Hormone Testing

 

You can order your online hormonal tests and other tests from ZRT Labs and The Birmingham Hospital

 

I would like to thank Wray Whyte for providing the information on hormone testing, a great deal of research has gone into finding the correct information.   All too often people will say that their hormone levels are 'normal' - but what is normal?   Ask to see your results, you paid for them.  I hope that this page will be of benefit to you all.  It is important that you look at the links and research papers given.

Estrogen

This is something for you all to think about when having your estrogen level/s tested.  There are 3 major naturally produced estrogens:

  • Estrone (E1)
  • Estradiol (2)
  • Estriol (E3)

Once in menopause our E2 level should drop, but E1 rises. Doctors are fixated on E2, whether we are menopausal or not. E3 is of course the pregnancy estrogen. No test is ever done for the many estrogen mimics which all of us have in our blood now. There are over 100 of them see the website Our Stolen Future. It is the estrogen mimics which are a concern.  Having a test for E2 only is incorrect.  Strictly speaking all 3 should be tested, try if you can and insist that they test all 3.  However, very few doctors or labs will test all 3 estrogen levels for reasons only they can explain.  Perhaps it's because they look for a low level of E2 as an excuse to prescribe HRT, which should never be taken.  They then ignore the other 2 estrogens.  You decide.

There are 2 forms of testing:

  1. Saliva
  2. Serum or blood

Advantages of saliva hormone testing:

  • stress free
  • noninvasive - no needles
  • less expensive - more convenient for health care provider and patient
  • optimized for collection any time of day/month, any place
  • no special processing  -  eg: centrifugation, ice-packs prior to shipment
  • hormones stable in saliva for prolonged period of time
  • convenient shipment by regular US mail
  • more representative than serum of total bio available steroid hormone levels

Disadvantages of saliva hormone testing:

  • technically more challenging
  • interfering substances - food, beverages etc
  • saliva easily contaminated with topical hormones on lips and hands
  • inacurrate results with peridontal disease - more problems with chewing gum
  • lack of familiarity - serum is gold standard
  • sublingual (under the tongue) use of hormones often leads to inaccurate (high) results
  • no proficiency testing - CAP, AAB that reflects saliva hormone levels
  • topical application of hormones results in saliva levels higher than serum

Please note:  The first figures given below are the Conventional Unit and the second figures are the SI Unit.

The Conventional Unit is usually used in America, while the SI Unit is used by the rest of the world.  Reference ranges can vary between countries and laboratories.  Some results are given in pg/ml and others in ng/ml, or pmol/L and nmol/L.  A pg/pmol is 1000 times smaller than a ng/nmol.

Even more confusing, if there is only one Unit given, that is the standard the world over.  For conversion factors see here

All too often women are told that their progesterone and estrogen levels are 'normal'.  The critical factor is not the LEVELS of each hormone, but rather the RATIO of progesterone to estrogen which is often written as P:E2, this is vital.

If saliva tests are performed, finding the ratio is easy - simply divide the estrogen result into the progesterone result. Adding to this complication which is often overlooked is that in blood tests, estrogen is measured in pg/ml and progesterone is ng/ml.  A pg is 1000 times small than an ng, so divide the estrogen result by 1000 to convert it to ng. Then divide this into the progesterone result as per example:

EXAMPLE

If BLOOD tests are done and the estrogen result is 250pg/ml and the progesterone result is 5ng/ml - first divide 250 by 1000 = 0.25ng/ml then divide 5 by 0.25 = 20. The progesterone/estrogen RATIO is 20:1, it should be 600:1 and over.  If SALIVA tests are done, simply divide the estrogen result into the progesterone result.

When to test Progesterone Levels? ~ The test should be done approximately 7 days after ovulation or before bleeding.

