Hompes Method Prac00oner Training Level II

Transcription

1 Hompes Method Prac00oner Training Level II 2015 Class Lesson Fifty-One Blood and Saliva Hormone Tests Health for the People Ltd not for reuse without expressed permission Hompes Method is a trading name of Health For The People L< Registered in England & Wales Company # VAT #

2 Hormone Tes0ng - Introduc0on Symptoms and health history are helpful Hormone quizzes are helpful In many cases they will suffice Some clients want hard lab data In some cases these data are helpful

3 Hormone Tes0ng - Introduc0on Three main ways to test hormones: Serum standard method (requires blood draw) Saliva well document as being helpful Dried urine the relacvely new kid on the block There are pros and cons to each tescng method none of them are perfect.

4 Hormone Tes0ng - CBC CBC and SMAC: Blood sugar, HbA1c & insulin Massively important for HPG axis Sodium, potassium & calcium Lipids (cholesterol, triglycerides) Tend to increase as sex hormones decline Liver and kidney Red blood cell indices Anemia, B vitamins White blood cell indices Thyroid (including TSH, T4, T3, ancbodies) Closely related to sex hormone balance & functon

5 Hormone Tes0ng - CBC CBC and SMAC (customized): Serum copper/zinc Vitamin D C-reacCve protein Homocysteine Magnesium Selenium ReproducTve hormones

6 Hormone Tes0ng - CBC If a client/pacent has been diagnosed with PCOS, or displays the symptoms, the CBC/SMAC is essencal Insulin is the key hormone and must be monitored Can be helpful to monitor sex hormones, of course Perform a functonal blood chemistry analysis

7 Hormone Tests reproduc0ve hormones Most medical experts agree that following hormone levels is not useful in the treatment of symptoms of hormone deficiency. Performing blood hormone level testng is a ma<er of comfort for both doctors and patents. Erika Schwartz MD The Hormone SoluTon. Page 122

8 Hormone Tests reproduc0ve hormones FSH: High levels indicate not producing enough E and P LH: Only really used in fertlity studies, or a[er menopause Estrogen (E1, E2, E3) must consider SHBG: Only learn how much of the hormone is available for measurement; no bearing on how much estrogen is available for body to use Progesterone must consider carrier proteins Useful for infertlity; differs widely during the month Testosterone: Li<le correlaton with symptoms; useful to measure in women

9 Hormone Tests Erika Schwartz MD If the level is normal and the patent is feeling good, everything s fine. The picture grows complicated when, for example, the level is high and the patent is feeling good. If the level is high, I repeat the test in a couple of months. If it s low, I leave it alone. So much for scientfic informaton! Erika Schwartz MD The Hormone SoluTon. Page 124

10 Hormone Tests Erika Schwartz MD Each one of the above tests reflects the level of a given hormone at a stagnant point in Tme. It s important to remember, however, that the human body is a beautful dynamic system. By taking a blood test here or there, we are doing a disservice and simplifying an intricate system. Taking a snapshot will never reflect the whole picture. Unless we start measuring hormones multple Tmes a day and week and month, accurate interpretaton of the results is impossible. Erika Schwartz MD The Hormone SoluTon. Page 125

11 Hormone Tests Lee / Hopkins The most common way to test hormone levels has been with a blood test that measures the hormone levels in the watery blood serum or blood plasma. In our opinion these tests are not very useful because they don t measure your bioavailable, free hormones accurately. John Lee, MD Natural Hormone Balance Made Simple, p.54

12 Hormone Tests Lee / Hopkins At any given moment, most of the hormones in your body are unusable Tghtly bound to proteins in the bloodstream. Only 1-2% escape the binding proteins and are free, or bioavailable, to enter Tssues throughout the body. ConvenTonal blood tests measure only the total level of hormones in the blood stream. John Lee, MD Natural Hormone Balance Made Simple, p.26

13 Hormone Tests Summary so far Blood hormone tescng may not be that useful Lible agreement on normal levels Blood test needed hassle and inconvenience Single Cme points / snapshots Time of month is important Testosterone may be a useful test May need to measure SHBG Standard blood test markers from CBC and SMAC may be very helpful.

