Determining what panels to test is the first step in understanding your patients 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 overview of their needs. Now available to add on to any saliva test: Melatonin. For patients that are reporting sleep disturbances such as trouble falling asleep or staying asleep, add the Melatonin Panel to any saliva panel.
Below you will find the test panels offered and the associated symptoms.
Total: 3 tests (cortisol at 0-5 minutes after waking, 30 minutes, and 60 minutes)
This panel can be added to any saliva test. Requires a 6 tube collection kit, click here to order.
The cortisol awakening response is the natural rise in cortisol that is seen 30 to 40 minutes after awakening followed by a noticeable drop by 60 minutes. CAR can be utilized as a biomarker for assessment of the HPA axis function in routine clinical practice. CAR is influenced by overall HPA reactivity, as well as a person’s anticipation of stress.
The CAR involves a measure of the percent rise in cortisol from awakening to 30 minutes post-awakening and the expected decline in cortisol seen at 60 minutes. The Diurnal Cortisol Profile involves 4 cortisol samples taken at 30 minutes post-awakening, noon, dinner time, and bedtime. While the CAR can provide the best information on HPA axis reactivity and function, the Diurnal Cortisol Profile can identify dysregulation in the natural cortisol circadian rhythm.
Who tends to experience a low or blunted CAR?
Research has found that a lower cortisol response to awakening is often seen in individuals with:
Who experiences a high CAR?
Factors associated with an elevated CAR include:
Total: 10 Tests (E1, E2, E3, Pg, T, D, Cx4)
The Comprehensive Plus Panel expands on the Comprehensive Hormone 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:
Total: 10 Tests (E1, E2, E3, Pg, T, D, Cx4)
A comprehensive preventative breast health program extends beyond imaging and lifestyle optimization, and includes accurate assessment and comprehensive treatment of demonstrated hormone imbalances. Labrix offers the Women’s Health and Breast Panel as an accurate, non-invasive tool to advance risk prevention and support you in providing exceptional care to your patients.
The Women’s Health and Breast Panel evaluates foundational hormone and adrenal status. This panel provides an in-depth look at estrogen levels, conversion patterns and offers two risk assessment ratios (Estrogen Quotient and PG/E2 Ratio) and also a customized women’s health and breast health specific interpretation. This additional clinical information is essential to further the conversation with your patients about targeted treatment options such as BHRT, nutraceutical and herbal supplementation, as well as potential lifestyle modifications.
Total: 8 Tests (E2, Pg, T, D, Cx4)
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:
Total: 6 Tests (E2, Pg, T, D, Cx2)
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:
Total: 5 Tests (E2, Pg, T, D, C)
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:
6 Tests (D, Cx4, sIgA)
SIgA is most often measured in feces or saliva. Measuring sIgA in feces can reveal information about gut immunity, inflammation, recent or current infections, and potential acute or chronic stress generally associated with GALT (gut-associated lymphoid tissue). SIgA measured in the saliva primarily provides insight into the body’s stress response, however there is some evidence that activated B cells can migrate from GALT to salivary glands, which could potentially demonstrate systemic inflammation and possibly link GI pathology via salivary sampling.
Elevated levels of sIgA are associated with an upregulated, active immune or inflammatory response, and may be reflective of acute psychological and/or physical stressors. Chronic alcoholics, heavy smokers, and those with oropharyngeal carcinoma have also shown elevations in salivary sIgA.
Decreased levels of sIgA are commonly seen in individuals with low immune system functioning, and are a sign of chronic, ongoing psychological and/or physical stress (HPA axis dysfunction) to the body which has depleted sIgA reserves. SIgA declines with age, and can be seen with some chronic gastrointestinal disorders. Persistent low levels can help to explain why people can’t shift an immune problem like allergies, chronic skin conditions or infections. Lower levels have been associated with increased risk for periodontal disease and caries.
Total: 5 Tests (D, Cx4)
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:
Total: 4 Tests (Cx4)
This panel is similar to the Adrenal Function Panel, but would be used in patients who do not require DHEA testing.
Total: 3 Tests (Mx3)
The Melatonin Panel provides a snapshot of the sleep/wake cycle during a one day period. This panel (also can be added on to any saliva panel) is recommended for those experiencing sleep disturbances.
|Comprehensive Plus Panel||E1, E2, E3, Pg, T, D, Cx4|
|Women’s Health & Breast Panel||E1, E2, E3, Pg, T, D, Cx4|
|Comprehensive Hormone Panel||E2, Pg, T, D, Cx4|
|Comprehensive Adrenal Function Panel||Cx4, D, sIgA|
|Short Comprehensive Panel||E2, Pg, T, D, Cx2|
|Basic Hormone Panel||E2, Pg, T, D, C|
|Adrenal Function Panel||D, Cx4|
|Diurnal Cortisol Panel||Cx4|
*Note: All saliva samples are frozen and kept for 25 days beyond receipt to enable additional testing. If preliminary values indicate the need for a more comprehensive panel, missing hormones can be added.