Different Types of Hormone Testing: Pros and Cons

Dr. Mike: Hey, Dr. Mike here. There are many ways to test your hormones, but which way is best for you? Stay tuned to find out.

Live Foreverish Introduction: You're listening to Live Foreverish, a show dedicated to helping you live just a little longer. Here are your hosts, Dr. Mike and Dr. Crystal Gossard.

Dr. Mike: All right. Welcome to Live Foreverish. So, Dr. Crystal, what is the best way to check your hormones? We're going to talk about that, right?

Dr. Crystal: Yes.

Growing Interest in Hormone Testing 00:00:24

Dr. Mike: Yeah. Hormone testing is becoming more and more popular, right? Even though more conventional doctors are ordering it for people and stuff like that, they usually don't; it’s usually not the complete package you need. That's one of the issues, right?

Dr. Crystal: Yes.

Dr. Mike: And most of them just do blood. So, there's urine, there's blood. There's like there's so many ways to do this! But I just think number one: it's good that more people are interested.

Why Do Hormone Levels Change Over Time? 00:00:47

Dr. Crystal: Absolutely. We know that hormone levels change over time and often the decline of hormones is just considered a “normal” part of aging.

Dr. Mike: Yeah. You lost testosterone.

Dr. Crystal: That's okay. You don't need that beneficial hormone!

Dr. Mike: You're losing muscle and getting fat. Oh, well!

Dr. Crystal: Right.

Impact of Hormonal Decline 00:01:07

Dr. Crystal: That's just normal. And so, it's nice that doctors are realizing that when these hormone levels decrease, it compromises blood glucose management and bone health. Well, we've always known at least estrogen in that connection with bone health.

Dr. Mike: Which is a good example.

Dr. Crystal: But also: mental health!

Dr. Mike: Yeah, for sure.

Dr. Crystal: And so many other aspects of health.

Dr. Mike: Cardiovascular health. Yeah, I mean, we've shown our sponsor of this, Life Extension. By the way, Life Extension offers this test we're going to talk about coming up. So, we'll get you that information coming up.

But, you know, when you think about just losing hormones in general, even just lower numbers, and losing a nice balance between them, it's not always necessarily meaning disease. Sometimes, it's just you want to age better. And if you have a better balance of hormones, optimal levels of hormones, I mean, that just sounds better. I mean, these are the messengers between your brain and your body.

Dr. Crystal: And they make you who you are. Sometimes when they decline, people just start questioning, who am I? They have to adjust, of course, to the new normal if they don't do anything about it, but many people just feel like they lose their identity.

When Should You Have Hormone Levels Checked? 00:02:28

Dr. Mike: Yeah. That's interesting that you kind of frame it that way because when men and women kind of go through the change in life, the midlife crisis: is that more related to hormonal imbalance?

Dr. Crystal: I think so.

Dr. Mike: And stuff like that, right? Because that's a time when people question a lot of things, right?

Dr. Crystal: Yes.

Dr. Mike: And maybe part of that is your body is adjusting to these different levels of hormones. Listen, I’ve got to tell you, I think for me, it's simple. It just is. I want to know my hormones. I want to know where I'm at because I want to do everything I can to preserve the levels I had when I was in my 20s.

How Do I Know If My Hormones Are Imbalanced? 00:03:04

Dr. Crystal: Very true. So routine testing is important for that.

Dr. Mike: Yeah. Get a baseline and then follow it, and when you start to see drops, maybe it's time to start. And there's different ways to boost them. This show is not about how to boost hormone levels, it's about following and testing hormones, and what are the best ways to do that? And again, as I said, our sponsor, Life Extension, has a really cool urine test for this now.

How Do I Know Which Hormone Test to Take? 00:03:28

Dr. Crystal: Yes, and there are many methods, as you mentioned. Most doctors will conduct blood testing.

Dr. Mike: That's the standard.

