Many patients seek functional medicine to address hormone-related concerns. Unfortunately, in conventional medicine, it’s common for patients to hear, “We don’t test hormones in your age group,” especially if they are in perimenopause, approaching menopause, or even a year past their last period.
At Tendwell, we take a different approach. Functional medicine values data. Our motto is “test, don’t guess.” While we recognize the limitations and variability of testing, we use a range of strategies to get the most comprehensive understanding of your hormonal health.
Hormone Testing at Tendwell
For a baseline assessment, we typically use Labcorp to measure serum levels of key hormones, including:
- Testosterone (both free and total)
- DHEA-S
- Progesterone
- Estradiol
- Sex Hormone Binding Globulin (SHBG)
Timing matters when testing hormones. For those with regular menstrual cycles, estradiol is best tested during the follicular phase (days 2–3 of the cycle), while progesterone is ideally tested during the luteal phase (around days 19–21). Cycle length can vary, so tracking your cycles with an app can be a valuable tool for determining the best testing windows.
Beyond Serum Testing: Understanding Estrogen Metabolism
In addition to serum testing, we often use the DUTCH test, a dried urine hormone test from Precision Analytical, to gain insights into estrogen metabolism. This test helps us understand how your body detoxifies estrogen through specific pathways.
- The 2-OH pathway, which I like to call the “broccoli pathway,” is the preferred route for estrogen detoxification.
- Identifying how your body processes estrogen can help us optimize detox pathways and promote hormonal balance.
Supporting Estrogen Detoxification
Another valuable tool in assessing estrogen metabolism is a comprehensive stool test. This test can identify specific enzymes that may interfere with estrogen elimination during bowel movements. Proper gut function is critical to maintaining healthy hormone levels, as imbalances in gut enzymes can hinder estrogen removal.
Takeaway: Hormonal health is complex, but with the right tools and a functional medicine approach, we can uncover what’s happening in your body and support you in achieving balance.