14 Hormone Tests at home Is there any way we can overcome some of the challenges with blood tests? Can pacents/clients gain any real benefit from hormone tescng? Let s see

15 Home tests Erika Schwartz [Saliva testng] is a new and easy method of determining free hormone levels available for use in the saliva. It s performed by a few mail-order labs; data on the usefulness of this test are largely anecdotal. STll, it s cheap, it isn t invasive, and it can be made available to practcally anyone. Erika Schwartz MD The Hormone SoluTon. Page 125

16 Home tests John Lee MD One of the Tssues that the bioavailable hormones enter is the saliva gland, and they then freely pass through into the saliva. By collectng saliva and measuring its level of hormones, it is possible to determine the amount of hormones available to other Tssues. John Lee, MD Natural Hormone Balance Made Simple, p.56

17 Home tests John Lee MD Saliva testng is quicker, less expensive and less painful than blood tests, and is a reliable way for your doctor to measure hormone levels and test for hormone deficiencies It doesn t involve a trip to a lab or drawing blood; and it s inexpensive enough that you can do a number of tests for instance, several over the course of a day or a month. John Lee, MD Natural Hormone Balance Made Simple, p.56

18 Home tests John Lee MD Saliva testng is an inexpensive, uninvasive and easy way to get an accurate reading of your hormone levels in order to determine whether your E2, or P, or T level is in a healthy range. John Lee, MD Natural Hormone Balance Made Simple, p.56

19 Home tests Joseph Collins ND Through new technology, we are now able to assess hormonal levels by measuring the hormones that are detectable in your saliva. Saliva collecton is simple. You can collect the saliva yourself in the privacy of your home, and it s not as invasive as blood testng. I have found saliva testng to be an extremely important useful tool in helping women identfy their menopause types. Joseph Collins, ND Discover Your Menopause Type, p. 45.

20 Home tests Joseph Collins ND Measuring serum/blood hormone levels is stll considered by many physicians to be the gold standard of hormone testng. However measuring only estrogen for menopause assessment disregards the vital roles that progesterone and testosterone play in women s health. Joseph Collins, ND Discover Your Menopause Type, p. 54.

21 Home tests Joseph Collins ND Serum tests must include all three hormones estradiol, progesterone and testosterone - as well as sex hormone binding globulin (SHBG)... SHBG is a carrier protein that carries estradiol and testosterone throughout the blood and maintains the body s equilibrium by sustaining a steady state between bound and unbound levels of hormones. Joseph Collins, ND Discover Your Menopause Type, p. 54.

22 Home tests Joseph Collins ND SHBG levels may be affected by natural estrogens, synthetc estrogens, soy isoflavones, and tamoxifen, as well as conditons such as thyroid disease. Joseph Collins, ND Discover Your Menopause Type, p. 54.

23 Home tests Joseph Collins ND The amount of hormones detectable in saliva have a consistent relatonship to the levels in the blood and the rest of the body. As research has found that salivary progesterone levels are an accurate and reliable measure of body levels, they are shown to be useful to evaluate and monitor women who have fertlity problems. Joseph Collins, ND Discover Your Menopause Type, p. 47.

24 Home tests Joseph Collins ND Salivary estradiol levels are similarly accurate and reliable, so have been useful to determine when ovulaton has occurred, as a means of evaluatng fertlity. Saliva testng is also promising as a method of identfying both normal and abnormal levels of testosterone in women. Joseph Collins, ND Discover Your Menopause Type, p. 47.

25 Types of Saliva Test 1. Single sample: Typically done on days of menstrual cycle (as long as cycle is regular) Measures progesterone and estradiol 2. Month long: Sample taken every 2-3 days throughout cycle Progesterone and estradiol mapped Delays gehng women started on a program Soak co<on wool in saliva, or spit into tubes

26 Single sample salivary hormone test Take sample on day to check progesterone and estrogen balance when P should be peaking Common to see women with low P (and possibly even low estrogens) at this Cme of the month

27 Single sample salivary hormone test Simple to do for post-menopausal women Women do actually concnue cycling aier menopause, but the hormone levels are not high enough to trigger an overt cycle Good test for men, too (though I tend to prefer serum tescng for testosterone) How do you standardise the test when re-testng? that s the queston!

28 Single sample salivary hormone test You can check corcsol and DHEA (and some labs check melatonin) The single day hormone test typically measures: CorCsol x4 DHEA-S Oestradiol Oestriol Progesterone Testosterone Melatonin

29 Single sample salivary hormone test I ve mostly used the Biohealth DiagnosTcs test #205 Learned of this test from Dan Kalish Ran a lot of tests and got used to interpretacon Results translated into good clinical outcomes InternaTonal shipping is a pain in the bu< Can also consider: Genova DiagnosCcs Diagnostechs (no longer in the UK) Labrix

30 Single sample salivary hormone test Every woman s cycle is unique. DuraCon, ovulatory Cming, luteal phase length, estradiol & progesterone paberns vary significantly Thus, a single-day sample can be tough to reproduce. in terms of both her monthly fluctuacons AND preparacon for the test

31 Month long female hormone test One of the single most powerful tests in the armoury is the month long female hormone test, which is available through several labs (Genova DiagnosCcs, Biohealth DiagnosCcs and Diagnostechs, to name but three).

