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HORMONE BALANCE - Four Steps to Optimize Hormone Testing

Hormone Balance is one of the most common reasons patients seek my care, and for good reason! Hormones have profound effects on your mental, physical, and emotional health and well-being.

Hormones are chemical messengers made in cells throughout the body. These messengers are carried in your blood to the organs and tissues they affect. There are many types of hormones which influence nearly every bodily function.


  • Energy
  • Mood
  • Brain Function
  • Weight
  • Metabolism
  • Muscle Mass and Bone Health
  • Breast and Vaginal health
  • Menstrual cycles
  • Sleep cycles
  • Body Temperature
  • Skin Health

There are many symptoms and conditions associated with hormone imbalance, including:

  • Polycystic Ovarian Syndrome
  • Infertility
  • Mood Swings or Mood Disorders (depression, anxiety)
  • Poor Memory
  • Brain “Fog”
  • Poor Libido or Sexual Dysfunction
  • Poor Sleep
  • Acne and/or Aging Skin
  • Increased Appetite
  • Weight gain
  • Bone and/or Muscle Loss
  • PMS
  • Painful and/or Heavy Menstrual Periods

Hormone testing is an essential part of your journey toward hormone balance. Testing hormones can provide a more clear picture of your current hormone patterns and testing is invaluable to monitor hormone therapy and treatment protocols.

Testing hormones can be complicated, confusing, and at times expensive. Taking the right steps when testing hormones can ensure that you get the most useful and accurate information.



Conventional practitioners often fall short when it comes to
hormone testing because they are not trained in how to appropriately order and interpret hormone tests (I certainly did not get this training in medical school). There are many types of hormones, and many types of tests. Working with a practitioner who is knowledgeable in how to order and interpret hormone testing is the first step in your journey toward hormone balance.

Hormones can be tested in blood, urine and saliva. When choosing the appropriate test many factors should be taken into consideration, including gender, age, and current symptoms. Many hormones are easy to test in blood, including estrogen, progesterone, testosterone, thyroid, insulin, cortisol, leptin and more. Urine testing can be used to measure hormone levels over a 24 hour period, and can also provide valuable information about hormone metabolism and bone loss. Saliva can be used to easily collect multiple samples over a day, week, or month, and is most often used to measure adrenal hormones and sex-steroid hormones such as estrogen, progesterone, and testosterone.


For accurate and meaningful test results, the timing of hormone testing must be considered. Hormones can be tested on a specific day or time for a “snapshot” of that moment, or measured over the course of 24 hours or an entire menstrual cycle.

The time of day a hormone test is collected will impact results. For example, thyroid hormones measured first thing in the morning will look different than those measured in the late afternoon. Certain hormones, such as insulin and cortisol, are best measured in a fasting state first thing in the morning.

Finally, timing of testing in patients taking hormone therapy should be precise, and you should have clear instructions on if and when to take your medication in relationship to your hormone test. For example, thyroid medication is often held the morning of testing.

There is no “one size fits all“ to interpreting hormone test results.
While “normal ranges” are provided for each test, these ranges can vary widely. To feel and look your best, the goal should be optimal hormone levels! One of the best examples of this is thyroid hormone. I can’t tell you how many patients I have met with who had been told their thyroid levels were “normal“ despite ongoing symptoms. After shifting the focus to optimal levels, these patients are able to experience improved energy, vitality, and well-being.

Optimal levels may vary from person to person. Each test result should be interpreted in light of the individual patient, their age and their symptoms or concerns. For example, the optimal estrogen level for a post menopausal woman on hormone therapy is often a lower level designed to provide enough hormone for bone health, not to restore the levels of a 20 year old.

Carin Nielsen, MD Integrative Medicine I use an Integrative/Functional Medicine approach with my patients to treat a variety of chronic medical conditions, including many that are linked to unhealthy hormone balance. Treating symptoms simply by prescribing medication as a “band-aid” does not address the underlying factors that contributed to your problems in the first place, and is not likely to provide lasting results. During the COVID-19 pandemic I continue to see both new and returning clients using our secure, easy video-visit format. If you are interested in learning more or if you would like to schedule a consultation, please contact our office This email address is being protected from spambots. You need JavaScript enabled to view it. or 231-638-5585.

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