Allara’s Guide to Hormonal Testing

At your annual check up, or when at the doctor’s for a different reason, you may have encountered the following testing: complete blood count (CBC), a urinalysis (UA), and a chemistry panel. Beyond that, the American Heart Association recommends everyone gets a lipid panel (otherwise known as a cholesterol test); this is to check your levels of HDL – “good cholesterol” – to your LDL – “bad cholesterol” and levels of triglycerides (generally speaking, the lower the better). This is to monitor your risk of long term complications such as heart disease.

But what about hormonal testing? What does this encompass? If you have symptoms that may signify a hormonal imbalance or reproductive health issue, there’s no one size fits all when it comes to what tests you should take. That journey should be undertaken with the help of a medical professional: they can help interpret results, guide your treatment, and work toward managing symptoms. That being said, the more you know the better. That’s why we’re giving you the breakdown on what types of testing often fall under hormonal testing, what tests fall under metabolic testing, different testing options available, and questions to ask as you consider choosing the best option for you. Let’s dive in.  

Hormonal testing

When do you need hormonal testing?

First things first: if you feel something is ‘off’ in your body, speak to your doctor immediately.

Apart from that, if you have symptoms that could indicate a thyroid disorder (such as symptoms of hypothyroidism or symptoms of hyperthyroidism), high levels of testosterone (symptoms associated with PCOS can indicate androgen excess), irregular or painful periods, or any other troubling symptoms that you can’t explain the root cause of: it is important you speak with a medical professional ASAP; they can work with you to develop a plan to understand what is going on internally.

Types of hormonal tests  

The following are popular tests your doctor may order when considering a hormonal imbalance:

• LH
• FSH
• Testosterone
• AMH

Let’s tackle each in turn.

LH stands for luteinizing hormone, and this hormone is made by your pituitary gland. In women, LH is responsible for things like the menstrual cycle (including ovulation), and this test can help determine everything from causes of infertility, to when ovulation occurs, to the underlying reason for missed or irregular periods.

FSH testing is often conducted alongside LH testing. FSH stands for follicle-stimulating hormone, and this hormone is made by the pituitary gland as well. FSH plays an important role in regulating the menstrual cycle, in particular the growth of eggs in the ovaries. FSH levels change during the stages of a woman’s menstrual cycle, peaking before an egg is released by the ovary around the time of ovulation. Too low levels of FSH can cause menstrual irregularities and even infertility in women.

AMH stands for anti-mullerian hormone, and this test is often used to check a woman’s ability to produce eggs that can be fertilized. AMH levels can be extremely useful in figuring out why someone may be struggling to get pregnant, and they can tell a woman how many potential egg cells she has left (i.e. letting her know the state of the ‘ovarian reserve’). Generally speaking, if one’s ovarian reserve is high, they may have more time to get pregnant, while a low ovarian reserve may indicate they should not delay too long before trying to have a baby. Of course, the results of an AMH test should be discussed in conjunction with your primary care physician and, if necessary, a fertility specialist.  

Testosterone testing in women is usually conducted when physical symptoms arise that could indicate PCOS or another hormonal imbalance. In particular, abnormal hair growth on the face or body, androgenic alopecia (hair loss that manifests primary in the center of the hairline and a thinning around the temples),  deepening  voice,  and acne (particularly the hormonal, cystic type) can all be noted and used as a reason to pursue hormonal testing. Testosterone tests can be finicky in that a blood sample should be taken in the morning (generally between 7am and 10am, according to MedlinePlus), when testosterone levels are highest, but otherwise this is a very quick blood test (just like the ones listed above).

Finally, let’s talk about PCOS tests. PCOS testing is unusual in that there isn’t one single test to determine whether you have PCOS, but rather the process encompasses several tests that – when results are evaluated altogether – can help reveal a positive or negative PCOS diagnosis. For instance, a PCOS test can include the following:

• Pelvic exam (to check for growths or masses)
• Ultrasound exam (to check for cysts on the ovaries)
• Glucose tolerance test (since women with PCOS are at increased risk for type 2 diabetes)  
• Testosterone test
• Tests done to rule out other conditions which may mimic they symptoms of PCOS

Interested in learning more about the process of figuring out a PCOS diagnosis? Check out our article, here!

Other at home tests that can provide health insights

When our bodies are working as they should and we feel in good health, your doctor might have no reason to order blood work, and you may be unlikely to request it. But sometimes when troubling symptoms show up, testing can be useful for figuring out what’s going on underneath the surface. Used alongside hormonal testing, or sometimes alone, here are just a few popular tests:

• Cholesterol test
• Used to check ‘good’ and ‘bad’ cholesterol in your blood, this is an important test when figuring out your risk for heart disease, and whether dietary and lifestyle changes may be necessary to get you feeling your best again and prepared with the information to look after your long term health.

