- My labs are considered “normal” . I have been told that it’s just the aging process, the fact that I have kids and that I just have to live with the fact that I don’t feel myself, can this program help?
- My labs are considered “normal” , but I am tired all the time, can’t seem to lose weight and have all the symptoms that the internet says are related to thyroid, can this program help?
- I just want to get my hormones tested, can I just do that?
- What is the difference between blood testing and saliva testing?
- How soon will my lab test results be ready?
My labs are considered “normal”. I have been told that it‘s just the aging process, the fact that I have kids and that I just have to live with the fact that I dont’t feel myself, can this program help?
Unfortunately, this is a common complaint that we hear at our center. There are many reasons this may happen including:
In Proper Labs: Proper assessment begins with ensuring the right lab tests are being run, with the right lab, and with the right timing depending on your hormone cycle when indicated. An example of this is knowing what day of the month your hormone test is being run to reflect the monthly changes of that hormone.
Optimal Focus: The Revivelife™ Hormone Optimization Program (HOP) is designed to assess your labs in the range of optimal health vs the red zone, which is the development of disease or the zone where disease is already at high risk. Our goal is to assist you in living your best life and helping your body perform at its optimal level. By focusing on optimal levels vs normal levels, Many of our clients indicate that they have never felt better!
Personal Variation: Each person will have a lab value range that represents their personal optimal vs the “normal range”. At Revivelife™ we track your hormone levels relative to your degree of wellness to find what is your personal optimal value.
I think I have a thyroid problem, however, my labs are considered “normal” , but I am tired all the time, can‘t seem to lose weight and have all the symptoms that the internet says are related to thyroid, can this program help?
The Colorado Thyroid Disease Prevalence Study found that 13 million Americans may be unaware of an undiagnosed of their thyroid conditions. The significance of undiagnosed thyroid imbalance is that the thyroid can impact everything from your energy, metabolism, cholesterol, heart disease, constipation to a child’s IQ (if the mother is thyroid deficient during pregnancy).
Health does not change overnight, but is a steady process, including thyroid hormones, when the thyroid begins to become unbalanced, one may have many symptoms of thyroid concerns, but yet have “normal labs” according to the red zone where a diagnosis of thyroid disease is made ie. hypothyroid or hyperthyroid. In this transitional zone integrative doctors recognize this as a “Functional Thyroid Imbalance”, meaning that the thyroid is not at its optimal function, leaving you with many thyroid type symptoms, but may not yet show a positive marker on labs. Other concerns include:
In Proper Testing: The current model of testing only uses the TSH as a screen to view how your thyroid gland is functioning and that it must be elevated before a diagnosis of hypothyroidism is made. TSH is a measure of how much the pituitary gland is attempting to “talk” to the thyroid gland to encourage the release of more thyroid hormone, in response to a low thyroid hormone level. A “normal” TSH tells us only that your thyroid gland is working enough to produce “normal” TSH levels, but it does not tell us if it is working optimally or if you have sufficient levels of inactive thyroid hormone (T4) or active thyroid hormone (T3) that are bio-available. Free T3 and Free T4 levels are the only accurate measure of the actual active thyroid hormone levels in the blood. Thus a “normal” TSH does not rule out hypothyroidism. A proper assessment would include a thyroid panel including TSH, fT4, fT4, rT3, fT3/rT3 ratio (optimal= 2+) and integrating this with the percentage of positive thyroid imbalance symptoms, including a basal body temperature (<97.6ºF).
Optimal Focus: The current myth that persists regarding thyroid diagnosis is that an elevated TSH (thyroid stimulating hormone) level is always required before a diagnosis of hypothyroidism can be made. There is also evidence to suggest that the current “normal range” should be moved to catch, thyroid imbalances at an earlier stage, as at present one may be considerably overweight , have suffered from thyroid symptoms for a great number of years before any therapeutic support is offered. Research shows that optimal range for TSH is 0.4-2.5 mIU/L with the optimal level of TSH being 1 mIU/L for both women and men vs the “normal range” of 0.35-5.0 mIU/L.(1)(2) One of the largest studies of thyroid problems is the Whickham Survey , which studied the thyroid levels of 2,779 randomly selected adults living in Whickham England from 1972-1973 and subsequently followed for 20 years. Data published from the twenty year follow up published in 1995 demonstrated an increased risk for the development of hypothyroidism once TSH levels exceed 2.0 mIU/L (3). In addition, the third National Health and Nutrition Examination Survey (NHANES) screened 17,353 people and found that 95% of people had TSH levels that fell between 0.3 and 2.5 mIU/L (4)(5 ) Our goal is to determine if any weakness in the thyroid or any other weaknesses in your health, exist, including the adrenal gland which is often linked to the thyroid gland , that are hindering you feeling at your best.
Personal Variation: Although the “normal range” for TSH when thyroid health is being evaluated is 0.35-5.0 mIU/L, an individual may feel their personal best when their hormones are titrated to 0.6 mIU/L which if a doctor was to just rely on normal values, this individual would not normally have received hormone support. Tracking the level of when you feel “well” is important in understanding how to reach hormone support that is right for you.
