Week 8
Welcome to the Module 2 Week 8 of the Fertile Ground Holistic Fertility Program!
Module 2
Week 8
Module 2 - Week 8 will be focusing on lab tests and optimal ranges as well as handouts for Increasing Progesterone Naturally and a Low Estrogen Protocol
Lab Testing
Objectives for This Unit
My goal is for you to have a clear understanding of what’s going on with your health, your best treatment options, which is why it is helpful to understand the tests that are most commonly ordered and what these tests are used for.
Normal test ranges vs optimal test ranges?
Countless clients have come to me in desperation after being told their test results were “normal” and that they were fine, and then they were sent on their way.
Sound familiar?
Test results are typically assigned a range of normal values in western medicine. This is done using standardized statistical methods that only look at the average. Most of the people who have these tests done are sick, because as you know, healthy people generally aren’t getting tested. As such, these tests are skewed towards illness, and are simply meant to identify and diagnose disease states.
I want to empower you to achieve optimal health. And as you know, optimal health isn’t about a number on a graph. It’s about a picture of a person’s overall health and wellness. So, while normal may please the scientists, it most often does not translate into great health for you.
Over the years the usefulness of these very wide ranges has been called into question, and as a result, we now have what’s known as “optimal” or “functional” lab ranges that are narrower and much more accurately reflect a person’s state of health.
One thing to remember about testing is that it isn’t a final answer; rather, it’s the beginning of helping you understand the whole picture of your health.
Which tests can you get to see if you have any imbalances? This is a great question. These tests help identify hormonal imbalances, thyroid issues, gut related problems, mineral imbalances, and toxic burdens like heavy metals and mold. There are a few different ways that these tests can be performed, so I’ll also be talking about the different methods of testing.
Four main methods to test hormone levels -
There are pros and cons to each of these tests. And each type of test has its own set of optimal levels. I’ve included a handout in this module, called Optimal Levels for Laboratory Values that can be used for reference if needed, so don’t worry about memorizing any of this information.
Blood testing
Blood tests, also known as serum tests, are the tests most commonly performed by Western medical doctors and practitioners. These require little effort on the part of the patient and are generally accurate, but they provide limited data. This is because serum testing is like a single snapshot of a person’s hormones, taken once, because it’s not really feasible to do multiple blood collections, like you would if you were collecting saliva and urine (however, those have their own limitations too).
Additionally, some hormones are bound to carrier proteins in the blood, which makes a significant portion of them unavailable to use by the tissues. With serum testing, you won’t see what is bound versus what is available, whereas with saliva and dried urine it is possible to see the levels of bioavailable hormones. A classic example of this is the protein Sex Hormone Binding Globulin, or SHBG which predominantly binds to estrogen and testosterone, making only a small portion of these hormones available for use in the body.
Serum hormone tests are best for testing thyroid, LH, FSH, prolactin, DHEA-S, fasting insulin, and sex hormone binding globulin. They work fine for testing sex hormones too, and can certainly give a good baseline as long as the above caveats are taken into consideration.
Saliva testing Saliva tests are somewhat more comprehensive, and they’re available without a doctor’s prescription. Clients can purchase these online, through companies like ZRT Laboratory, as well as a few others in the US and in other countries. I’ve seen quite a few spring up over the last couple of years.
For many years, saliva has been a preferred method by functional medicine practitioners for testing reproductive and adrenal hormones. Saliva tests are non-invasive, and don’t require the client to go to a laboratory to run the test, because it can be done from home, and mailed in. These also allow for multiple collections, which, as I mentioned, provides a more accurate big picture especially when it comes to cortisol.
However, there are limitations of saliva testing. First, it can only be done for the steroid hormones, such as cortisol and the sex hormones. It does not work for testing the thyroid, for example. It also appears that it isn’t as accurate for estradiol and the other estrogens. When compared to serum and urine tests, saliva estradiol tests show levels much lower than the other two testing options. This doesn’t appear to be the case for progesterone, as it matches the progesterone numbers on comparable serum and urine tests. In addition to that, these tests are highly affected by topical and oral hormone replacement therapy, which appears to disproportionately raise saliva levels of these hormones. Those who are on prescribed hormone supplements, particularly topical hormones, should definitely take this into consideration if they’re considering taking one of these tests.
Lastly, strict instructions must be followed in order to collect an accurate and adequate sample. There are restrictions around eating, drinking, chewing gum, lipstick use, and tooth brushing that must be observed to get a usable specimen.
24-Hour Urine Testing
Now let’s move on to urine testing. This is an established method of testing steroid hormones and their metabolites. From my understanding, it hasn’t been used extensively by practitioners in the past because it requires a 24 hour collection of urine to complete the test. This can be pretty inconvenient as you can imagine.
While it may be a little challenging, this test is considered the most comprehensive and accurate way of testing steroid hormones and their metabolites on the market.
Essentially, the patient has to collect a sample in a small collection cup every time they urinate over the course of 24 hours. They then have to add each collected sample to a large jug and refrigerate it until testing is complete. Then a sample from the large jug is sent off to the lab for analysis. It’s also possible to collect individual urine samples throughout a day in order to identify the diurnal pattern of cortisol in the patient.
