I don't know if you know, but there are a lot of women out there with some messed up hormones. I talk to some of them, and the hormonal imbalance seems to be becoming more extreme and is happening at younger and younger ages. When you chat with a women in her 30s who's already experiencing symptoms associated with perimenopause, or who has been on hormonal birth control nonstop since her teens for reasons other than birth control, or who is sidelined by debilitating hormonal migraines almost every single month of the year, you know something's up. Women are struggling.
I've found what these women often do is go to their gynecologist and ask for hormone testing. Normally I would champion such an effort, and in this regard I would, too, except...
Except that it's not really the best use of your efforts.
First of all, if you are testing willy-nilly with no understanding of where you are in your monthly cycle, the results are fairly meaningless. Hormones naturally fluctuate over the course of a month, so it does no good to test estrogen levels, for example, if the day of testing corresponds with a day in your cycle when estrogen is at moderate levels. Instead, you'd want to test on a day when estrogen should be peaking, like between Days 10-14 as opposed to Day 2 or 20. Or if you suspect estrogen excess, test on a day when levels should be at their lowest point, like during the menstrual phase, to see if your levels are unusually high. It's the same with progesterone. If you test before ovulation, your results will most likely be inconclusive because the range of what is considered "normal" is so variable. But if you test around Day 21 when progesterone is supposed to be at its highest, you'll get much better data about how well your hormones are functioning. In my experience, most doctors are not communicating this information to their patients, and many women don't know enough about their own bodies to ask. And those that do can't track their cycles anyway because of such cycle irregularity and/or birth control use.
Another reason I often delay hormone testing is that I can usually get most if not all of the information I need from a few basic inputs: a 3-day food and mood journal, a description of common symptoms, and an honest conversation about sleep patterns, alcohol consumption, and stress management behaviors. Sometimes it's helpful to have the objective evidence of lab results and numbers, but a skilled practitioner should have a pretty good idea what's going on just by talking to the individual for an extended time over a series of meetings, which is a luxury many mainstream health professionals just don't have. Did you know the average length of an appointment - the actual time spent with the doctor, I mean - is about 8-12 minutes? Barely enough time to scratch the surface of an individual's health concerns!
Lastly, I don't recommend conventional hormone testing straight away because the the individual often doesn't know what to do with the results. Okay, so you have estrogen excess. What is your doctor going to do about that? Suggest surgical removal of your ovaries? Or maybe it's low progesterone. Are you jumping straight into hormone replacement therapy without understanding the root cause?
This brings me to an alternative option, and the 3-step course of action I would recommend.
Find a practitioner who is well-versed in holistic care and/or functional medicine.
Request a CBC with differential (complete blood count), a CMP (comprehensive metabolic panel), an iron panel, a thyroid panel, and a lipid panel. There are other tests besides these that might be relevant, but you'll garner so much information from these that additional markers might not be necessary.
Log your food and drink for 3-4 days, and be honest! It's important to know if it's home-cooked food or restaurant food. Some people (especially women) feel edgy about recording amounts, but in general when I ask for this kind of detail I'm more concerned with under-eating rather than the opposite. I'd also recommend tracking your bowel movements using the Bristol Stool Chart for the same amount of time.
What will all of this tell you about your hormone dysfunction?
It will reveal if you are eating enough, which is critical to know. If a woman is chronically depriving herself of necessary nutrients, the body is going to prioritize cortisol production over the production of reproductive hormones - because a body in danger of starvation knows it is not fit to create new life.
It will tell me if there is enough quality protein and natural fats in your diet for your body to have the raw materials necessary for hormone production.
It will paint a picture of your overall digestion - whether nutrients are being absorbed or not, whether your body is excreting wastes efficiently or recycling them back into your system, and whether your liver is able to detoxify easily or is congested with way too much muck.
It will reveal data about your toxic load - whether you are chronically exposed to plastics, to chemical preservatives, to industrial seed oils, to sugar, to artificial colors and flavors, to infection (bacterial, viral, fungal, and/or parasitic), and to high sodium foods.
It will detail your body's ability to regulate your blood sugar, which is a major driver (if not the primary driver) of hormonal imbalance.
It will tell me about your daily life - if you sleep enough, if you're relying on caffeine and adrenaline to get through your day, and if you have a support system at home that's going champion your recovery and help you achieve optimal hormonal health.
Go ahead and get the hormone testing if it makes you feel good. There's a possibility you'll get useful information in return. But take the slower, harder, and more demanding path with the right practitioner, and I guarantee you'll get the answers you need - - maybe not the answers you want to hear, but the ones that will lead to the greatest degree of change, assuming you do the work and trust the process.
Let me know if you need more information or would like to talk in more detail. It brings me a lot of joy to get people moving on the right path, and I absolutely believe that you could be feeling and living better than you do right now.
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