(1) Demers LM, Spencer CA. Laboratory medicine practice guidelines: laboratory support for the diagnosis and monitoring of thyroid disease. Clin Endocrinol (Oxf).2003;58:138-40
(2) Dr. Tierry Hertoghe, MD, The Hormone Handbook, ISBN 978-2-95997-13-5-8, May 2010, page 393
Vanderpump, M.P., Tunbridge, W.M., French, J.M., Appleton, D., Bates, D., Clark, F., Grimley Evans, J., Hasan, D.M., Rodgers, H., Tunbridge, F.,The incidence of thyroid disorders in the community; a twenty-year follow up of the Wickham Survey, Clin. Endocrinol ( Oxf) 1995, Jul;43 (1):5-68
(3) Hollowell, J.G., Staehling, N.W., Flanders, W.D., Hannon, W.H., Gunter, E.W., Spencer, C.A., Braverman, L.E. Serum TSH, T4, and thyroid antibodies in the United States population (1988 to 1994): National Health and Nutrition Examination Survey (NHANES III). J Clin Endocrinol Metab 2002 Feb;87(2):489
(4) Lee, S.L. When is the TSH normal? New criteria for diagnosis and management. Lecture presented at 12th Annual Meeting of the American Association of Clinical Endocrinologists (AACE), San Diego, CA, May 14, 2003 ( thyroidtoday.com)
(5) Dr. Tierry Hertoghe, MD, The Hormone Handbook, ISBN 978-2-95997-13-5-8, May 2010, page 393
I just want to get my hormones tested, can I just do that?
Laboratory testing is important but is only one piece of the puzzle. How you feel and how it relates to the laboratory results gives your hormone team the full picture. Your hormones also need to be monitored to ensure that they are being prescribed in the right balance for you on an ongoing basis, thus you can have your hormones tested, however we cannot prescribe HIHS without having a new patient visit and ongoing follow ups to ensure that you are getting the best results.
Can I use any lab work that I already had done?
You may bring along any lab work, bone density, mammograms, PAP smears, or other diagnostic tests you have had done in the past year. Once we review your past labs we may find it necessary to have you complete additional labs including hormone testing to determine your current hormone replacement needs.
What is the difference between testing hormones by blood (serum), saliva or urine?
There is no one test method that is the best for hormones as each comes with advantages and disadvantages. It is important to keep in mind that lab testing gives you an idea of what is going on clinically, from an objective perspective. However, it is important to integrate the subjective part of how you feel, how this correlates to the signs and symptoms of each hormone imbalance and then integrating the lab results. For example one could be within the “normal range” for thyroid testing , however an individual may have all the signs and symptoms of thyroid imbalance. In this instance it may be important to prescribe based on the weight of the signs and symptoms.
Blood (serum): The advantages of blood hormone testing are that is an easy test, the results are available within a week, not as expensive as the other methods of testing and that the test provides relatively accurate values with established reference ranges. With a patient’s health information including symptoms a relatively clear picture can be formed for prescribing. Blood testing is best used for DHT, FSH, LH, Prolactin, TSH, rT3, Prolactin, IGF-1, and 3β-Adiol which shows great promise as a biomarker for the development of prostate cancer. ( Link to 3β-Adiol and the Testosterone Metabolite Test.)Link to Blood (serum) Hormone Testing
The disadvantage is that blood hormone testing measures a “snapshot” of “total” hormones, which includes those hormones already bound to protein AND free hormones(2-5% of hormones in your body). This does not necessarily give you a clear picture of what hormones are “bioavailable”, as bound hormones in general are not as readily accessible for your body to use as compared to free hormones. Testosterone blood testing however, is available as bound and free, giving you more of an idea of what is free and available to the body.
Saliva : The advantages of saliva hormone testing is that it measures “free” hormones (2-5% of the hormones in your body), which are the hormones that are available to go to work for you – stimulating receptor cells and carrying out the tasks they are designed to perform. Generally samples are taken throughout the month to give you an overview of the variations of hormones over time. This gives you a monthly map to work with and prescribe accordingly. The disadvantages are that saliva samples may be more difficult to obtain, take longer to gather for the monthly mapping, the test is more costly and test results may be hindered in elderly patients with limited salivary output. Saliva testing can yield higher than physiological levels when using exogenous hormone replacement therapy; this can give a false impression of overdosing. Single point saliva tests also have the disadvantage of being a ‘snapshot’ look at hormones that ebb and flow throughout at 24-hour period.
Link to Saliva Hormone Testing
Urine (24 hour): The advantages of 24 hour urine hormone testing, is that it measures the hormone levels with a stable indicator of output not susceptible to the hour to hour fluctuation that may be seen in a blood or salivary measurement, and it is an easy test. 24 hour urine hormone testing in addition tests for liver detoxification capability, breast, ovarian (2/16α ratio) and prostate cancer risk (3β-Adiol) biomarkers ; adrenal gland health, and growth hormone. The disadvantages are that it is a more costly test. Link to 24 Hour Urine Hormone Testing
How soon will my lab test results be ready?
Blood (serum) test results are generally available in 7 business days, saliva and 24 hour urine testing results are generally available in 14 business days after the lab receives the samples (sample transport generally takes 3-4 business days). Saliva sampling may take 1 month to gather the samples if you have a menses and we are tracking multiple samples over the month to create a “monthly map”.
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