Hormone Health, Women - Comprehensive

The following is a list of what is included in the item above. Click the test(s) below to view what biomarkers are measured along with an explanation of what the biomarker is measuring.

Also known as: 17Hydroxyprogesterone LCMSMS

17 Hydroxyprogesterone,

Also known as: Cortisol AM

Cortisol, A.M.

A cortisol level is a blood test that measures the amount of cortisol, a steroid hormone produced by the adrenal gland. The test is done to check for increased or decreased cortisol production. Cortisol is a steroid hormone released from the adrenal gland in response to ACTH, a hormone from the pituitary gland in the brain. Cortisol affects many different body systems. It plays a role in: bone, circulatory system, immune system. metabolism of fats, carbohydrates, and protein. ervous system and stress responses.

Also known as: Dehydroepiandrosterone Sulfate, DHEA SO4, DHEA Sulfate Immunoassay, DHEAS, Transdehydroandrosterone

DHEA SULFATE

DHEA-sulfate test measures the amount of DHEA-sulfate in the blood. DHEA-sulfate is a weak male hormone (androgen) produced by the adrenal gland in both men and women.

Estradiol

Estradiol (estradiol-17 beta, E2) is part of an estrogen that is a group of steroids that regulate the menstrual cycle and function as the main female sex hormones. Estrogens are responsible for the development of female sex organs and secondary sex characteristics and are tied to the menstrual cycle and pregnancy. They are considered the main sex hormones in women and are present in small quantities in men. Estradiol (E2) is the predominant form of estrogen and is produced primarily in the ovaries with additional amounts produced by the adrenal glands in women and in the testes and adrenal glands in men. Estradiol levels are used in evaluating ovarian function. Estradiol levels are increased in cases of early (precocious) puberty in girls and gynecomastia in men. Its main use has been in the differential diagnosis of amenorrhea – for example, to determine whether the cause is menopause, pregnancy, or a medical problem. In assisted reproductive technology (ART), serial measurements are used to monitor follicle development in the ovary in the days prior to in vitro fertilization. Estradiol is also sometimes used to monitor menopausal hormone replacement therapy.

Also known as: Estrogen Total Serum

Estrogen, Total, Serum

Estrogen is a group of steroids that regulate the menstrual cycle and function as the main female sex hormones. Estrogens are responsible for the development of female sex organs and secondary sex characteristics and are tied to the menstrual cycle and pregnancy. They are considered the main sex hormones in women and are present in small quantities in men.

Also known as: Follicle Stimulating Hormone (FSH) and Luteinizing Hormone (LH), Follicle Stimulating Hormone and Luteinizing Hormone

Fsh

Lh

Also known as: GH, Growth Hormone GH, HGH, Human Growth Hormone (hGH), Somatotropin

Growth Hormone (Gh)

This test measures the amount of growth hormone (GH) in the blood. GH is a hormone produced by the pituitary gland. Growth hormone is essential for a child's normal growth and development and promotes proper linear bone growth from birth through puberty. Children with insufficient GH production grow more slowly and are smaller in size for their age. Excess GH is most often due to a GH-secreting pituitary tumor (usually benign). Too much GH can cause children's long bones to continue to grow beyond puberty, resulting in gigantism with heights of 7 or more feet tall. Those with excess GH may also have thickening of facial features, general weakness, delayed puberty, and headaches. Gigantism is an extremely rare condition. Although GH is not as active in adults, it does play a role in regulating bone density, muscle mass, and lipid metabolism. Deficiencies can lead to decreased bone densities, less muscle mass, and altered lipid levels. Excess GH in adults can lead to acromegaly, marked not by bone lengthening but by bone thickening.

Also known as: A1c, Glycated Hemoglobin, Glycohemoglobin, Glycosylated Hemoglobin, HA1c, HbA1c, Hemoglobin A1c, Hemoglobin A1c HgbA1C, Hgb A1c