• Vitamin test
• There are many vitamins and minerals our bodies need to keep us feeling energized and upbeat, but some of the most common vitamin deficiencies in our society include: vitamin D, vitamin B6, vitamin B12, and folic acid (although magnesium and iron are also popular deficiencies)
• What type of test your doctor orders will likely depend on your symptoms and lifestyle: for instance, if you follow a mostly or entirely vegan diet, you may be vulnerable to B12 deficiency, in which case your doctor may recommend supplements

• Inflammation levels
• There are several tests available for testing inflammation, but suffice it to say, these tests can help figure out whether you suffer from inflammation (which comes in two forms, chronic and acute). Acute inflammation is when your body responds to sudden “body damage” like cutting your finger, while chronic inflammation is when your body “keeps sending inflammatory cells, even when there is no outside danger.” Chronic inflammation is known to play a role in the progress of several severe long term health implications, such as Alzheimer’s, asthma, heart disease, type 2 diabetes, and rheumatoid arthritis.

Can you do at home testing?

This is most certainly a question for you to bring to your doctor, making sure to include lifestyle considerations (for instance, informing your doctor at home testing may be more convenient because of problems with reliability of transit) so that your doctor can guide you on if at-home testing is a right fit for you, or whether you will need to return to their office to complete testing.

The important thing is that you: 1) complete trusted testing with accurate results that you can discuss with your physician, and that you 2) don’t have to keep waiting for testing for months, not knowing the answers to your troubling symptoms. In particular on this second note, because sometimes tests do take varying amounts of time to be run, it is important that you speak with your doctor as soon as possible about symptoms, so they can get the ball rolling on testing.

Visiting a lab for testing

Keep in mind that some people who can do at home testing choose not to: they prefer having complete peace of mind that a registered nurse or doctor is conducting their test, and they don’t have to worry about anything else than showing up to the appointment.

Also remember that if travel time to your medical provider is a concern as well, or if they are a fully remote telehealth service – like Allara is – rest assured you can always request to be referred to a lab that is closer to your house or place of work (just be sure to check in advance with your insurance to see if it is in network).

Allara testing

Allara conducts lab testing with trusted partners Quest Diagnostics and LabCorp. Allara’s MDs first meet with you to discuss your symptoms, hear about your medical history, and understand your concerns before ordering specific testing related to your symptoms. When the results are ready, your Allara MD will get in touch and arrange a time to go over your test results in depth; in this session, you work together to determine evidence-based lifestyle changes and potential medications that are a good fit for your needs and wants.

What to do if you think you need a hormonal test?

Likely, if something feels off, it is only a good thing that you are listening to what your body is telling you.

1. The first step is to seek out the help of your primary care physician, and if you feel you want extra support, a reproductive health specialist service like Allara. Allara is a telehealth service that matches you with an MD who specializes in either endocrine (hormonal) or reproductive health.
2. Speak with a doctor about your concerns, and ask what tests they recommend based on symptoms. If you have specific tests in mind (for instance, you have hair loss, and you are worried it could be PCOS, but you don’t know your vitamin D levels), consider advocating for a certain test and explain to your doctor why you feel that test may be insightful about what is going on in your body. You can start an insightful conversation about whether that test may or may not be a fit. On the off chance your physician is reluctant to even listen to your thoughts, it may be worth getting a second opinion – remember: you deserve to feel heard! This is your health.
3. Go to your test, or take an at home test that is approved by your doctor. Not all at-home tests are created equal, so it’s important that you have the peace of mind that the testing service you choose has the highest standards in place and is signed off by a trusted physician.
4. While you wait for your results, keep educating yourself. Reading this blog, and leveraging resources such as Healthline, the CDC, and MedlinePlus (run by the US government) are all useful in making sure that you are empowered to advocate for yourself. Your doctor should be a critical part of this – in other words, they should take the time to explain to you the concepts and medications they are talking about – but it is always helpful to be informed, and you can dive deeper into your conversation if you want with increased knowledge, too.
5. Stay calm, and know that whatever the result – you have a community who is on your side. Countless women encounter fertility issues, problems with their thyroid health, irregular periods, and much more: our bodies are incredibly complex, and sometimes the answers aren’t simple when things aren’t working as we expect. But remember that others have gone through it too, and they can help support you in this time of flux.

Allara Health provides personalized treatment that takes the guesswork out of managing PCOS, and offers a customized, holistic plan of attack that merges nutrition, medication. supplementation, and ongoing, expert support to begin healing your body.

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