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Where Should I Start?

 

Determining what panels to test is the first step in understanding your patient's hormone requirements. We believe the bare minimum for assessing hormonal status and endocrine function is the eight hormone panel: estradiol, progesterone, testosterone, DHEA and four cortisols. The symptom questionnaire is an invaluable tool for evaluating the severity of your patients symptoms and providing a quick "at a glance" overview of their needs.

Below you will find the test panels offered and the associated symptoms.

 

Comprehensive Panel

Total: 8 Tests

The Comprehensive Hormone Panel is the starting point for initial assessment of hormonal status and endocrine function and includes estradiol(E2), progesterone, testosterone, DHEA and four cortisols. This panel is useful with male and female patients because it looks at the full diurnal cortisol pattern; it is especially important in patients who are experiencing the following symptoms in addition to the symptoms listed for the Basic Hormone Panel:

  • Weight gain

  • Multiple chemical sensitivity

  • High blood sugar

  • Elevated lipids (cholesterol and/or triglycerides)

  • Insomnia

  • Chronic fatigue

  • Fibromyalgia

Comprehensive Plus Panel

Total: 10 Tests

The Comprehensive Plus Panel expands on the Comprehensive Panel and includes estrone (E1) and estriol (E3) plus the Estrogen Quotient.  The Estrogen Quotient (EQ) is a simple ratio of the cancer protective E3 to the proliferative estrogens E1 and E2.  The EQ provides an assessment of breast cancer risk, with a lower number (<1.0) indicating increased risk, and a higher number (>1.0) signifying a lower risk.  For maximum protection, an optimal EQ is >1.5.  Because the research on the Estrogen Quotient and the protective properties of estriol has not been done with men, this panel is currently recommended for women only.  This panel should be considered for patients who have:

  • Increased risk of developing breast cancer

  • History of breast cancer or other hormonally sensitive cancers

  • Personal or strong family history of autoimmune disease

  • PCOS

Short Comprehensive Panel

Total: 6 Tests

This assessment is useful in men and women whose primary symptoms are related to sex hormone imbalances (elevated or depressed E2, P or T).  The abbreviated adrenal panel that includes DHEA and the AM and PM cortisol levels provides a brief assessment of the level of involvement of adrenal dysfunction.  Additionally, this condensed panel (like the Basic Hormone Panel) is often used for re-evaluation 2-3 months after hormone replacement has begun to monitor therapeutic values.  The Short Comprehensive Panel should be ordered if the patient is suffering from:

  • Fatigue

  • Sleep disturbances

  • Family history of breast cancer

  • Brain fog

Basic Hormone Panel

Total: 5 Tests

The Basic Hormone Panel provides a basic evaluation of the sex hormones and a brief glimpse at adrenal function with the AM cortisol level.  This panel is useful when retesting patients who have begun hormone therapy, but we encourage use of the Comprehensive Panel for initial evaluation.  This is the minimal test recommended for symptoms that include:

Men Experiencing:

  • Decreased libido

  • Erectile dysfunction

  • Loss of stamina

  • Decrease in mental sharpness

  • Reduced muscle size

  • Tearful episodes or increased moodiness

  • Metabolic syndrome

  • Prostate enlargement or cancer

  • Hot flashes

  • Irritability

Women Experiencing:

  • Hot flashes

  • Anxiety/Depression

  • Night sweats

  • Breast tenderness

  • Irritability

  • Forgetfulness

  • Irregular menstrual cycles

  • Vaginal dryness

  • Urinary incontinence

  • Uterine fibroids

  • Increased facial / body hair

  • Acne

Adrenal Function Panel

Total: 5 Tests

This panel provides a comprehensive view of adrenal function and includes 4 cortisol levels timed throughout the day as well as DHEA.  Symptoms that would indicate ordering this panel include:

  • Fatigue

  • Nervousness

  • Weakness

  • Sugar cravings

  • Insomnia

  • Dizzy spells

  • Headaches

  • Decreased stamina

  • Irritability

  • Fibromyalgia

  • Anxiety / Depression

Diurnal Cortisol Panel

4 Tests

This panel is similar to the Adrenal Function Panel, but would be used in patients who do not require DHEA testing.

 

 

*Note: All saliva samples are frozen and kept for 25 days beyond receipt to enable additional testing. If preliminary values indicate a more comprehensive panel, missing hormones can be added.