Tuesday, May 19, 2009

Testing for bioidentical hormones

Bio-identical hormones are very much in fashion today and rightfully so. We need adequate hormone levels to function well into the second part of our lives. So the question that I ask myself as a naturopathic doctor is which hormones and what quantity will be most supportive in creating health.
There have been many different methods of testing that I have worked with over the last 15 years. I have not yet found one that is more accurate then simply taking a good case and examining the "signs and symptoms" of a case.  I have found this testing to be very inconsistent even within the same patient.  This concept was reinforced for me when I questioned the directors of the major bio-identical hormone testing labs.  Because many patients will have self medicated with natural progesterone cream, I has the lab directors how long they had to be off of the topical hormone prior to testing for an accurate baseline.  I received answers that varied from 3 days to 6 weeks!
The more testing the better, of course.  However many people that come to me are paying out of pocket or don't have insurance, so we need to make some educated choices.  The only testing that I think is essential at this point is that the patient get an FSH test.
FSH stands for "follicle stimulating hormone". The amount of this hormone in the blood will tell us if the brain is asking for more hormones. If there is a high FSH I think that we can assume that the body has lost its ability to self create hormones.  This is not a big deal, thank goodness the main gifts of the human body are not endless hormone supply but big brains.  So we can figure out options.  I don't think it makes any more sense for a patient to have a high FSH then a high TSH. TSH stands for thyroid stimulating hormone and when it is elevated we know that the brain is asking for hormones that it is not getting and we add thyroid hormones.  If a high TSH indicates low thyroid, then a high FSH indicates low ovaries.
I believe that is the FSH is high we should also add hormones to achieve a normal level.  Ideal these hormones should be bio-identical so that the body can make the best use of them.