Hemoglobin A1c

The A1c test evaluates the average amount of glucose in the blood over the last 2 to 3 months. It does this by measuring the concentration of glycated (also often called glycosylated) hemoglobin A1c. Hemoglobin is an oxygen-transporting protein found inside red blood cells (RBCs). There are several types of normal hemoglobin, but the predominant form – about 95-98% – is hemoglobin A. As glucose circulates in the blood, some of it spontaneously binds to hemoglobin A. The hemoglobin molecules with attached glucose are called glycated hemoglobin. The higher the concentration of glucose in the blood, the more glycated hemoglobin is formed. Once the glucose binds to the hemoglobin, it remains there for the life of the red blood cell – normally about 120 days. The predominant form of glycated hemoglobin is referred to as HbA1c or A1c. A1c is produced on a daily basis and slowly cleared from the blood as older RBCs die and younger RBCs (with non-glycated hemoglobin) take their place. This test is used to monitor treatment in someone who has been diagnosed with diabetes. It helps to evaluate how well their glucose levels have been controlled by treatment over time. This test may be used to screen for and diagnose diabetes or risk of developing diabetes. In 2010, clinical practice guidelines from the American Diabetes Association (ADA) stated that A1c may be added to fasting plasma glucose (FPG) and oral glucose tolerance test (OGTT) as an option for diabetes screening and diagnosis. For monitoring purposes, an A1c of less than 7% indicates good glucose control and a lower risk of diabetic complications for the majority of diabetics. However, in 2012, the ADA and the European Association for the Study of Diabetes (EASD) issued a position statement recommending that the management of glucose control in type 2 diabetes be more "patient-centered." Data from recent studies have shown that low blood sugar (hypoglycemia) can cause complications and that people with risk of severe hypoglycemia, underlying health conditions, complications, and a limited life expectancy do not necessarily benefit from having a stringent goal of less than 7% for their A1c. The statement recommends that people work closely with their doctor to select a goal that reflects each person's individual health status and that balances risks and benefits.

Also known as: IGF-1, IGFI LCMS, Insulin-Like Growth Factor, Insulin-like Growth Factor - 1, Somatomedin C, Somatomedin-C

Igf I, LC/MS

The insulin-like growth factor-1 (IGF-1) test is an indirect measure of the average amount of growth hormone (GH) being produced by the body. IGF-1 and GH are polypeptide hormones, small proteins that are vital for normal bone and tissue growth and development. GH is produced by the pituitary gland, a grape-sized gland located at the base of the brain behind the bridge of your nose. GH is secreted into the bloodstream in pulses throughout the day and night with peaks that occur mostly during the night. IGF-1 is produced by the liver and skeletal muscle as well as many other tissues in response to GH stimulation. IGF-1 mediates many of the actions of GH, stimulating the growth of bones and other tissues and promoting the production of lean muscle mass. IGF-1 mirrors GH excesses and deficiencies, but its level is stable throughout the day, making it a useful indicator of average GH levels.

Z Score (Female)

z Score. A z-score (aka, a standard score) indicates how many standard deviations an element is from the mean. A z-score can be calculated from the following formula. z = (X - µ) / s where z is the z-score, X is the value of the element, µ is the population mean, and s is the standard deviation.

Also known as: Insulin (fasting)

Insulin

Insulin is a hormone that is produced and stored in the beta cells of the pancreas. It is vital for the transportation and storage of glucose at the cellular level, helps regulate blood glucose levels, and has a role in lipid metabolism. When blood glucose levels rise after a meal, insulin is released to allow glucose to move into tissue cells, especially muscle and adipose (fat) cells, where is it is used for energy production. Insulin then prompts the liver to either store the remaining excess blood glucose as glycogen for short-term energy storage and/or to use it to produce fatty acids. The fatty acids are eventually used by adipose tissue to synthesize triglycerides to form the basis of a longer term, more concentrated form of energy storage. Without insulin, glucose cannot reach most of the body's cells. Without glucose, the cells starve and blood glucose levels rise to unhealthy levels. This can cause disturbances in normal metabolic processes that result in various disorders, including kidney disease, cardiovascular disease, and vision and neurological problems. Thus, diabetes, a disorder associated with decreased insulin effects, is eventually a life-threatening condition.

Also known as: Progesterone Immunoassay

Progesterone

Serum progesterone is a test to measure the amount of progesterone in the blood. Progesterone is a hormone produced mainly in the ovaries. In women, progesterone plays a vital role in pregnancy. After an egg is released by the ovaries (ovulation), progesterone helps make the uterus ready for implantation of a fertilized egg. It prepares the womb (uterus) for pregnancy and the breasts for milk production. Men produce some amount of progesterone, but it probably has no normal function except to help produce other steroid hormones.

