Because we believe in the merging of the best of conventional medicine and the best of functional medicine, we like to educate our ladies on their options for getting testing.
The testing you can get at your primary care doctor is fairly basic but most doctors are more than happy to get it done if you ask them for it.
Testing from Your PCP
Day 21 (of your cycle, where Day 1 is the first day of your full-blown period) progesterone and estrogen levels can be very helpful for establishing a baseline of hormonal levels. Some providers will also be comfortable getting LH and FSH levels at this time because these are the signaling compounds made in the pituitary that “tell” the ovaries how much hormones they need to create and when.
Fasting blood sugar levels and HgbA1C testing can be done through your primary care provider as well. While fasting blood sugar levels give you just a snapshot in time of what is going on with your blood sugar regulation, getting a HgbA1C tells you about your blood sugar regulation over the last 3 months.
A pelvic ultrasound done before ovulation and after can be another source of information that many doctors feel comfortable ordering. The pre-ovulation ultrasound can tell you about how many follicles are being stimulated in the ovaries and a post-ovulation ultrasound will tell you if the dominant follicle ruptured to (theoretically) release an egg. The post-ovulation ultrasound will also give information about the thickness and integrity of the lining of the uterus, which is important for baby implantation and healthy periods that aren’t too heavy or mistimed.
If you get all of this done through your primary care provider, you can get some pretty decent information! But unfortunately, sometimes all this comes back as “normal”, despite a whole host of symptoms.
Going to a reproductive endocrinologist is a way to take it up another level within the conventional medicine world.
Getting More Detailed
Reproductive endocrinologists are the best conventional MDs to diagnose and pinpoint problems within the feminine cycle. They’re one of the only branch of physicians who look at female health within the setting of the cycle.
The testing you will get through a reproductive endocrinologist is similar to the testing we already talked about but they do in a much more comprehensive way. They will have you track and map out an ENTIRE cycle via blood tests and pelvic ultrasounds. This means they get progesterone, estrogen, LH, and FSH levels on Day 3, 7, 11, 14, 18, 21, and 27. They will also get pelvic ultrasounds at each point of blood work to correlate what is happening with the signaling to the reproductive organs, as well as what is actually manifesting in the tissues.
What you get as a result is your own personal hormonal curve that can be compared to the “normal” feminine cycle curve of hormones. At this point, you can pinpoint where things are going wrong.
In addition to testing the signaling compounds mentioned previously, they’ll often get thyroid testing, blood glucose testing, inflammatory signal testing, other hormones made in the pituitary (like prolactin) and autoimmune markers. The depth of this testing is dependent on each physician but they tend to be quite thorough in their work ups!
Functional Lab Work
To get the most complete picture of your hormonal health possible, we like pairing any and all of this conventional testing with functional lab work.
This is for a couple reasons. For one, functional lab work gives you MUCH more information on hormone creationing, metabolism, and elimination. This means that we can get much more specific in a protocol for each individual female. (See the previous article for a full-blown explanation of why we use functional lab work.)
Secondly, this extra information opens the door to a whole world of specific supplements and lifestyle interventions that can help the body balance from the inside out. Instead of simply slapping birth control or supplemental hormones on the problems that are diagnosed, we like providing our ladies with the toolkits they need to achieve a healthy hormonal system and maintain it through the ups and downs of life as they go along.
Adding in Neurotransmitters
For a complete look at the hormonal system, we also add functional neurotransmitter testing to the mix. In order to balance the signals within the hormonal cascade, we need to know what messages this system is getting from the brain and spinal cord. By addressing any imbalances there, we pave the wave for long-term balance and good health (instead of a just a bandaid for a little while that covers up symptoms).
Up Next In the Series
Now that we’ve gotten some lab work questions out of the way, we’re going to be talking about progesterone deficiency in the next article. Next to estrogen dominance, it’s one of the most common hormonal imbalances we see in the ladies we work with.