What is the Best Way to Test Hormones?

bioidentical hormones

Bio-identical hormone balancing, also referred to as Natural Hormone Balancing, goes far beyond the treatment of hot flashes.  This form of therapy provides women in their 40’s and older with support for their brain, heart and bone health.  This form of therapy is also available to men for treatment of low testosterone to improve drive, focus, motivation, libido and neuroplasticity.  We commonly think of administering sex hormones for two reasons: low libido or hot flashes, but there’s much more that hormones can do for you.  Cutting edge scientists, researchers and physician’s revealed at a recent conference I attended on neuroplasticity that there are significant benefits to being on bio-identical hormones close to the time that those hormones drop in order to help prevent further neuro-degeneration that could lead to Alzheimer’s.  This groundbreaking discovery can lead to a 50% reduction of Alzheimer’s symptoms or more in some cases.  In fact, we also know that testosterone can be used successfully in cases of brain trauma.

When it comes to hormone testing, this can be done in three ways:  blood, saliva or urine.  There are several key advantages to testing hormones in the urine. The disadvantage of blood testing is that there is no differentiation between bound hormone and free hormone, which can lead to misleading results as it’s only the free hormone that is active.  Salivary testing measure free and bound sex hormones, but unfortunately does not measure hormone metabolites, and levels are artificially elevated when hormones are applied in cream.

Both blood and saliva test miss a critical factor that urine testing has which is the metabolites. 

When hormones circulate through the body they are metabolized by the liver and broken down into metabolites. Those metabolites have their own physiological effects and are rarely if ever measured or taken into account.  Urine hormone testing shows the free hormone, as well as the bound form to measure the total pool of bioavailable hormones.  Interestingly, it’s the metabolites of hormones that can increase or decrease the risk of breast and uterine cancer, as well as give us a picture of the overall health of the adrenal glands long term.   These metabolites have critical clinical implications. There are 3 different types of estrogen:  estrone, estradiol, and estriol and each bind with higher or lower affinity to estrogen receptor alpha or beta receptor sites.  The beta sites are “better” because they are anti-carcinogenic, whereas the alpha sites tend to promote cell growth and proliferation.  One noticeable difference in the urine test we use is in it’s ability to measure 2-methoxyestradiol. 2-methoxyestradiol is the most protective of the estrogens and in ongoing clinical research it is showing promise of being an adjunct to cancer treatment.

The metabolites of the hormones found in the urine also show how well a person is methylating. Methylation occurrs not just in the metabolism of sex hormones, but also for most biochemical reactions in the body.  Therefore this urine test can show if you are methylating well or not.

The urine test also measures progesterone and testosterone, as well as adrenal function, which gives us a complete look at all the sex hormones. Based on the results that show up in the urine of the adrenal hormones your doctor can deduce how long you may have had adrenal fatigue and which are the best herbal protocols for it.

In summary, urinary hormone testing demonstrates free and total hormone levels, and how healthy you are metabolizing your hormones.   This comprehensive test provides a wealth of information about your health that both blood and saliva miss.  We are pleased to be using this urine hormones test for on all of our patients who have hormonal imbalances, or are on hormone replacement therapy.