Also known as: PRL

Prolactin

Prolactin is a hormone produced by the anterior portion of the pituitary gland, a grape-sized organ found at the base of the brain. Prolactin secretion is regulated and inhibited by the brain chemical dopamine. Normally present in low amounts in men and non-pregnant women, prolactin's primary role is to promote lactation (breast milk production). Prolactin levels are usually high throughout pregnancy and just after childbirth. During pregnancy, the hormones prolactin, estrogen, and progesterone stimulate breast milk development. Following childbirth, prolactin helps initiate and maintain the breast milk supply. If a woman does not breastfeed, her prolactin level soon drops back to pre-pregnancy levels. If she does nurse, suckling by the infant plays an important role in the release of prolactin. There is a feedback mechanism between how often the baby nurses and the amount of prolactin secreted by the pituitary as well as the amount of milk produced. Another common cause of elevated prolactin levels is a prolactinoma, a prolactin-producing tumor of the pituitary gland. Prolactinomas are the most common type of pituitary tumor and are usually benign. They develop more frequently in women but are also found in men. Problems resulting from them can arise both from the unintended effects of excess prolactin, such as milk production in the non-pregnant woman (and rarely, man) and from the size and location of the tumor. If the anterior pituitary gland and/or the tumor enlarge significantly, it can put pressure on the optic nerve, causing headaches and visual disturbances, and it can interfere with the other hormones that the pituitary gland produces. In women, prolactinomas can cause infertility and irregularities in menstruation; in men, these tumors can cause a gradual loss in sexual function and libido. If left untreated, prolactinomas may eventually damage the tissues around them.

Vitamin D, 25-Oh, D2

Vitamin D2 ((ergocalciferol,) is found in fortified foods and in most vitamin preparations and supplements. Vitamin D comes from two sources: endogenous, which is produced in the skin on exposure to sunlight, and exogenous, which is ingested in foods and supplements. The D2 form is found in fortified foods and in most vitamin preparations and supplements. Vitamin D2 is effective when it is converted by the liver and the kidney into the active form, 1,25-dihydroxyvitamin D.

Vitamin D, 25-Oh, D3

Vitamin D3 (cholecalcifero) which comes from animals. Vitamin D comes from two sources: endogenous, which is produced in the skin on exposure to sunlight, and exogenous, which is ingested in foods and supplements. Vitamin D3 is the form produced in the body and is also used in some supplements. Vitamin D3 are is converted by the liver and the kidney into the active form, 1,25-dihydroxyvitamin D.

Vitamin D, 25-Oh, Total

Vitamin D comes from two sources: endogenous, which is produced in the skin on exposure to sunlight, and exogenous, which is ingested in foods and supplements. The chemical structures of the types of vitamin D are slightly different, and they are named vitamin D2 (ergocalciferol, which comes from plants) and vitamin D3 (cholecalciferol, which comes from animals). The D2 form is found in fortified foods and in most vitamin preparations and supplements. Vitamin D3 is the form produced in the body and is also used in some supplements. Vitamin D2 and D3 are equally effective when they are converted by the liver and the kidney into the active form, 1,25-dihydroxyvitamin D.

Vitamin D, 25-Oh, Total

Vitamin D comes from two sources: endogenous, which is produced in the skin on exposure to sunlight, and exogenous, which is ingested in foods and supplements. The chemical structures of the types of vitamin D are slightly different, and they are named vitamin D2 (ergocalciferol, which comes from plants) and vitamin D3 (cholecalciferol, which comes from animals). The D2 form is found in fortified foods and in most vitamin preparations and supplements. Vitamin D3 is the form produced in the body and is also used in some supplements. Vitamin D2 and D3 are equally effective when they are converted by the liver and the kidney into the active form, 1,25-dihydroxyvitamin D.

Also known as: Free T3, FT3, T3 Free

T3, Free

This test measures the amount of triiodothyronine, or T3, in the blood.

Also known as: Free T4, FT4, T4 Free

T4, Free

The free T4 test is not affected by protein levels. Since free T4 is the active form of thyroxine, the free T4 test is may be a more accurate reflection of thyroid hormone function.

Also known as: Testosterone Total And Free And Sex Hormone Binding Globulin

Free Testosterone

In many cases, measurement of total testosterone provides the doctor with adequate information. However, in certain cases, for example when the level of SHBG is abnormal, a test for free or bioavailable testosterone may be performed as it may more accurately reflect the presence of a medical condition.

Sex Hormone Binding

The sex hormone binding globulin (SHBG) test measures the concentration of SHBG in the blood. SHBG is a protein that is produced by the liver and binds tightly to testosterone, dihydrotestosterone (DHT), and estradiol (an estrogen). In this bound state, it transports them in the blood as an inactive form. The amount of SHBG in circulation is affected by age and sex, by decreased or increased testosterone or estrogen production and can be affected by certain diseases and conditions such as liver disease, hyperthyroidism or hypothyroidism, and obesity. Changes in SHBG levels can affect the amount of testosterone that is available to be used by the body's tissues. A total testosterone test does not distinguish between bound and unbound testosterone but determines the overall quantity of testosterone. If a person's SHBG level is not normal, then the total testosterone may not be an accurate representation of the amount of testosterone that is available to the person's tissues.

