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First let’s discuss a strategy to get your health insurance to pay for as much of this testing as your policy allows. Good hormone testing is pricey.
(Those $30 kits that test all your hormones are only moderately accurate, especially when it comes to estrogen and progesterone. If you’re having periods, levels of these hormones change virtually every day, and trying to get an accurate picture with a single day’s result is a waste of your money.)
The best way to get your doctor to sign off on hormone tests is to arrive prepared, knowing what you want, and being able to counter a response like “You don’t need those tests.” This would be your opportunity to say something like (obviously you’ll describe your own symptoms) “I’m miserable and all my other tests are normal. I’m tired and cold, gaining weight, and my periods are a mess. Believe me, women know their hormones.”
Doctors are almost always in a hurry and since your doc’s not paying for the tests, she may capitulate to your request rather than argue. Your doctor can order most of the following tests from whatever lab she regularly uses. The nurse will draw your blood and your doctor will receive the results in a few days.
If you’re a WholeHealth Chicago patient, just contact my nurse Mary, or my assistant Liz, and she’ll schedule a time for you to arrive for drawing blood. This won’t require an appointment with me until after your test results are back.
Thyroid hormone testing Low levels of thyroid hormone (hypothyroidism) are extremely common, causing fatigue, puffy facial features, a sense of feeling cold, dry skin and hair, weight gain, and irregular periods. Consider low thyroid especially if thyroid problems run in your family. Ask your doctor for these tests: TSH (thyroid stimulating hormone), free T-3, free T-4.
Adrenal hormone testing Definitely under-appreciated by many physicians as a cause of chronic symptoms, especially fatigue, “crashing” in the late afternoon, salt cravings, and low blood pressure. Ask your doctor for these tests: DHEA, AM and PM cortisol levels.
Sex hormones testing If you’re in your late thirties, early forties, or beyond AND your periods are becoming irregular, two hormones produced by the pituitary (the master gland) are measured to determine if you’re entering menopause. Ask your doctor for these simple blood tests: FSH (follicle stimulating hormone) and LH (luteinizing hormone).
If you’re menstruating, the best test measures your hormone levels throughout a single cycle. The “Female Hormone Panel” by Genova Diagnostics supplies you with a take-home kit containing ten plastic vials to collect specimens of saliva over a month. After you FedEx the kit to the lab, they measure your levels of estrogen, progesterone, and testosterone, and graph the results for you. Your doctor can order the kit at www.gdx.net.
She may prefer to test your blood for these hormones, which requires returning to the office at least three or four times over a month to have your blood drawn at appropriate intervals.
Remember: if you have chronic symptoms and your doctor tells you everything is fine, the problem is probably a hormone imbalance. But you already knew that, didn’t you?
Next time: correcting estrogen, progesterone, and testosterone imbalance without drugs.