Many people with thyroid and autoimmune thyroid conditions not only have an imbalance in thyroid hormone, but also have other hormone imbalances as well. As I’ve mentioned in past posts and articles, an imbalance in the hormones estrogen and progesterone is very common. Despite this, most endocrinologists and other types of medical doctors don’t evaluate for these other hormone imbalances.
If you have hypothyroidism or Hashimoto’s Thyroiditis, then you know what most medical doctors will usually do is to give synthetic thyroid hormone to manage the symptoms. And if you have hyperthyroidism or Graves’ Disease, then you’ll be told to either take antithyroid drugs, and perhaps a beta blocker, or to receive radioactive iodine treatment. There aren’t too many medical doctors who will even consider whether someone with a thyroid or autoimmune thyroid condition has an imbalance of the sex hormones.
One Simple Test Can Make A Big Difference
When it comes to detecting whether someone has a hormone imbalance, the person’s symptoms can be an obvious red flag. For example, common symptoms of estrogen dominance include weight gain, depression, breast tenderness, mood swings and irritability, fatigue, and there are numerous other symptoms. So without question, when I consult with a new patient I look at the person’s health questionnaire and symptom survey I have them fill out, and see if any of their symptoms indicate a potential hormone imbalance. Although you can’t go by symptoms alone, often times it is obvious that the person has some type of hormone imbalance, while at other times it isn’t as clear.
The only way to confirm that someone has a hormone imbalance is through the proper testing. So when I suspect that a patient has such an imbalance I will recommend for them to receive a male or female hormone panel. I have mentioned in the past that I use the company Diagnos-Techs, mainly because they do a great job and have accurate reference ranges. There are of course some other good labs out there. And there are also other labs which aren’t too good.
In any case, I almost always will recommend an expanded male or female hormone panel. And the reason for this is because the expanded hormone panel also includes the pituitary hormones, which are important to evaluate. And the reason for this is because if there is an imbalance of the the pituitary hormones (FSH and LH), then this can tell us about the output of estrogen and progesterone, and the reason why there is a hormone imbalance in the first place. In other words, looking at these two pituitary hormones can potentially tell us the cause of the estrogen dominance condition.
One-Sample Testing Usually Isn’t Sufficient In Cycling Women
While most medical doctors don’t perform any additional hormone testing other than for thyroid hormone, most doctors who DO perform such testing only collect a single sample of the hormones estrogen and progesterone. This might be sufficient with menopausal women. But it’s not sufficient for many pre-menopausal women and definitely not sufficient for cycling women. The reason for this is because the hormone levels are fluctuating, and so taking a one sample test of estrogen and progesterone won’t give the complete picture of what’s happening throughout a woman’s cycle.
This is actually one reason why some women have fertility issues which aren’t resolved. Most women who have difficulty getting pregnant obtain a one-sample test of progesterone, and if the levels on this single sample are sufficient, the doctor will usually rule out a hormone imbalance as being the cause of the problem. However, just because the progesterone levels are normal for a single day doesn’t mean it’s normal for the entire length of the cycle. In fact, it’s not only the total output of progesterone we’re looking at, but the distribution of progesterone throughout the cycle. This is why multiple sample testing is important in cycling women.
An expanded female hormone panel requires the cycling woman to collect multiple saliva samples over the course of her menstrual cycle. This will give a much better indicator as to whether she has a problem with the hormones estrogen and progesterone. These panels also measure the levels of some of the other hormones, such as testosterone and DHEA, which don’t directly relate to estrogen dominance, but since hormones are interactive they can plan a role in this condition.
Estrogen Dominance Can Affect Men Too
While estrogen dominance is more common in women, it can also affect men too. As a result, if a man has symptoms which indicate a potential hormone imbalance, I will recommend an expanded male hormone panel. This will measure the levels of estradiol and progesterone, testosterone, DHEA, Androstenedione, and DHT, along with the pituitary hormones LH and FSH.
In summary, the reason why most medical doctors “miss” the diagnosis of estrogen dominance is because they don’t test for it to begin with. And those who do hormone testing usually only obtain a one-sample test, which might be sufficient in menopausal women, men, and some women in pre-menopause, but isn’t sufficient for cycling women. So if you’re a cycling woman with symptoms of a hormone imbalance then you definitely want to make sure you receive a multiple-sample test. And regardless of whether you are in menopause or not, or what gender you are, if you do any type of hormone testing then it’s a good idea to obtain an expanded hormone panel to determine the levels of pituitary hormones, which in turn relate to the output of estrogen and progesterone.