TESTOSTERONE, TOTAL,

A testosterone test measures the amount of the male hormone, testosterone, in the blood. Both men and women produce this hormone. In males, the testicles produce most of the testosterone in the body. Levels are most often checked to evaluate signs of low testosterone: In boys -- early or late puberty and in men -- impotence, low level of sexual interest, infertility, thinning of the bones In females, the ovaries produce most of the testosterone and levels are most often checked to evaluate signs of higher testosterone levels, such as: decreased breast size, excess hair growth, increased size of the clitoris. irregular or absent menstrual periods and male-pattern baldness or hair thinning.

Free T4 Index (T7)

FTI stands for the Free Thyroxine Index and is also sometimes referred to as T7. It is a calculated value determined from the T3 uptake test and total T4 test and provides an estimate of the level of free T4 in the blood.

T3 Uptake

T3 uptake is also known as T3 Resin Uptake (T3RU) or Thyroid Uptake. It estimates how much thyroid hormone-binding proteins are available in the blood through a calculation based on levels of T3 or T4 added to a person's blood specimen.

T4 (Thyroxine), Total

This test measures the amount of thyroxine, or T4, in the blood. T4 is one of two major hormones produced by the thyroid gland. The total T4 test is used to help diagnose hyperthyroidism and hypothyroidism. It is a useful test but can be affected by the amount of protein available in the blood to bind to the hormone.

Also known as: Thyroid Stimulating Hormone, Thyroid Stimulating Hormone (TSH), Thyrotropin

TSH

A TSH test is a lab test that measures the amount of thyroid stimulating hormone (TSH) in your blood. TSH is produced by the pituitary gland. It tells the thyroid gland to make and release thyroid hormones into the blood.

TSH

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The Hormone Health, Women - Comprehensive panel contains 18 tests with 28 biomarkers.

Brief Description: The Hormone Health, Women - Comprehensive panel is the pinnacle of hormonal evaluation, offering an all-encompassing view of a woman's hormonal landscape. This extensive panel is designed to assess a wide spectrum of hormonal functions, from reproductive health and metabolic processes to stress response and bone health. By integrating a broad array of hormonal tests, this panel provides a deep dive into the intricate hormonal interplay that governs various physiological systems, making it an invaluable tool for diagnosing complex hormonal imbalances and guiding personalized treatment strategies.

This panel contains Estradiol #4021 which is not intended for patients under the age of 18 years old. For patients under 18 years old, order Estradiol, Ultrasensitive LC/MS/MS #30289. If Estradiol #4021 is ordered for a patient under 18, the lab will automatically change the code to and charge for Estradiol, Ultrasensitive LC/MS/MS #30289.

Collection Method: Blood Draw

Specimen Type: Whole Blood Serum

Test Preparation: Fasting is required. Collection must be performed before 9 a.m.

Specific to Cortisol AM: Test is not recommended when patient is receiving prednisone/prednisolone therapy due to cross reactivity with the antibody used in this assay.

Specific to Growth Hormone: Random growth hormone collection should be performed on fasting patients who have rested for at least 30 minutes prior to collection

Specifc to TSH: Specimen collection after fluorescein dye angiography should be delayed for at least 3 days. For patients on hemodialysis, specimen collection should be delayed for 2 weeks.

According to the assay manufacturer Siemens: "Samples containing fluorescein can produce falsely depressed values when tested with the Advia Centaur TSH3 Ultra assay."

When and Why the Panel May Be Ordered

The Hormone Health, Women - Comprehensive panel is typically ordered for women experiencing symptoms that suggest multifaceted hormonal imbalances or endocrine disorders. These can include persistent menstrual irregularities, unexplained infertility, signs of menopause, symptoms indicative of thyroid dysfunction, metabolic syndrome, and conditions such as polycystic ovary syndrome (PCOS). It is also instrumental for women undergoing hormonal therapies to monitor the effectiveness of treatments and make necessary adjustments.

What the Panel Checks For

This comprehensive panel delves into the assessment of various hormonal systems:

  • 17-Hydroxyprogesterone: This test measures the level of 17-hydroxyprogesterone, a hormone produced by the adrenal glands and ovaries. It's crucial for diagnosing congenital adrenal hyperplasia (CAH) and monitoring women with PCOS or those at risk for adrenal dysfunction.

