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Hormones are chemical compounds that our bodies produce to regulate various functions, from metabolism to appetite and even heartbeat and breathing. Too much or too little of certain hormones (hormonal imbalance) affects the well-being and provokes various diseases.
You can identify the problem with the help of hormonal testing, which helps to assess hormonal imbalance. Modern diagnostic capabilities of laboratories allow us to receive adequate therapy in the future.
Hormone levels fluctuate with age, and for some even throughout the day. Doctors use hormonal tests to identify and evaluate hormonal imbalances that could make a patient sick. Hormone testing is often done with a blood sample, but some tests require urine or saliva samples.
Often tested levels:
- estrogen and testosterone, progesterone;
- adrenal hormones such as cortisol;
- growth hormone, prolactin and other pituitary hormones;
- thyroid hormones such as thyroxine.
Sometimes hormone stimulation and suppression testing is done to assess hormonal imbalances. Doctors first give the patient hormones and other substances that either start (stimulate) or stop (suppress) the production of certain hormones. Then they evaluate the reaction of the body.
Common types of stimulation and suppression tests include.
- Growth hormone response to glucagon. In this study, the hormone glucagon is injected into the muscle tissue, and then its level is measured within 4 hours. This test helps confirm or rule out growth hormone deficiency in adults.
- Cortisol response to cosyntropin. In this test, the patient is given cosyntropin, which acts as an adrenocorticotropic hormone that is produced by the pituitary gland and stimulates the adrenal glands to produce cortisol. Cortisol levels are then measured every 30 minutes for an hour. This test helps confirm adrenal insufficiency.
- Glucose tolerance test. In this case, the patient is given a sugary drink, which should lower the level of growth hormone. Then the level of growth hormone in the blood is measured every two hours. This test helps confirm acromegaly.
- Cortisol response to dexamethasone. The patient takes a dexamethasone tablet at night, which is supposed to block the production of cortisol. The next day, a blood sample is taken from him to measure the level of this hormone. The test helps confirm or rule out Cushing’s syndrome.
- Metyrapone suppression test. Here the scheme is the same – at night the patient takes a tablet of metyrapone, which should block the production of cortisol. The next day, a blood sample is taken from him to measure his cortisol and adrenocorticotropic hormone levels. This test helps confirm or rule out adrenal insufficiency.
What tests are given for hormones
For hormone testing, blood, dried blood spots on special paper, saliva, individual urine samples, and XNUMX-hour urine tests are usually taken. The type of sample will depend on what is being measured, the accuracy required, or the age of the patient.
Hormone test results can be affected by food, drink, rest, exercise, and the menstrual cycle, which can lead to inaccurate results. More accurate data is obtained in dynamic tests, when analyzes are taken two or more times within a certain period of time.
There are several options for hormonal studies.
Female hormonal profile
The profile of female hormones includes the following tests:
- FSH (follicle stimulating hormone);
- estradiol (the most active form of estrogen);
- progesterone;
- testosterone;
- DHEA-S (dehydroepiandrosterone sulfate);
- vitamin D
For research, blood tests are most often taken, but a urinalysis may be recommended (including during pregnancy).
Male Hormonal Profile
This includes tests for:
- PSA (prostate specific antigen);
- estradiol;
- progesterone;
- testosterone;
- DHEA-S (dehydroepiandrosterone sulfate);
- SHBG (sex hormone-binding globulin).
Usually donate blood, perhaps the appointment of a urine test and other options.
Thyroid Profile
Thyroid profile tests include:
- TSH (thyroid-stimulating hormone);
- free T4;
- free T3;
- thyroid antibodies;
- antibodies to thyroid peroxidase.
Assessment of calcium levels and bone metabolism
In this case, research:
- 25-hydroxyvitamin D;
- 1,25 dihydroxyvitamin D;
- parathyroid hormone.
Assessing the work of the adrenal glands
In this case, examine the level:
- aldosterone;
- renin;
- cortisol: no XNUMX-hour urine, serum/plasma, late-night saliva
- ACTH;
- catecholamines and metanephrines (urinary excretion);
- plasma catecholamines;
- metanephrines without plasma.
Growth processes
To assess them, tests are carried out on:
- a growth hormone;
- insulin-like growth factor 1.
Glucose homeostasis
These tests are taken when diabetes is suspected:
- insulin;
- C-peptide.
They are carried out simultaneously with plasma glucose levels, a glucose tolerance test.
Where can I get my hormones tested?
Analyzes for the assessment of the hormonal profile can be taken in the laboratory of polyclinics and hospitals, if included in the examination program for compulsory medical insurance. But some tests may not be included in the free program, and they must be taken for a fee.
In private clinics and laboratories, you can undergo hormonal testing under the VHI policy or for a fee, it depends on the amount of research.
How much do hormone tests cost?
Tests for hormones cost from several hundred to several thousand rubles, depending on the complexity of the test and its duration.
The preliminary cost can be clarified on the clinic’s website, the final cost will depend on the amount of necessary research.
Popular questions and answers
Answered questions about hormonal tests endocrinologist Zukhra Pavlova. We also addressed some of the questions on hormone tests endocrinologist Elena Zhuchkova.
Who and when should be tested for hormones?
The level of hormones can be examined as part of a medical examination. Thyroid hormones and thyroid-stimulating hormone (TSH) are most often looked at, since thyroid pathologies are very common.
The doctor prescribes an analysis for hormones if the patient has any complaints. Or pregnancy is planned – then they can prescribe a fertility test and examine the level of testosterone, globulin, estradiol, prolactin.
How to prepare for a hormone test?
I often hear: if I donate thyroid hormones, then what does it have to do with whether I ate or not. In fact, everything is interconnected. Let’s say the level of testosterone, which seems to have nothing to do with food. If you look at it before eating and 20-30 minutes after, then in the second case, its level will decrease by 30%. And this is very significant!
After eating, the amount of intestinal hormones, glucagon and insulin, also increases, and they already affect all other hormones.
Moreover, we try to take into account the circadian rhythms of hormones. For example, cortisol and testosterone levels are highest in the morning, and some other hormones are higher in the evening.
There are certain requirements for the delivery of hormones. It is necessary that the patient be in the supine position, because the vertical position of the human body also affects the level of hormones.
Before passing the test for the level of cortisol, it is advisable not to eat meat for a day, not to be nervous, to exclude the most stressful situations, heavy physical exertion.
Can there be incorrect results, which affects the research?
The results of some tests for hormones can be changed if they are made immediately after a physiotherapy procedure, X-ray examination, ultrasound (for example, it is not necessary to conduct a study for some hormones on the day of an ultrasound of the breast, ultrasound of the prostate). At the same time, you can safely take tests for thyroid hormones after an ultrasound of the thyroid gland. This will not affect the result in any way. An endocrinologist will help you navigate and suggest the best plan before the examination.
Blood for research on sex hormones in women is donated on a certain day of the cycle. The specialist should definitely warn you about this.
Some diseases that are not associated with endocrine pathology may affect the result of the examination. So, for example, it is worth considering the presence of cancer, chronic pathology of the liver, kidneys, severe mental illness. Also, the combination of several endocrine diseases makes adjustments to the interpretation of the results and should be evaluated by a specialist.
Almost all blood tests for hormones should be carried out not once, but in dynamics. Analysis in dynamics is more informative both in terms of diagnostics and for predicting the course and outcome of the disease.