There is growing evidence that hormone imbalance may be the root cause of many chronic health issues.

 

Hormone management

Your hormones should exist in harmony with each other. When levels of each hormone are out of balance- body systems are unstable raising your risk of disease. It takes time to restore the balance within your body. It took some time for you to have these imbalances, so it takes time for your body to achieve a new level of harmony.

 

Here is what is expected when you come in for hormone management:

  • Office Visit #1: At this visit, we will conduct a comprehensive history of your symptoms and a hormone panel will be ordered to identify what hormones are imbalanced. The laboratory tests that were ordered will depend on the individual’s history and current therapies. For more information on hormone testing, see below. Micronutrient testing may also be recommended to identify any concurrent nutritional deficiencies that may be contributing to your overall symptoms.
  • Office Visit #2: Normally, this consultation is scheduled either 3-4 weeks after your first consultation.
    • Blood Tests: About 10 days
    • Saliva Testing: About 2 weeks
    • Urine Testing: About 3 weeks
    • Micronutrient Testing: About 4 weeks

    During this visit, we will discuss your results, offer alternate methods to achieve hormone balance and then customize a plan of care according to your individual needs.

  • Office Visit #3: This visit will be scheduled one month after consultation #2 to evaluate how you are doing on the selected treatment plan and to address any of your concerns and/or questions.
  • Additional office visits: Every 3 to 4 months, you will be asked to return to evaluate your progress and make any necessary changes/adjustments needed to your current regimen of hormones/supplements/nutrition/exercise. Follow-up hormone testing may be required at one of these visits to ensure you are on the best hormone regimen for long term or continued use. For more information on hormone testing, see below.Please Note:A hormone consultation is not covered during the annual / GYN visit. Evaluation and a follow-up on hormone testing results will require separate office visits as described above. The cost of laboratory testing may or may not be covered by your insurance. This information will be provided to you before ordering any tests.

*** Hormone Rx refills: We understand how busy life is, so when you request a refill of your hormones, we may allow one additional month. However, you MUST come in for an annual exam where we will require you to have your hormones levels evaluated . If changes need to be made, we will require an office visit to discuss your hormone test results and to make these changes on your future hormone prescriptions. For us to provide you with the best care, this is our standard protocol.

Benefits of the Three Types of Hormone Testing
 

Serum

  • Highly sensitive evaluation for primarily bound circulating hormones
  • Quick, in-office collection
  • Single Sample
  • Evaluates primary hormones for deficiencies or excesses
  • Excellent evaluation for oral HRT

Saliva

  • Highly sensitive evaluation for unbound (free) hormones
  • Convenient, at-home collection
  • Single sample or sequential samples collected throughout the day or month
  • Evaluates primary hormones for deficiencies or excesses
  • Evaluates for cycle abnormalities
  • Excellent evaluation for transdermal HRT

Urine

  • Highly sensitive evaluation for unbound (free) hormones and their metabolites.
  • Convenient, at-home collection
  • 24-hour collection or First Morning Void (FMV)
  • Evaluates primary hormones for deficiencies or excesses
  • Provides a robust evaluation of hormone metabolites
  • Excellent evaluation for oral and transdermal HRT

Saliva versus blood versus urine hormone testing

Hormones circulate in the body and are delivered to the tissues in many different forms, for example, a hormone may be bound to a protein, a red blood cell, a sulfur compound or it may be an unbound or free hormone. Measuring the free hormone level in serum underestimates the total amount of hormone that is available to the tissues. Measuring the bioavailable hormone level is very important but, unfortunately, there is not one perfect lab test to measure this. However, choosing the best laboratory test is critical in order to evaluate hormone balance and select the correct dosing of hormone replacement therapy, ( HRT), not just the amount of hormone but the delivery route of the hormone as well, i.e. oral (pills), topical (on the skin), sublingual (under the tongue), or intramuscular (injection).

Saliva testing is the best method to accurately measure the bioavailable hormone levels when the route of administration is topical. Blood testing for hormone levels is the preferred test for determining menopausal levels before replacement or after starting oral HRT. Urine testing for hormone metabolites is an excellent tool for determining the major hormone pathways for both oral and transdermal HRT and gives valuable information regarding the individual’s cancer risk.

The type of hormone testing ordered will depend on the individual’s clinical history, medications, and current hormone replacement therapies. The purpose of measuring hormone levels is to achieve optimal hormone balance during all phases of a woman’s life and to maintain these levels with or without hormone therapy in safe and therapeutic ranges.