With numerous peer-reviewed studies validating that hormone test results support symptomatology, science now recognizes that hormones are a fundamental part of treating the whole body. Evidence shows that hormonal imbalances are the root cause of many chronic health issues.
Andropause Testing
Men at mid-life are just as susceptible to an age-related drop in hormone production as their female counterparts. Andropause, the so-called male menopause, signifies the retreat of the key male hormone testosterone.
As a man ages, his body naturally makes less testosterone. In fact, by the time a man is in his mid-forties, testosterone levels can be down by 40%. Lifestyle factors such as excessive stress, weight gain, and lack of exercise can lower levels even further – impacting stamina, drive, and virility.
Men tend to notice a subtle downward shift in strength and energy first, followed by a lack of enthusiasm for life’s challenges like work and competition. A man may also lose interest in sex. The hidden imbalances contributing to these factors generally include:
- Low Testosterone : Leads to decreased stamina and libido, fatigue & erectile dysfunction
- High Estrogen : Results in weight gain, increased chest and belly fat, hot flashes, night sweats & excessive need to urinate (BPH)
- High Cortisol : Results in insomnia, anxiety, sugar cravings, feeling tired but wired & increased belly fat
- Low Cortisol : Causes chronic fatigue, low energy, food and sugar cravings, poor exercise tolerance or recovery & low immune reserves
- Thyroid Imbalance : This condition is commonly missed in men and may often mimic symptoms of low testosterone.
- CardioMetabolic Issues : This includes high blood pressure and diabetes, and may mimic some symptoms of low testosterone – like fatigue or erectile dysfunction.
- High DHT : Results in excessive need to urinate (BPH), hair loss, acne
Stress Testing & Adrenal Fatigue:
The adrenal glands, otherwise known as the “stress glands,” enable our bodies to cope with stress and survive. Shaped like two tiny pyramids, they sit atop the kidneys and from this central location mobilize the response to changes in our environment.
Whether stress comes from outside in the form of a natural disaster, or from within like the anxiety we experience before public speaking, it’s the adrenals’ job to help us adapt to the situation.
They accomplish this by secreting key hormones:
Cortisol
The primary stress hormone that fine-tunes our response to the stress of everyday living
DHEA
One of the most abundant hormones in the body, and a precursor to estrogens and testosterone; also balances some of the negative effects of high cortisol
Epinephrine / Norepinephrine
Neurotransmitters that mobilize the body’s natural “fight or flight” response in an emergency
Patients can conduct a saliva cortisol test or a urine cortisol test to assess adrenal hormones. This involves collecting four non-invasive samples over the course of one day, from which ZRT is able to generate results with a diurnal cortisol curve. This four-point graph reveals cortisol levels throughout the day and allows health care providers to pinpoint issues with adrenal gland function.
Diurnal cortisol curves – understanding HPA axis dysfunction
Diurnal curves for chronic stress – understanding epinephrine and norepinephrine patterns
Adrenal glands that are in balance produce adequate amounts of hormones to power us through the day. These hormones impact just about every process in the body, from energy production and immune activity to cellular maintenance and repair. They are key regulators of glucose, insulin and inflammation, and play a major role in bone and muscle building, mood and mental focus, stamina, sex drive and sleep cycles.
Adrenal glands that are out of balance can lead to:
- High Cortisol : Results in insomnia, anxiety, sugar cravings, feeling tired but wired, increased belly fat & bone loss
- Low Cortisol : Causes chronic fatigue, low energy, food and sugar cravings, poor exercise tolerance or recovery & low immune reserves
- DHEA : Out of balance adrenals can lead to high or low DHEA.
Ideal Ways to Assess Adrenal Hormones
Saliva testing has long been used as an accurate and reliable method for measuring cortisol because it’s simple and non-invasive, and patients can collect these samples multiple times per day. It’s easy to assess DHEA in these samples too.
A newer method that’s just as reliable as saliva testing has also been gaining ground – dried urine testing. Studies show that urine is just as effective for measuring cortisol and DHEA levels, and it’s also simple enough for patients to collect multiple times per day.
Due to the nature of the sample collection, there are some difference between saliva and urine testing for diurnal cortisol.
The added benefit to dried urine testing is that epinephrine and norepinephrine can be measured at the same time, so patients who want a complete adrenal assessment can now get all four key markers together.
Cortisol Awakening Response
The Cortisol Awakening Response – also called CAR – reveals more detailed clues that help in assessing adrenal hormone/HPA Axis dysfunction. This testing is often useful for cases of PTSD, major depression, chronic fatigue syndrome and other severe stress conditions.
During a normal cortisol awakening response, adrenal hormone levels should increase 50% in the first 30 minutes after waking for the day and then begin to progressively drop through the afternoon and evening. To capture this response, three – rather than one – morning saliva collections are needed to properly chart the diurnal cortisol curve.
Cortisol Awakening Response Sample Collection
6-Tube Collection: Six cortisol collections in 24 hours is the most common method for assessing CAR. Start saliva collection within five minutes of waking for the day, followed by a second sample at 30 minutes, and a third sample at 60 minutes. The rest of the diurnal rhythm can be assessed at the normal time intervals – noon, evening and night (shown below).
4-Tube Collection: Alternately, CAR can be assessed with four cortisol collections in 24 hours. When using this method, collect a sample immediately upon waking, 30 minutes after waking, then at noon or evening, and night.
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Menopause Testing:
Menopause is not a single point in time when hormone production is switched off, but a gradual decline that brings an end to female fertility. During menopause, a woman’s levels of estrogen and progesterone diminish – leading to a lack of menstrual periods.
A woman is considered to be in menopause when she’s had no menstrual cycles for 12 months.
The right balance of hormones is vital to a woman’s health. But in menopause, when levels are dropping, a deficiency of one hormone can trigger a relative excess of another and result in common imbalances such as:
- Estrogen Dominance or Low Progesterone : Results in mood swings, migraines, fat gain in hips and thighs
- Low Estrogen or Fluctuations of Estrogen : Triggers hot flashes, night sweats, palpitations, foggy thinking, memory lapse & vaginal dryness
- Low Testosterone or DHEA : Leads to decreases in bone or muscle mass, metabolism, energy, strength, stamina, exercise tolerance & libido
- High Cortisol : Results in insomnia, anxiety, sugar cravings, feeling tired but wired & increased belly fat
- Low Cortisol : Causes chronic fatigue, low energy, food and sugar cravings, poor exercise tolerance or recovery & low immune reserves
- Neurotransmitter Imbalance : Changes in estrogen and progesterone levels can impact neurotransmitter levels. For instance, a drop in estrogen can result in a drop in serotonin.
- Thyroid Imbalance : Changes in estrogen levels can lead to thyroid symptoms like slowed metabolism and always feeling cold. In fact, many women experiencing menopause will be diagnosed with hypothyroidism.
- Low Vitamin D : Sufficient levels of Vitamin D, estrogen and testosterone are important for maintaining bone health in the menopause years.