBasic as you'll only need that.