Progesterone - blood/serum

  • Female (follicular) <1 ng/ml or <3.18 nmol/L
  • Female (luteal) 5 to 20 ng/ml or 15.9 to 63.6 nmol/L
  • Postmenopausal <1 ng/l or <3.18 nmol/L
  • Male <1 ng/ml or <3.18 nmol/L

Pregnancy - serum

  • 1st trimester 11.2 to 90.0 ng/ml or 35.6 to 286.2 nmol/L
  • 2nd trimester 25.6 to 89.4 ng/ml or 81.4 to 284.29 nmol/L
  • 3rd trimester 48.4 to 425 ng/ml or 153.9 to 1351.5 nmol/L
  • Medline Progesterone

Estrogen (E1) - serum

Estradiol (E2) - serum

  • Female - premenopausal 30 to 400 pg/ml or 110.13 to 1468.4 pmol/L
  • Female - postmenopausal 0 to 30 pg/ml or 0 to 110.13 pmol/L
  • Male 10 to 50 pg/ml or 36.71 to 183.55 pmol/L
  • Medline Estradiol

Testosterone total - serum

  • Male - 300 to 1200 ng/dl or 10.41 to 41.64 nmol/L
  • Female - 30 to 95 ng/dl or 1.041 to 3.29 nmol/L
  • Medline Testosterone

Free Testosterone - ranges from 1 to 4% of total

  • Female ages - 20 to 40 years 0.6 to 3.1 pg/ml or 20.8 to 107.5 pmol/L
  • Female ages - 41 to 60 years 0.4 to 2.5 pg/ml or 13.9 to 86.7 pmol/L
  • Female ages - 61 to 80 years 0.2 to 2.0 pg/ml or 6.9 to 69.3 pmol/L
  • Keratin.com

Free Testosterone - ranges from 1 to 4% of total

  • Male ages - 20 to 40 years 15.0 to 40.0 pg/ml or 520 to 1387 pmol/L
  • Male ages - 41 to 60 years 13.0 to 35.0 pg/ml or 451 to 1213 pmol/L
  • Male ages - 61 to 80 years 12.0 to 28.0 pg/ml or 416 to 971 pmol/L
  • Keratin.com

Progesterone - saliva

  • Female (follicular) 12 to 100 pg/ml or 38.16 to 318.00 pmol/L
  • Female (luteal) 75 to 270 pg/ml or 238.5 to 858.6 pmol/L
  • Postmenopausal 12 to 100 pg/ml or 38.16 to 318.00 pmol/L
  • Male 15 to 100 pg/ml or 47.70 to 318.00 pmol/L

Estradiol (E2) - saliva

  • Female - premenopausal 1.3 to 3.3 pg/ml or 4.7 to 12.11 pmol/L
  • Female - postmenopausal 0.5 to 1.7 pg/ml or 1.84 to 6.24 pmol/L
  • Male 0.82 pg/ml or 2.94 to 8.08 pmol/L

Testosterone - saliva

    • Female all ages 16 to 55 pg/ml or 0.56 to 1.91 pmol/L
    • Female ages 16 - 30 18 to 55 pg/ml or 0.62 to 1.91 pmol/L
    • Female ages >30 16 to 47 pg/ml or 0.56 to 1.63 pmol/L
    • Male all ages 44 to 148 pg/ml or 1.53 to 5.14 pmol/L
      Male ages 16 - 30 72 to 148 pg/ml or 2.50 to 5.14 pmol/L
    • Male ages 31 - 50 58 to 120 pg/ml or 2.01 to 4.16 pmol/L
    • Male ages 51 - 70 44.94 pg/ml or 1.53 to 3.26 pmol/L
    • Males ages >70 30 to 77 pg/ml or 104 to 2.67 pmol/L

ZRT Labs

Serum hCG levels

GA (gestational age) occasionally given as LMP (last menstrual period).  NOTE: this is not taken from time of conception, but from the last menstrual period.  If the date of conception is known, take off the days for the follicular phase.