  • Cortisol AM: Cortisol levels are tested to assess the adrenal gland's response to stress. Morning (AM) levels provide a baseline cortisol status, essential for evaluating adrenal health and conditions like Cushing's syndrome or adrenal insufficiency.

  • DHEA Sulfate: DHEA sulfate is an androgen produced by the adrenal glands. This test is used to evaluate adrenal function, detect adrenal tumors or hyperplasia, and assess overall androgen levels.

  • Estradiol: Estradiol is the primary estrogen hormone in women, playing key roles in reproductive health, bone density, and cardiovascular function. This test is crucial for evaluating menstrual cycle issues, fertility, and menopausal symptoms.

  • Estrogen Total: This test measures all forms of circulating estrogen, providing a comprehensive view of estrogen activity, which is vital for assessing hormonal balance, especially in conditions like estrogen dominance or deficiency.

  • FSH: Follicle-stimulating hormone is integral to reproductive health, influencing menstrual cycle regulation and ovarian function. It's often measured to assess fertility, ovarian reserve, and menopausal status.

  • Growth Hormone: Growth hormone plays a pivotal role in growth, metabolism, and muscle mass. This test helps in diagnosing pituitary disorders and growth hormone deficiencies or excesses.

  • Hemoglobin A1c: Hemoglobin A1c provides a three-month average of blood sugar levels, making it essential for diagnosing and monitoring diabetes and pre-diabetes.

  • Insulin Like Growth Factor-1: IGF-1 is a marker of growth hormone activity in the body, reflecting overall growth hormone levels. It's used to assess growth disorders and evaluate pituitary function.

  • Insulin: Insulin levels are measured to evaluate insulin production and assess insulin resistance, which is crucial for diagnosing metabolic syndrome and type 2 diabetes.

  • Luteinizing Hormone: LH is key for regulating the menstrual cycle and ovulation. LH testing is vital for investigating infertility, menstrual irregularities, and pituitary disorders.

  • Progesterone: Progesterone is a hormone produced after ovulation, essential for regulating the menstrual cycle and supporting early pregnancy. This test is often used to assess ovulation and reproductive health.

  • Prolactin: Prolactin levels are tested to evaluate pituitary gland function and investigate menstrual irregularities, infertility, and galactorrhea (unexplained milk production).

  • QuestAssureD 25-Hydroxyvitamin D Total with D2 and D3: This test measures levels of vitamin D, essential for bone health, immune function, and overall well-being. It differentiates between D2 (ergocalciferol) and D3 (cholecalciferol) forms.

  • Sex Hormone Binding Globulin: SHBG levels affect the availability of sex hormones in the body. This test is crucial for understanding conditions related to excess or deficiency in sex hormones.

  • Thyroid Function Tests: Including T3 Free, T3 Uptake, T4 Total, T4 Free, and Thyroid Stimulating Hormone (TSH), these tests provide a comprehensive evaluation of thyroid health, assessing hormone production, metabolic impact, and potential thyroid disorders.

  • Testosterone Free and Total: This test measures both the free and total levels of testosterone in the body, important for diagnosing conditions related to androgen excess or deficiency.

Each test within the Hormone Health, Women - Comprehensive panel contributes to a detailed hormonal profile, aiding in the diagnosis and management of a wide range of health conditions, from endocrine disorders to metabolic syndromes and beyond.

Conditions and Diseases Detected

This comprehensive panel can aid in diagnosing and managing a wide range of conditions, including but not limited to:

  • Thyroid disorders such as hypothyroidism and hyperthyroidism, which affect metabolism, energy, and overall health.
  • Reproductive issues like PCOS, infertility, and menopause, which are influenced by imbalances in reproductive hormones.
  • Adrenal disorders, including adrenal fatigue or hyperplasia, revealed by cortisol and DHEA sulfate levels.
  • Metabolic syndrome and insulin resistance, indicated by insulin, IGF-1, and hemoglobin A1c levels.
  • Bone health concerns, such as osteoporosis, which can be linked to vitamin D deficiency.

Clinical Applications

Healthcare professionals use the results from the Hormone Health, Women - Comprehensive panel to develop targeted treatment plans, which may include hormone replacement therapy, dietary and lifestyle interventions, or medication to address specific hormonal imbalances. Regular monitoring with this panel allows for the fine-tuning of treatments and the proactive management of hormonal health.

The Hormone Health, Women - Comprehensive panel stands as a cornerstone in the assessment of women's hormonal health, offering an unparalleled depth of insight into hormonal function and its impact on various physiological systems. Through this panel, healthcare providers can achieve a holistic understanding of hormonal health, enabling them to deliver personalized and effective care that addresses the unique hormonal challenges women face.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.

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