Advanced Hormone Panel:
1. Estrogens (total and fractionated)
a) Estrone (E1)
b) Estradiol (E2)
c) Estriol (E3)
Fractionated panel measures sub-types of estrogen and help determine the following conditions,
Estrogen or progesterone dominance
Conditions such as endometriosis etc.
Estrogen and progesterone are considered female hormones but can be tested in men as well specially those undergoing hormone replacement treatment. Blood tests only provide a snapshot of the hormone status and do not reflect wide fluctuations in estrogen and progesterone levels which occur throughout the month in women who have not reached menopause yet. In order to see a detailed picture of such variation, a comprehensive saliva test can be used. See an example of test results display for hormone evaluation based upon saliva testing.
3. Testosterone (Total, Free and SHBG)
Testosterone (total and free) levels are of value for both men and women. Lower levels in both men and women indicate loss of youthfulness (andropause or menopause), loss of muscle mass etc. SHBG (sex hormone binding globulin) reflects how much hormone is bound versus free and available for action.
Derived from cholesterol, this hormone plays important role in cognitive function and levels can decline with age. Supplementation can help improve some cognitive function. For brain health and additional factors which contribute to cognitive function, see Brain Health.
DHEA or Dehydroepiandrosterone is often checked when a diagnosis with elevated androgen levels such as PCOS is suspected. This test is often done in menstruating women when clinical symptoms indicate elevated levels.
6. LH & FSH
Luteinizing hormone and follicle stimulating hormones are secreted from the pituiatry gland and are tested in various conditions such as menopause, PCOS, pituitary mass and other endocrine abnormalities.
7. Thyroid function tests
Thyroid panel or thyroid function tests include TSH, T4, T3, reverse T3 and TPO. Elevated TPO usually indicates hypothyroidism (low functioning thyroid and slow metabolism) and low TSH levels usually indicate hyperthyroidism (high functioning thyroid) For more details on these tests and associated thyroid disorder, see Thyroid disease.
Fasting insulin levels can indicate insulin resistance and are often high prior to development of type 2 diabetes mellitus. Levels rise with obesity and are often accompanied by low adiponectin levels which are released from adipose tissue or fat cells and also are a predictor of type 2 diabetes. See diabetes and diabesity for more information and what can be done about these conditions.
Cortisol levels are measured through saliva testing. Elevated cortisol levels indicate a) hypercortisolism, and/or b) Cushing disease syndrome. Low cortisol levels or a flat cortisol curve indicates a) Hypothalalmic pituitary axis dysfunction, and / or b) Addison disease.
PTH or parathyroid hormone is tested under very specific circumstances such as abnormal vitamin D or calcium levels, chronic symptoms such as abdominal pain, depression, recurrent kidney stones etc. Abnormal levels may indicate the need for further imaging.