  • non-pregnant females or negative test: <5.0 mIU/ml or <5.0 IU/L
  • 3 weeks GA - 5 to 50 mIU/ml or 5 to 50 IU/L
  • 4 weeks GA - 5 to 426 mIU/ml or 5 to 426 IU/L
  • 5 weeks GA - 18 to 7,340 mIU/ml or 17 to 7340 IU/L
  • 6 weeks GA - 1,080 to 56,500 mIU/ml or 1,080 to 56,500 IU/L
  • 7-8 weeks GA - 7,650 to 229,000 mIU/ml or 7.650 to 229,000 IU/L
  • 9-12 weeks GA - 25,700 to 288,000 mIU/ml or 25,700 to 288,000 IU/L
  • 13-16 weeks GA - 13,300 to 254,000 mIU/ml or 13,300 to 254,000 IU/L
  • 17-24 weeks GA - 4,060 to 165,400 mIU/L or 4,060 to 165,400 IU/L
  • 25-40 weeks GA - 3,640 to 117,000 mIU/ml or 3,640 or 117,000 IU/L
  • American Pregnancy Association hCG levels ???

SHBG - sex hormone binding globulin

FSH levels

  • male before puberty 0 to 5.0 IU/L
  • male during puberty 0.3 to 10.0 IU/L
  • male adult 1.5 to 12.4 IU/L
  • female before puberty 0 to 5.0 IU/L
  • female during puberty 0.3 to 10.0 IU/L
  • menstruating  3.5 to 30.0 IU/L
  • postmenopausal 40 to 250 IU/L
  • pregnant women - too low to measure
  • Medline FSH

LH levels - an LH level higher than FSH is a possibler indication of PCOS

  • women follicular phase 1.68 to 15 IU/L
  • women mid-cycle peak 21.9 to 56.6 IU/L
  • women luteal phase 0.61 to 16.3 IU/L
  • women menopause 14.2 to 52.3 IU/L
  • men 1.24 to 7.8 IU/L
  • WebMD

Prolactin

  • women non-pregnant 2 to 29 ng/mL or 86.96 to 1260.86 pmol/L
  • women pregnant 10 to 209 ng/mL or 434.78 to 9086.90 pmol/L
  • men 2 - 18 ng/mL or 86.96 to 782.60 pmol/L
  • Medline Prolactin

Vitamin D - essential test

The test should be done for 25-hydroxyvitamin D, also called calcidiol.  The following list gives an indication of levels of vitamin D found in the blood:

  • Sufficient: 70 to 100ng/ml or 175 to 250nmol/L
  • Hypovitaminosis: less than 30ng/ml or 75nmol/L
  • Deficiency: less than 25ng/ml or 62.4nmol/L
  • Vitamin D  Council

PTH - parathyroid hormone

  • Normal values are 10 to 55 pg/mL or 10 to 55 ng/L
  • Medline PTH

TSH - thyroid stimulating hormone or thyrotrophin

T3 total - triiodothyronine

T4 total - thyroxine or tetraiodothyronie

  • Normal values are 4 to 11 mcg/dL or 60 to 140 nmol/L
  • Medline T4

Iodine

Median Population Urinary Iodine Values (g/L)

  • severe deficiency <20
  • moderate deficiency 20 to 49
  • mild deficiency 50 to 99
  • optimal 100 to 199
  • more than adequate 200 to 299
  • possible excess >299
  • ATA

CRP - C-reactive protein, a marker for inflammation

The level of CRP rises when there is inflammation throughout the body, normally none should be found

  • levels if found, vary from <1.0 mg/L to >3.0 mg/L
  • Medline CRP

And

  • late pregnant women, mild inflammation and viral infections 1040 mg/L
  • active inflammation, bacterial infection 40200 mg/L
  • severe bacterial infections and burns >200 mg/L
  • Wiki CRP

Homocysteine - a marker for inflammation

  • 12 to 19 years >/= 60 years cut off for high levels
  • male 4.3 to 9.9 umol/L 5.9 to 15.3 umol/L >/=11.4umol?l
  • female 3.3 to 7.2 umol/L 4.0 to 11.6 umol/L >/=10.4 umol/L
  • The Doctor's Doctor

MDA - Malondialdehyde, a marker for oxidative stress/inflammation, it forms when lipids are oxidised

