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Naturopathic Doctor's use innovative and thorough hormone assessment to collect all the important information related to your case. Any current blood work and ultrasound reports will be reviewed prior to further testing.
Hormones are a dynamic system, which means they are constantly being produced, utilized, and metabolized at a steady rate. Therefore, assessment tools must also be dynamic to allow for an accurate representation of this system, or imbalances can easily be missed. Excesses in one hormone may present the same way as deficiencies in another. Depending on your concerns, Dr. Holmberg, ND may use serum, saliva, or urinary collection methods to assess both primary sex hormones, as well as their metabolites, to help sort out the specifics of potential hormone imbalances. Hormonal imbalances may present in a variety of concerns, and with a variety of symptoms.
There are pros and cons to all collection methods of hormonal testing, making each scenario unique. Dr. Holmberg, ND will assess your symptoms on a case-by-case basis, and will determine the best form of hormone testing to assist in the diagnosis and management of your hormonal health concerns. Serum (blood) hormone testing is the most commonly used form of assessment across professionals. It provides the most diversity in terms of orderable markers. PROS - Many hormones can be assessed in the blood, making it the best method for broad spectrum testing. - Blood work can is the only accurate way to assess for pituitary hormones (LH, FSH, prolactin, etc) and metabolic hormones (thyroid, leptin, insulin, ghrelin, etc). - Helpful for accurate diagnosis of many disorders, including but not limited to PCOS, hirsutism, infertility, peri/menopause, premature ovarian failure, hypothalamic pituitary amenorrhea, etc - Results are quickly reported and can easily be interpreted by all of your primary health care providers (Family Doctor, Gynaecologist, Endocrinologist, Fertility Specialist, etc). CONS - Bloodwork underestimates hormone levels, making it more difficulty to diagnose subclinical disorders - Cannot assess for multiple/average hormone output - only provides you a snapshot in time. - Limited ability to view metabolites. Five primary hormones are typically assessed in the saliva: cortisol (single or multiple point), DHEAs, estradiol, progesterone and testosterone.
PROS - You can collect multiple data points in one test, making saliva a great for assessing trends over 24 hours, or throughout a full menstrual cycle. As mentioned, since hormones are constantly fluctuating, a single snapshot fails to catch the underlying cause of the concerns. This is where a month long assessment can often provide more insight. In these cases, Dr. Holmberg may suggest a month long salivary hormone assessment. - Samples can be collected at home - Some hormones are highly concentrated in saliva (like cortisol) CONS - No ability to view metabolites - Cannot be used to assess efficacy of oral hormone replacement dosing 
Urine hormone testing is the newest and most innovative form of hormone testing available. You can test both sex steroid and adrenal hormones in the urine.
PROS - Ordering wet/dry urine steroids provides an added layer of information: we can collect both primarily hormones AND their metabolites. Some metabolites can be 2.5x more active that their primary hormones, making them a valuable piece of information in hair loss, acne, PMS, polycystic ovarian syndrome, cancer prevention, etc. This additional layer of information provides insight not only on excesses or deficiencies in your hormones, but also how the body is utilizing them. - Multiple samples collected over 24 hrs account for temporary pulsations in hormones throughout the day. - Helpful in diagnosing subclinical disorders due to increased sensitivity. CONS - Most costly form of testing - Cannot be used to assess pituitary or metabolic hormones - Less helpful in pathologic diagnosis 
Why get hormone testing? While clinical symptoms provide some insight, hormone testing gives you and your Naturopath a detailed snapshot into every step of the process in your endocrine system. Getting a full insight to both preliminary hormones and their metabolites can change the course of treatment in case management.
For example, a patient may present with a phenotype of elevated androgens, but when tested, testosterone may appear within a normal range on blood-work. However, if blood-work fails to assess its metabolite, dihydrotestosterone (which is 2.5x more potent), the metabolite of testosterone may in fact be creating the symptoms. When indicated, benefits to hormone assessments include the ability to assess both primary hormone levels, their pathway of breakdown, and the efficacy of the enzymes that are doing so. The results allow for a tailored treatment plan that are specific to you and your hormonal needs, and treatments often work faster and more effectively. PLEASE NOTE: testing cannot be ordered without a medical assessment. If you wish to conduct any form of naturopathic testing, an initial consultation with Dr. Holmberg is required. Information and pamphlets collected and adapted from Rocky Mountain Analytical and DUTCH complete. Courtney Holmberg, ND does not endorse or have professional affiliation with this lab company. The information provided is for general education, and is not intended to assist in diagnosing or treating a medical condition. |
