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Health Protocols

Lab Testing

Women’s Health Concerns

Pregnenolone (serum or plasma, frozen)

Pregnenolone is sometimes called “the mother of all hormones.” All other steroids including testosterone and estrogens are derived from this important hormone (Velarde 2014).

  • Reference Range for Women: <151 ng/dL
  • LE’s Optimal Range for Women: 130-180 ng/dL

Estradiol (E2) (serum)

Estradiol (E2) is the predominant sex hormone present in women and is also found at lower levels in men (Wise 2009; Schulster 2016). It represents the most important estrogen, functionally, in humans (Chai 2014; Vermeulen 2002). E2 not only impacts reproductive and sexual functioning, but also affects other systems including bone health, heart health, the nervous system, and metabolism (Cui 2013; Bunt 1990).

E2 is the most active of all three estrogens commonly measured in a clinical setting (Wise 2009; Yang 2017). For women, it is important to compare the relationship between E2 and progesterone in evaluating menopausal symptoms such as hot flashes, mood disorders, and aging skin.

In both men and women, low levels of E2 are associated with osteoporosis (Vermeulen 2002; Shi 2017; Klaiber 1982; Carlsen 2000; Ettinger 1993; Quigley 1987).

  • Reference Range for Pre-Menopausal Women:
    • Follicular: 12.5-166.0 pg/mL
    • Ovulation: 85.8-498 pg/mL
    • Luteal: 43.8-211.0 pg/mL
  • LE’s Optimal Range: Varies with time in cycle, but maximum of 528 pg/mL
  • Reference Range for Postmenopausal Women: <6.0-54.7 pg/mL
  • LE’s Optimal Range for Menopausal Women:
    • Lowest levels shown to ameliorate symptoms: 30-50 pg/mL
    • With typical Bi-est: 80-100 pg/mL
    • Restoration of menstrual cycle (around day 21): 90-211 pg/mL

Total Estrogens (serum or plasma)

Total estrogen is a measure of overall estrogen status. In addition to their role in reproduction, estrogens affect several organs in the body. They are critical for the functioning of the nervous system, cardiovascular health (Navarro-Pardo 2017), and are involved in cognitive functioning (Sherwin 2003), metabolic pathways, muscle strength, the responses to injury and inflammation (Horstman 2012), and in maintaining the health of the urinary tract (Robinson 2003). Clinically estrogens are important in evaluating symptoms of menopause, cardiovascular risk, and bone health in aging women (Baker 2003; Wharton 2012; Riggs 2000). The total estrogen test does not break down the individual estrogens but looks at the total body burden of estrogens and can even include exogenous estrogens such as phytoestrogens and xenoestrogens from the environment.

  • Reference Range for Pre-Menopausal Women:
    • Day 1-10: 61-394 pg/mL
    • Day 11-20: 122-437 pg/mL
    • Day 21-30: 156-350 pg/mL
  • Optimal Ranges vary with time in cycle
  • Reference Range for Postmenopausal Women: <40 pg/mL
  • LE’s Optimal Range for Postmenopausal Women: 75-200 pg/mL (with hormone replacement therapy)

Progesterone (serum)

In both men and women, progesterone balances and offsets the powerful effects of estrogens. Some of the most common concerns of aging that women have include weight gain, insomnia, anxiety, depression, and migraines. For other women, even more debilitating conditions such as cancer, uterine fibroids, ovarian cysts, and osteoporosis may affect them at various stages of their lives.

As men age, complaints of weight gain, loss of libido, and prostate enlargement top their list of health concerns. Many physicians and scientists are becoming more aware of a common link between these conditions and an imbalance between two sex hormones: progesterone and estrogen.

  • Reference Ranges for Pre-Menopausal Women:
    • Follicular: 0.1-0.9 ng/mL
    • Luteal: 1.8-23.9 ng/mL
    • Ovulatory: 0.1-12.0 ng/mL
  • LE’s Optimal Range for Pre-Menopausal Women: 15-23 ng/mL at ~day 21
  • Reference Range for Postmenopausal Women: 0.0-0.1 ng/mL
  • LE’s Optimal Range for Postmenopausal Women: 2-6 ng/mL

Testosterone (Total) (serum)

Testosterone is a steroid hormone from the androgen group primarily secreted in the testes of males and the ovaries of females with small amounts also secreted by the adrenal glands (Burger 2002; Wood 2012). On average, an adult male has about 10 times more testosterone in the circulation than an adult female (Gentil 2016). However, women are far more sensitive to testosterone than men. Women with low testosterone may be more at risk for bone disease, dysfunction of the blood vessels, heart disease, muscle wasting, tiredness, and loss of libido (Lorenz 2017; Bolour 2005; Kaczmarek 2003; Rohr 2002; Rech 2016; Burger 2006; Bachmann 2006).

  • Reference Range for Women:
    • 8-48 ng/dL (20-49 years)
    • 3-41 ng/dL (over age 49)
  • LE’s Optimal Range for Women: 35-45 ng/dL

Free Testosterone (serum)

Free testosterone is the biologically active form of this hormone measured in the blood. 

  • Reference Range for Women: 0.0-4.2 pg/mL (over age 19)
  • LE’s Optimal Range for Women: 2.1-4.2 pg/mL

Sex Hormone-Binding Globulin (SHBG) (serum)

Testosterone and estradiol circulate in the bloodstream, bound mostly to sex hormone-binding globulin (SHBG) and to some degree other proteins. Only a small fraction of the sex hormones is unbound, or "free," and thus biologically active and able to activate their receptors (Holst 2004; Rosner 1991; Hammond 2016).

SHBG levels should not be too low or too high. SHBG helps protect androgens like testosterone from being metabolized rapidly by the liver or excreted in the urine by the kidneys. If SHBG levels are too low, then testosterone will be metabolized and/or excreted too quickly and essentially wasted. If SHBG is too high, it decreases the active form of the hormone available to the tissues by binding too much of it up. Thus, bioavailability of sex hormones is influenced by the level of SHBG (Laurent 2016). High levels of insulin decrease SHBG level (Strain 1994). On the other hand, thyroid hormone and estrogen increase it (Serin 2001; Kalme 1999; Selva 2009).

  • Reference Ranges for Women:
    • 24.6-122.0 nmol/L (20-49 years)
    • 17.3-125.0 nmol/L (over age 49)
  • LE’s Optimal Range for Women: ~60-80 nmol/L

Refer to Life Extension’s Female Hormone Restoration protocol for additional information about the benefits of these and other tests to overall health.

Disclaimer and Safety Information

This information (and any accompanying material) is not intended to replace the attention or advice of a physician or other qualified health care professional. Anyone who wishes to embark on any dietary, drug, exercise, or other lifestyle change intended to prevent or treat a specific disease or condition should first consult with and seek clearance from a physician or other qualified health care professional. Pregnant women in particular should seek the advice of a physician before using any protocol listed on this website. The protocols described on this website are for adults only, unless otherwise specified. Product labels may contain important safety information and the most recent product information provided by the product manufacturers should be carefully reviewed prior to use to verify the dose, administration, and contraindications. National, state, and local laws may vary regarding the use and application of many of the treatments discussed. The reader assumes the risk of any injuries. The authors and publishers, their affiliates and assigns are not liable for any injury and/or damage to persons arising from this protocol and expressly disclaim responsibility for any adverse effects resulting from the use of the information contained herein.

The protocols raise many issues that are subject to change as new data emerge. None of our suggested protocol regimens can guarantee health benefits. The publisher has not performed independent verification of the data contained herein, and expressly disclaim responsibility for any error in literature.