Cholesterol

Total cholesterol

  • desirable <200 mg/dL or <5.2 mmol/L
  • borderline high 200 to 239 mg/dL or 5.2 mmol/L to 6.2 mmol/L
  • high risk 240 mg/dL and higher or 6.2 mmol/L

HDL cholesterol

  • levels should be >40 mg/dL or >1.04 mmol/L
  • men are at risk if their HDL is below 37 mg/dL or 0.96 mmol/L
  • women are at risk if their HDL is below 47 mg/dL or 0.96 mmol/L

LDL cholesterol

  • optimal <100 mg/dL or <2.59 mmol/L - 3.34 mmol/L
  • near optimal 100 to 129 mg/dL or 2.59 mmol/L to 3.34 mmol/L
  • borderline high 130 to 159 mg/dL or 3.38 mmol/L to 4.12 mmol/L
  • high 160 to 189 mg/dL or 4.14 mmol/L to 4.90 mmol/L
  • very high 190 mg/dL and higher or 4.92 mmol/L
  • Medline Cholesterol

Triglycerides

  • normal <150 mg.dL or <1.79 mmol/L
  • borderline high 150 - 199 mg/dL or 1.79 mmol/L to 2.25 mmol/L
  • high 200 to 499 mg/dL or 2.26 mmol/L to 5.64 mmol/L
  • very high 500 mg/dL and above or 5.65 mmol/L
  • Medline Triglycerides

DHEA sulphate - Dehydroepiandrosterone-sulphate

  • ages 18 - 19 145 to 395 ug/dL or 503.2 to 1370.7 nmol/L
  • ages 20 - 29 65 to 380 ug/dL or 225.6 to 1318.6 nmol/L
  • ages 30 - 39 45 to 270 ug/dL or 156.2 to 036.0 nmol/L
  • ages 40 - 49 32 to 240 ug/dL or 111.0 to 832.8 nmol/L
  • Medline DHEA-S

Cortisol

  • normal values for a blood sample taken at 8am are 6 to 23 ug/dL or 165 to 635 nmoll/L
  • during the afternoon they are 3 to 16 mcg/dL or 83-441 nmol/L
  • Medline Cortisol
  • WebMD 

Normally cortisol levels rise and fall during the day, repeating on a 24 hour cycle (diurnal variation).  Highest levels are at about 6 - 8am and lowest levels are around midnight.

Physical and emotional stress can increase cortisol levels, because during the normal stress response, the pituitary gland increases its release of ACTH.

Higher than normal cortisol levels are expected in women who take estrogen (HRT)or birth control pills.

Glucose - fasting

  • normal levels <100 mg/dL or <5.5 mmol/L
  • levels between 100 to 125 mg/dL or 5.5 to 6.9 mmol/L may indicate impaired fasting glucose or insulin resistance
  • diabetes >126 mg/dL or >6.9 mmol/L
  • insulinoma (a pancreatic tumour which causes excessive secretion of insulin)
    • women <40 mg/dL or <2.2 mmol/L
    • men <50 mg/dL or <2.8 mmol/L
  • WebMD
  • Medline Glucose

Insulin resistance

The following are often tested:

  • blood pressure equal to or higher than 130/85 mmHg
  • fasting blood glucose equal to or higher than 100 mg/dL or 5.55mmol/L
  • insulin levels >20 IU/mL or 140 pmol/L
  • normal range 2.0 to 20 IU/mL or 14 to 140 pmol/L - many believe it should be <10 IU/mL or 70 pmol/L
  • elevated CRP - see above for info
  • large waist circumference 35 inches or 87.5cm or more
  • low HDL cholesterol under 50 mg/dL or 1.32 mmol/L
  • triglycerides equal to or higher than 150 mg/dL  
  • Medline Insulin Resistance
  • NDIC
  • Lab Test Online - Inderstanding Insulin Resistance
  • Glycated or glycosylated haemoglobin (HbA1c or A1C)
  • Normal 20 to 40 mmol/mol or 4% to 5.8%
  • WebMD
  • Wiki

Liver Function tests

    • Wikipedia - scroll through the contents and click on Liver Function
    • Medline - scroll through the list to the desired test