Functional Tests for Hormones

Ashley's picture

Hormone imbalances are common. I see this frequently in patients. Many times adjusting diet, addressing nutritional deficiencies, or acupuncture can do wonders for rebalancing the system. However, sometimes, we need to test hormones to figure out the root cause of what is going on. 



Functional testing is a little different from standard blood work. Standard blood work and imaging is an important step in a hormone workup. It can rule out western pathologies such as PCOS, or endometriosis etc. However, for those who have had these work-ups and are still not feeling balanced, functional testing can be a nice option to explore a little deeper. Functional testing for hormones takes a comprehensive look at how your body is producing and metabolizing hormones. 


Hormones are produced through complex pathways and they are metabolized and excreted in multi-step processes. Each step is important. Determining the specific path YOUR body takes to excrete hormones may tell us if there are blocks or imbalances in these pathways, allowing us to better target treatment.


My two favorite functional tests for hormone balance are the DUTCH hormone panel and the Genetic Test.



This is a dried urine test, taken at several time points throughout the day. It gives you a measure of your stress hormone (cortisol), and your sex hormones (testosterone, estrogen, and progesterone); taking a comprehensive look at the efficiency of producing and breaking them down.


What I really love about this test is that it looks at how your body breaks down hormones into “metabolites”, and how efficiently these metabolites are cleared. This is important because these metabolites are active in the body and can be the root cause of clinical symptoms in some cases. So if these metabolites are imbalanced, or not properly broken down, this can be an area we focus on with treatment.


Whether you’re experiencing painful, crampy periods, or have a family history of breast cancer or are prone to facial hair growth and hair loss, these clinical differences may due to how you are breaking down your hormones, and which metabolites are present at higher levels. 


 The agouti mouse model demonstrated the dramatic influence our environment has on our gene expression. Genetic testing takes a functional look at your genes and your predispositions. We know that our genes are influenceable, based on the environment. By taking a look at your genes, and how your body is predisposed to producing and metabolizing hormones, we can be more specific and tailor treatments for directly.


Our genetic test also looks at factors that indirectly impact our hormones, such as the efficiency of our detox pathways, methylation pathways, and key nutritional predispositions.  



Bonus: a third functional test that can be included in when taking a look at hormones, is our Gut Microbiome Test. Our gut microbiome participates in the last step of excreting hormones (aka Phase 3 detox). If our microbiome is imbalanced, it can prevent us from efficiently getting rid of our estrogens. This is known as the estrobolome. I wrote all about this here

When taking a functional approach to hormones (i.e. your doctor has ruled out all the known conditions), you begin to work through a list of other possible causes that are contributing to the imbalance. This can include nutritional deficiencies, stress, genetic predispositions, poor clearance/detoxification, a microbiome imbalance and more. These functional tests give us a comprehensive look at a number of these areas, letting us take a thorough look at what might be going on.


If you’re interested in learning more, give us a call at 604-678-8600


Dr. Ashley, ND


Functional Tests for Hormones. Naturopath Vancouver women's health