Dr. Crystal: It’s the standard. But there are advantages and disadvantages of the different types, and you know, I think we'll go over some of the pros and cons of each type of testing method to help you decide which one is for you. And I'll give you an example: a woman or a person that has gone through menopause, they've already gone through their menopausal transition. Their blood levels are kind of stable, right? But let's look at a perimenopausal person.

Dr. Mike: Different setup there.

Dr. Crystal: Their hormone levels are changing every day. So, you know, maybe a blood test may be a better analysis for a menopausal woman. And then maybe the urine test.

Dr. Mike: Better for perimenopause. Yeah.

Dr. Crystal: So, it all depends on the goals. What are you wanting to evaluate?

Dr. Mike: Absolutely. I think, you know, if you're doing this right and you're getting your baseline in your 30s, 40s, maybe blood testing is fine at that point or just a blood test baseline, whatever. But I know as a clinician, let's just get into this, like what's the cons of the blood test…the pros of blood testing are we know how to look at it, the results.

Blood Testing Pros and Cons 00:04:43

Dr. Crystal: And most doctors, you take it to any physician, they'll know how to look at a blood test.

Dr. Mike: Yeah: “I understand blood levels, right? I know the numbers.” So, that's one big thing, doctors know how to interpret that. Number two blood testing tends to give you a better picture just over a longer time, that's stable, like you said, in menopause. But a big pro for blood testing, a lot of these hormones, especially estrogen: they're heavily metabolized. And most of those metabolites, they get out of the blood quickly, and they get into the urine fast. So, you don't necessarily capture the true hormonal picture with blood testing.

Dr. Crystal: That's very true. And then sometimes the testing is just not available. When you look at estriol, for example, in women, the blood test that's available is designed to detect estriol in pregnant women!

Dr. Mike: Yeah, it does. It's not sensitive enough for a normal, non-pregnant woman. That doesn't mean pregnancy is “abnormal.” I don’t like the way I said that.

Dr. Crystal: And obviously, it's a snapshot. It's a moment in time.

Dr. Mike: Before we get into urine, because I think that's the way we want to spend most of this time, let's talk about saliva.

Saliva Testing Pros and Cons 00:06:04

Dr. Crystal: Yes.

Dr. Mike: I got to tell you; I have an issue with saliva.

Dr. Crystal: Okay. What's your issue, Dr. Mike?

Dr. Crystal: If you’re able to produce the…

Dr. Mike: The problem is that saliva levels have to be high enough to find those hormones, and depending on when you swab your mouth can make a big difference. How you swab your mouth can make a big difference. And less doctors really understand those numbers.

Dr. Crystal: That's true. But you can find doctors where they look at salivary hormones every day, and that's what they do.

Dr. Mike: Well, I don’t.

Dr. Crystal: And so, you know, if you're working with a doctor and that's their method or working with a doctor that's able to interpret them, you can still get some valid information specifically for DHEA, sulfate, melatonin and cortisol…through salivary testing.

Dr. Mike: And keep in mind, so those three, that's great. Keep in mind, it's not considered a gold standard by insurance companies, so, if you do saliva testing and let's say your testosterone looks low and your doctor wants to give you testosterone, the insurance company will often say, well, not until you get a blood test. So, often your saliva testing leads to blood testing anyway. And that's really the insurance part of it.

Dr. Crystal: But people like the fact that they can do it at home. Yeah, it's convenient.

Dr. Mike: Yeah, but that’s part of the problem. People aren’t doing it right.

Dr. Crystal: Well, that's true. I would say another con, and I go back and forth with this, but I have talked to so many people that they just cannot produce the amount of saliva that's needed. And so, we have to tell them, hey, you know, smell a lemon.

Dr. Mike: Then great, then the lemon juice gets into the sample and now it all looks weird, and we don't know! Yeah.

Dr. Crystal: So, you know, again some pros and cons with each.