The downside of urine tests is that results can be skewed by hydration level, particularly dehydration, use of diuretics, as well as abnormal kidney function or kidney disease.
Dried Urine Testing
There are a few companies doing dried urine testing, including ZRT Labs and Precision Analytical, which offers the Dried Urine Test for Comprehensive Hormones or DUTCH. This test allows for individual collection of urine samples throughout the day without the use of multiple jars. To take a dried urine test, multiple pads that are provided in the test kit are soaked in the person’s urine, and then allowed to dry.
There are a number of test options offered by both ZRT Labs and DUTCH. The most popular ones are the DUTCH Complete and the ZRT Urine Metabolites, which collect a very large amount of data, including sex and adrenal hormones, as well as additional tests for all of the sex hormone metabolites and melatonin. Because the samples are collected multiple times throughout the day, the test will reveal an individual’s diurnal cortisol pattern as well.
In addition, the DUTCH Complete also includes neurotransmitters through a mini organic acids test. ZRT offers a separate test kit for neurotransmitters. Both companies offer a Cycle Mapping option, which lets a person test their hormones throughout the month to get a snapshot of how their hormones are fluctuating during their cycle.
Advanced Lab Tests
If you want to have a sense of their hormone levels you need to establish a baseline, a basic hormone panel, which tests for the levels of the following hormones can help determine that.
Thyroid Testing
Other testing options are available for
Refer to the handout Lab Testing Checklist for a complete guide to important testing.
We can talk about these tests and if we need to test we can get them ordered.
Testing options:
Dried Urine testing - can be ordered at https://lcartier1.krtra.com/t/4iocLS0vjlCp
Let's Get Checked: https://trylgc.com/DoulaforYou - use promo code Doula at checkout.
ZRT Laboratory - ZRTlab.com
If you would like to order lab testing, get in touch and we can review the different options.
- Understand normal ranges of lab results vs optimal ranges of lab results.
- The most common types of lab tests and what they are recommended for
- Basic labs clients should get so they can see what’s happening with their cycle
- Four different formats of lab tests and the benefits and limitations of each kind
- Learn the different types of testing options available online
My goal is for you to have a clear understanding of what’s going on with your health, your best treatment options, which is why it is helpful to understand the tests that are most commonly ordered and what these tests are used for.
Normal test ranges vs optimal test ranges?
Countless clients have come to me in desperation after being told their test results were “normal” and that they were fine, and then they were sent on their way.
Sound familiar?
Test results are typically assigned a range of normal values in western medicine. This is done using standardized statistical methods that only look at the average. Most of the people who have these tests done are sick, because as you know, healthy people generally aren’t getting tested. As such, these tests are skewed towards illness, and are simply meant to identify and diagnose disease states.
I want to empower you to achieve optimal health. And as you know, optimal health isn’t about a number on a graph. It’s about a picture of a person’s overall health and wellness. So, while normal may please the scientists, it most often does not translate into great health for you.
Over the years the usefulness of these very wide ranges has been called into question, and as a result, we now have what’s known as “optimal” or “functional” lab ranges that are narrower and much more accurately reflect a person’s state of health.
One thing to remember about testing is that it isn’t a final answer; rather, it’s the beginning of helping you understand the whole picture of your health.
Which tests can you get to see if you have any imbalances? This is a great question. These tests help identify hormonal imbalances, thyroid issues, gut related problems, mineral imbalances, and toxic burdens like heavy metals and mold. There are a few different ways that these tests can be performed, so I’ll also be talking about the different methods of testing.
Four main methods to test hormone levels -
- blood testing (serum)
- saliva testing
- urine testing, and
- dried urine testing
There are pros and cons to each of these tests. And each type of test has its own set of optimal levels. I’ve included a handout in this module, called Optimal Levels for Laboratory Values that can be used for reference if needed, so don’t worry about memorizing any of this information.
Blood testing
Blood tests, also known as serum tests, are the tests most commonly performed by Western medical doctors and practitioners. These require little effort on the part of the patient and are generally accurate, but they provide limited data. This is because serum testing is like a single snapshot of a person’s hormones, taken once, because it’s not really feasible to do multiple blood collections, like you would if you were collecting saliva and urine (however, those have their own limitations too).
Additionally, some hormones are bound to carrier proteins in the blood, which makes a significant portion of them unavailable to use by the tissues. With serum testing, you won’t see what is bound versus what is available, whereas with saliva and dried urine it is possible to see the levels of bioavailable hormones. A classic example of this is the protein Sex Hormone Binding Globulin, or SHBG which predominantly binds to estrogen and testosterone, making only a small portion of these hormones available for use in the body.
Serum hormone tests are best for testing thyroid, LH, FSH, prolactin, DHEA-S, fasting insulin, and sex hormone binding globulin. They work fine for testing sex hormones too, and can certainly give a good baseline as long as the above caveats are taken into consideration.
Saliva testing Saliva tests are somewhat more comprehensive, and they’re available without a doctor’s prescription. Clients can purchase these online, through companies like ZRT Laboratory, as well as a few others in the US and in other countries. I’ve seen quite a few spring up over the last couple of years.
