To some degree, we’ve all been there… you’re starting to feel tired and run down, perhaps you’re not sleeping well and starting to feel more irritable, moody and down. Your periods are becoming harder to handle or you may even be entering menopause, but you’re not sure. Your weight is creeping up despite your hardest efforts and you’re just not feeling like yourself.
You decide to go to your family doctor to investigate your symptoms and after running some blood work, everything comes back as “normal”. Your doctor tells you that you must be fine, but if you’re not feeling well maybe you should try a sleeping pill, an anti-depressant, or try to exercise more. He does have the best intentions and he wants to help you after all.
This isn’t the answer you were looking for, however. You were really hoping something will be “off” on your blood work so at least you will have something tangible to explain why you are feeling this way and why things seem out of balance.
Many patients come to our office with what appears to be “normal” blood work, but when we take a closer to look, there is key information missing – what day of the month did you do the test? Only Total Testosterone was tested and not Free? Only TSH was looked at, not the complete thyroid panel? Did you fast before doing the test? Did you do it first thing in the morning?
Clearly, there’s more you need to know about your “normal” blood work than meets the eye.
Common mistakes women and doctors make when testing their hormones:
1. Hormones are not tested at the right time of the month.
Women are sometimes given a requisition and are simply told to go and test with no specification of what the best time of the month is to assess their specific symptoms. Some hormones, especially sex hormones (FSH, LH, estrogens, and progesterone) vary during the month and vary whether you are menstruating or not, therefore timing is key.
2. Hormones are not tested at the right time of the day.
Some hormones fluctuate during the day and have what is called “diurnal variation”. Testing first thing in the morning and in the afternoon may yield very different results. This is especially true for testosterone and cortisol. Usually, the best time is first thing in the morning (ideally on an empty stomach to stay consistent with repeat testing).
3. Too much weighing is put on testing to make clinical decisions.
No one way of testing will capture all the right information so it’s important to know the pros and cons of each form of testing (check out our Testing Cheat Sheet). It’s also important to remember that hormones fluctuate a lot, so even while some tests are more accurate than others, they are still just capturing a moment in time.
4. Minimal amount of markers are tested to assess your diverse symptoms.
If you leave in Canada and have the benefits of a free healthcare system, unfortunately sometimes that’s what you get. Doctors have limitations on the extent of testing they can do. Often very minimal markers are actually looked at, making it difficult to see the complete picture.
5. If everything appears “normal” symptoms are disregarded.
It’s always important to remember that your symptoms trump all testing! At the end of the day, while testing can provide great insight about your biochemistry when it comes to making clinical decisions, your symptoms should be the highest priority. Never settle for being told “everything is normal” if you clearly don’t feel that way.
Hormones are quite complex, and you may not even be aware that there are 3 different ways to test your hormone levels. However, using the correct method that is most fitting for you, may provide you the information about your body that you are looking for.
In the FREE Hormone Testing Cheat Sheet that we created for you, you will find a complete list that compares the pros and costs of testing your hormones through blood work, saliva and urine as well as a detailed checklist of which hormones you should ask your doctor to check for, what they assess, as well as when and how is the best way to check for them. There are alternatives!
You may be thinking, this is too complex, my doctor won’t listen to me, or this can get expensive if I invest in more comprehensive testing and so here is something I have to share with you from experience:
- You are right, it’s not easy. Doing different tests on different days is time-consuming and can get confusing. However, the more you let hormonal imbalances linger and go untreated, the longer they will take to correct and the worse they will get with time.
Your other option is to treat your symptoms without testing, which can get you great results as well. But if you’ve already tried that and didn’t see much improvement, consider investing is more a more comprehensive workup.
- If your doctor won’t listen to you, get another doctor. Sorry to be blunt, but at this day and age you have to take ownership of your own health and not sit and wait for someone else to do it for you. Keep in mind your doctor will only have access to blood work (not to saliva or urine testing as those are done through private labs).
At the very least, use our Tips in the Cheat Sheet to make the most of your bloodwork testing but I highly recommend you also consider seeing a naturopathic doctor or functional medicine practitioner that can give you access to these tests. Make sure they are well trained in being able to interpret these tests and create a highly customized plan specific to treating your imbalances.
3. Yes, it can get expensive. If you have not done even basic bloodwork, then start with that. If you have and have seen several practitioners that have run bloodwork and done things like pelvic ultrasounds and mammograms as a screening test and all come back as “normal” and you are left with no answers, then I highly recommend considering the DUTCH test (Dried Urine Testing for Comprehensive Hormones).
In our office, to get the most comprehensive assessment of your hormonal imbalances and concerns, we recommend combining the DUTCH test with markers that can be easily and best tested through blood-work (such as a thyroid panel, LH, FSH, fasting glucose, fasting insulin, HbA1C and nutritional markers such as ferritin, B12 and RBC magnesium).
Overall, testing can be extremely helpful to take the guesswork out and provide you with a highly personalized overview of your hormonal and metabolic imbalances, so you know exactly what you need to treat.
With that being said, remember that your symptoms should always have the greatest weighing when deciding on the best treatment plan. Never settle for being told things look “just fine” if that’s not how you feel. There are many natural and effective solutions to addressing your symptoms and improving your quality of life, whether you do testing or not.
Reach out to us if you would like to learn more!