Urine Testing Benefits 00:08:12

Dr. Mike: All right, so urine, though. You know, without a doubt, the biggest pro about urine is you're going to see a lot of the metabolites of hormones, right? That’s the key.

Dr. Crystal: Yes. And we do know some metabolites can have a positive impact on health and some of the metabolites, not so much. And looking at metabolites can tell you information about those, but it can also give you an idea of what's going on with your liver. Are these hormones being processed properly?

Dr. Mike: Yeah, the way they should be.

Another great thing with the urine, with estrogen at least, you know, estrogen, in both men and women, can be metabolized down good pathways or down not-so-good. What I mean by not-so-good is pathways that tend to be more proliferative: they produce these estrogen metabolites that can be linked to unhealthy cell growth and that kind of stuff, and urine can test those pathways.

Dr. Crystal: And I would just say another notch for urine testing is it's giving you the 24-hour picture of hormone levels versus the snapshot in time.

Dr. Mike: And so, Life Extension, again, is our sponsor. It's a great, scientific-based, research and supplement company. They offer labs, right? This one is called the Hormone and Urinary Metabolites Assessment Profile Map.

Dr. Crystal: HuMap.

Dr. Mike: And it's at home, obviously, you do this all at home. Just follow the instructions, you send it in, and you can get a wonderful profile. As a matter of fact, if you go to www.LifeExtension.com/HUMAP...

Dr. Crystal: HuMap. H…U…M…A…P.

Dr. Mike: …you can see all the different hormones that are tested in there.

Dr. Crystal: Yes. The testing hormones, the metabolites, the efficiency of the enzymes. It's a really complete analysis.

Dr. Mike: In summary, testing hormones and the fact that more people want to do it is great. Our podcast is called “Live Foreverish,” and we talk about being strong and vibrant, muscle mass, all that, and guess what helps with all that?

Dr. Crystal: Hormones.

Dr. Mike: Hormones, right? Hormones play a central role in the name of our podcast. We don't talk about them enough.

Dr. Crystal: I don't think so, Dr. Mike.

Dr. Mike: Now that I think about it, we don't.

Dr. Crystal: Well, you know, it's a topic that we used to talk about a few years back, and then I think we said that…

Dr. Mike: We had enough talking about it!

Dr. Crystal: But we're bringing it back!

Dr. Mike: We're bringing it back. Yeah. So, checking hormones is great. There's blood, there's saliva, there's urine. Speak with your own doctor, you know, first of all, what's best for you. You know, a lot of your integrative doctors, naturopathic doctors, they're into all this now.

Dr. Crystal: Now, can I note that Life Extension also has Wellness Specialists that can help you to identify which way may be best for you, the ideal way based on your needs?

Dr. Mike: Yeah. And when you do a test with Life Extension, whether it's blood, saliva or urine. In this case, we think the urine one's a great way to go, right?

Dr. Crystal: For hormones…

Dr. Mike: Yeah, for hormones. You can talk to those same Wellness Specialists, and they will help you understand your results for free.

Dr. Crystal: That's right.

Dr. Mike: Right. That's really cool. That's at www.LifeExtension.com/HUMAP. H…U…M…A…P, right?

Dr. Crystal: That's right.

Dr. Mike: Dr. Crystal, thanks for joining me today. Don't forget you're going to www.LiveForeverish.com where you can download a ton of episodes. Lots of things there, from hormones to acupuncture to neuro-hacking was a recent one we did.

Dr. Crystal: Yes, that was a good one.

Dr. Mike: And when you do that, go ahead and comment, like, share…we appreciate that and subscribe. We call it the one-two punch: boom boom. There you go. Just two punches. There you go. Punch one is your email; you join the family. As a matter of fact, our sponsor, Life Extension, will send you newsletters and stuff, and even some promotions here and there. And then, you subscribe to our show. The one-two punch at www.LiveForeverish.com. I'm Dr. Mike. Thanks for listening.