For many years, saliva has been a preferred method by functional medicine practitioners for testing reproductive and adrenal hormones. Saliva tests are non-invasive, and don’t require the client to go to a laboratory to run the test, because it can be done from home, and mailed in. These also allow for multiple collections, which, as I mentioned, provides a more accurate big picture especially when it comes to cortisol.
However, there are limitations of saliva testing. First, it can only be done for the steroid hormones, such as cortisol and the sex hormones. It does not work for testing the thyroid, for example. It also appears that it isn’t as accurate for estradiol and the other estrogens. When compared to serum and urine tests, saliva estradiol tests show levels much lower than the other two testing options. This doesn’t appear to be the case for progesterone, as it matches the progesterone numbers on comparable serum and urine tests. In addition to that, these tests are highly affected by topical and oral hormone replacement therapy, which appears to disproportionately raise saliva levels of these hormones. Those who are on prescribed hormone supplements, particularly topical hormones, should definitely take this into consideration if they’re considering taking one of these tests.
Lastly, strict instructions must be followed in order to collect an accurate and adequate sample. There are restrictions around eating, drinking, chewing gum, lipstick use, and tooth brushing that must be observed to get a usable specimen.
24-Hour Urine Testing
Now let’s move on to urine testing. This is an established method of testing steroid hormones and their metabolites. From my understanding, it hasn’t been used extensively by practitioners in the past because it requires a 24 hour collection of urine to complete the test. This can be pretty inconvenient as you can imagine.
While it may be a little challenging, this test is considered the most comprehensive and accurate way of testing steroid hormones and their metabolites on the market.
Essentially, the patient has to collect a sample in a small collection cup every time they urinate over the course of 24 hours. They then have to add each collected sample to a large jug and refrigerate it until testing is complete. Then a sample from the large jug is sent off to the lab for analysis. It’s also possible to collect individual urine samples throughout a day in order to identify the diurnal pattern of cortisol in the patient.
The downside of urine tests is that results can be skewed by hydration level, particularly dehydration, use of diuretics, as well as abnormal kidney function or kidney disease.
Dried Urine Testing
There are a few companies doing dried urine testing, including ZRT Labs and Precision Analytical, which offers the Dried Urine Test for Comprehensive Hormones or DUTCH. This test allows for individual collection of urine samples throughout the day without the use of multiple jars. To take a dried urine test, multiple pads that are provided in the test kit are soaked in the person’s urine, and then allowed to dry.
There are a number of test options offered by both ZRT Labs and DUTCH. The most popular ones are the DUTCH Complete and the ZRT Urine Metabolites, which collect a very large amount of data, including sex and adrenal hormones, as well as additional tests for all of the sex hormone metabolites and melatonin. Because the samples are collected multiple times throughout the day, the test will reveal an individual’s diurnal cortisol pattern as well.
In addition, the DUTCH Complete also includes neurotransmitters through a mini organic acids test. ZRT offers a separate test kit for neurotransmitters. Both companies offer a Cycle Mapping option, which lets a person test their hormones throughout the month to get a snapshot of how their hormones are fluctuating during their cycle.
Advanced Lab Tests
If you want to have a sense of their hormone levels you need to establish a baseline, a basic hormone panel, which tests for the levels of the following hormones can help determine that.
- Pituitary hormones - FSH, LH, and prolactin
- Estrogens - including estradiol (the most potent estrogen in the body), but can also include estriol and estrone
- Progesterone
- Sex hormone binding globulin (SHBG)
- Androgens - including free & total testosterone, which are the available testosterone and the total testosterone in the body, and DHEA-S
- Vitamin D
Thyroid Testing
- Thyroid Stimulating Hormone or TSH
- Free T3 and Free T4
- Thyroid peroxidase antibodies, or TPO
- Thyroglobulin antibodies, or TGAB
Other testing options are available for
- H. Pylori and Small Intestine Bacterial Overgrowth tests
- Comprehensive stool testing
- Organic Acids Testing
- Minerals and Heavy Metals Testing
- Mold Toxicity Testing
Refer to the handout Lab Testing Checklist for a complete guide to important testing.
We can talk about these tests and if we need to test we can get them ordered.
Testing options:
Dried Urine testing - can be ordered at https://lcartier1.krtra.com/t/4iocLS0vjlCp
Let's Get Checked: https://trylgc.com/DoulaforYou - use promo code Doula at checkout.
ZRT Laboratory - ZRTlab.com
If you would like to order lab testing, get in touch and we can review the different options.
Handouts and Resources
Action Items:
- Download and review each of the handouts and resources above
- Continue to fill out the information in the 4 Phase Symptom Tracker - we will look at the info at the end of a month
- Start to implement the information in the downloads - we will review at next appointment
- Continue to do cycle tracking
- Continue to do affirmations, gratitudes, journal entries and food diary
- Continue doing the Yoga Nidra meditation
- Do the Uterine Energy exercise - you can use the MP3 or print the handout to use
- Do the Name Your Fear exercise - you can use the MP3 or print the handout to use
Please complete this form so we can talk about info at next appointment
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