32 Month long female hormone test Map out hormone produccon over the course of an encre cycle Provides insight into the balance of eestrogen, progesterone and testosterone Some labs also test for LH and FSH (Diagnostechs) Let s look at some advantages

33 Month long female hormone test hbp://

34 Month long female hormone test 35-yr woman with acne and premenstrual problems Day 21 analysis (green) would seem ok because P is > E But it misses the high late-luteal phase estradiol levels producing estrogen dominance Also misses the big drop in progesterone aier day 21 In view of the low follicular phase progesterone level, biphasic progesterone supplementaton (fixed low-dosage in the follicular phase, plus Tmed graduated dosing in the luteal phase) seems indicated.

35 Month long female hormone test hbp://

36 Month long female hormone test 37-year-old woman complained of premenstrual problems and inferclity: Day 21 test (green) would miss both estrogen dominance in the last part of the luteal phase and very low progesterone. There is evident need for supplementary progesterone to build up a uterine mucosa sufficient to support a fertlized ovum.

37 Month long female hormone test Disadvantages of the month-long test: Takes longer for women to get their results and get onto a therapeucc program. If a woman were to contact you on day 3 of her cycle, for example, she d have to wait the course of that cycle, then take her saliva samples the following month She d then need to wait for the results The waitng Tme would be well in excess of two months.

38 Month long female hormone test Disadvantages of the month-long test: It s not appropriate to use the month-long test with women whose cycles are irregular one month to the next (e.g. in perimenopausal women). Such irregular cycles are oien due to anovulacon, which can be idencfied using temperature tescng.

39 Month long female hormone test Genova, Biohealth DiagnosCcs and Diagnostechs both run month-long panels. The laber has an opcon to add LH and FSH, which can be helpful in idencfying pituitary dysfunccon: Biohealth DiagnosCcs #208 Diagnostechs Expanded Female Hormone Panel (Genova Rhythm Plus )

40 Other lab op0ons As a single day test, ZRT has these tests: Saliva: oestrogen (E1, E2 and E3), progesterone, free testosterone, free corcsol, DHEA-S Bloodspot: LH, FSH, E2, Pg, total testosterone, DHEA-S, total corcsol, SHBG, thyroid panel

41 Other lab op0ons Genova DiagnosCcs carries a range of panels that assess hormone levels in urine, blood and saliva. The blood tests require a full blood draw. I ve never used Genova for these tests, so I can t comment on their efficacy.

42 Consider hormone interac0ons Adrenals Thyroid Sex

43 Hormone Interac0ons Estrogen suppresses thyroid and energy produccon Progesterone is pro-metabolic & supports thyroid Low thyroid increases SHBG (less free sex hormones) Excess corcsol can suppress everything Low T3 can impair the encre steroid hormone pathway (T3 needed for steroidogenesis)

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45 Thyroid & sex hormones Progesterone appears to both improve the signaling mechanisms of thyroid receptors as well as scmulacng thyroid peroxidase produccon. Too lible progesterone depresses TPO accvity, thus reducing T4 produccon.

46 Thyroid & sex hormones Thyroid hormones sensicze cells to progesterone, so that they are able to readily take it up when needed. When progesterone receptor sites are not exposed to enough thyroid, they lose the ability to allow progesterone into the cells. Thus, even if a woman has plenty of progesterone in her blood, she can stll have symptoms of progesterone deficiency

47 Always consider the basics! Many Cmes, improving adrenal and thyroid funccon will restore opcmal sex and reproduccve health. How do you do this? Diet, lifestyle, gut, liver, stress reduccon, etc.

48 Hormone lab tes0ng - summary A single sample saliva test can assess P, E and T, between days Markers can be added to the adrenal stress index test - very convenient Difficult to use this test when women are experiencing irregular cycles Snapshot in Cme may not reflect what s going on Quite a large error risk compared with a month-long profile Results can be obtained quickly

49 Hormone lab tes0ng - summary Month-long hormone tests can be used to assess women who have regular cycles Map E and P through the cycle OpCon of evaluacng testosterone, LH and FSH with some labs Disadvantages are number of samples required and waicng Cme for results

50 Thank You! As always, thanks a million for tuning in and consuming this info. It s been my pleasure sharing this wisdom with you. In the next lesson we ll look at some simple quesconnaires and home based methods to help assess hormone balance!

51 Sample Report 1 - MB IniCal Retest

52 Sample Report 2 - MO IniCal Retest

53 Sample Report 2 - JP IniCal Retest