Which sex hormones should I be tested for on Monday? (Relating to possible cancer/future DHEA suppl)

[Bluebell]

I am having blood drawn on Monday for a repeat CA-125 test, and I think I should probably also order a blood test on my sex hormones:
a. Because my DHEA-S is very low and I am going to consider supplementing with low-dose DHEA (5 mg capsules from Enzymatic Therapy), and they recommend getting a baseline test done of one's sex hormones before doing that. (And they recommend further testing 6 weeks out and 3 months after beginning to supplement, to make sure the DHEA isn't making the sex hormones go haywire, which I would do.)
b. And because I'm guessing it might be a wise thing to do to test my sex hormone levels, which I've never had tested before, in case I do have some kind of cancer (which my previous CA-125 test apparently should predict with 98% :thumbdown: certainty, given the high score I had on it).

As usual, the private lab test companies offer several permutations of female hormone tests -- some with one subset of hormones, others with different subsets of hormones, all at different price points.

I don't have the funds to do much testing, so I only want to do tests that are sure to provide useful, relevant information.

I also don't want to falsely economize by choosing a test panel that might miss out one or two of the really important hormones, and then in the future regret that I had not tested them.

I have tried to research this online, but I must not have the right search terms because I can't find any guidelines for exactly what sex hormones a woman should test before starting DHEA supplementation and/or if she is concerned that she might have a hormone-linked cancer.

Can anyone tell me, of the following female hormones, which should I definitely get tested, which would be nice to get tested, and which would be irrelevant?

(And have I left any important female hormones off this list??)

dihydrotestosterone DHT
estradiol
estrogens total
estriol
estrone
follicle-stimulating hormone FSH
luteinizing hormone LH
pregnenolone
progesterone
prolactin
sex hormone binding globulin SHBG
testosterone, free
testosterone, serum
testosterone, total LC/MS-MS

 

[Plum]

Sex hormones are cyclical so they are best tested over your entire cycle or 1 month. Salivary testing for that is best. I did it a while ago and it cost around £200.

I think blood testing for fsh and lh is fine. But I think this is only helpful if you're concerned about PCOS. Some people have prolactin issues so it's a good one to rule out.

If there's concerns about cancer I would be looking at all oestrogens and progesterone. Oestrogen dominance drives a lot of female related cancers.

DHEA issues means you need your cortisol checked - again this is best done with saliva samples. If you have a cortisol issue you will most likely have a porgesterone issue as your body takes what makes progesterone and uses it to make cortisol.

IR imaging for things like breast cancer are meant to help detect in much earlier so I'm sure it would show up cancer issues in other regions of the body or areas of concer.

Just my 2 cents worth from my own experiences. I would research as much as possible. Look into companies that offer testing where you are and see what the tests show etc. I know Genova has sample reports online which help you understand a bit more about what the tests show. Even if they're not available to you they'd at least shed some light on what you're after a bit more.

 

[sianrecovery]

Bluebell, I dont have an answer for you on your list, others know more, but I think you are right to be cautious. I was on DHEA for three years from my ME doc, and at that point both my oestrogens and progesterone and cortisol tested low; DHEA was low normal (via urine and salivary tests from Genova). Then my brother was diagnosed with a bilateral breast cancer and I went back to have NHS blood testing, and found my oestrogens were many times higher than they should have been. I stopped the DHEA and it returned to within the normal range. Someone on PR, think it was Ema, posted that for some of us DHEA converts to oestrogens not testosterone. I did another urine test and found my levels of unhelpful oestrogens to ok ones was poor; I started DIM and Rich's methylation protocol, and I certainly feel better, but havent retested. I will try and find a couple of my tests to post so you can see what they tested for.

 

[Bluebell]

By the way, I forgot to mention that Monday is my "day 21" of my cycle, and that's the day PhoenixRising member Ema advised me is best for this kind of female hormone testing. That's why I feel the urgency to get the blood drawn on Monday.

---
Also, I've had saliva cortisol testing, and blood and saliva DHEA-S testing:

Both DHEA-S tests came back very low (less than the acceptable level for an 85-year old woman, and I am in my mid-40s).

The cortisol test came back in the middle of the normal ranges for morning, noon, and evening, but at the highest score within the normal range for the bedtime sample. The testing company cautioned, in their commentary on my results, that I should be concerned about the bedtime level, and take steps to lower it.

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For more information on my health/genetic situation and why I do not at present have a doctor or health insurance, this thread explains: http://forums.phoenixrising.me/inde...-i-would-be-grateful-for-some-guidance.23975/

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Thank you Plum for your response!

I think blood testing for fsh and lh is fine. But I think this is only helpful if you're concerned about PCOS..

I am not concerned about PCOS, as far as I know.

Some people have prolactin issues so it's a good one to rule out...

Issues related to cancer?

If there's concerns about cancer I would be looking at all oestrogens and progesterone. Oestrogen dominance drives a lot of female related cancers.

Are these ALL the 4 hormones that start with "e" on my list, or which ones are the estrogens? (I really am ignorant about this stuff! Feel free to speak to me like I'm a toddler. )

DHEA issues means you need your cortisol checked - again this is best done with saliva samples. If you have a cortisol issue you will most likely have a porgesterone issue as your body takes what makes progesterone and uses it to make cortisol...

With the cortisol results I described at the start of this post, do you think I could have a progesterone issue?

IR imaging for things like breast cancer are meant to help detect in much earlier so I'm sure it would show up cancer issues in other regions of the body or areas of concer....

I have learned that ovarian/endometrial cancer is hard to detect through imaging studies or manual exams, and very hard to diagnose without a surgical biopsy, and I couldn't afford that (plus, just having a surgery, even if there is no cancer found, has a risk of complications and stress on the body) so I'm trying to do what I can on my own to see what I might be dealing with here.

I know Genova has sample reports online which help you understand a bit more about what the tests show. Even if they're not available to you they'd at least shed some light on what you're after a bit more.

Thank you for mentioning that - those sample reports do give a lot of information oftentimes.

 

[Bluebell]

Sian,

Thank you for your story! It's good to learn what other people have experienced when supplementing with DHEA.

I am sorry to hear about your brother's cancer.

I will try and find a couple of my tests to post so you can see what they tested for.

That would be great!

 

[Plum]

By the way, I forgot to mention that Monday is my "day 21" of my cycle, and that's the day PhoenixRising member Ema advised me is best for this kind of female hormone testing. That's why I feel the urgency to get the blood drawn on Monday.

I think from a medical perspective this is a good idea. BUT I think you don't get a good enough picture by doing just 1 day. Just like your cortisol was ok on 3 samples and too high on 1, you could have hormone issues on any part of your cycle or all of it. I personally would want to get a month view of the whole thing.
---
Also, I've had saliva cortisol testing, and blood and saliva DHEA-S testing:

Both DHEA-S tests came back very low (less than the acceptable level for an 85-year old woman, and I am in my mid-40s).

The cortisol test came back in the middle of the normal ranges for morning, noon, and evening, but at the highest score within the normal range for the bedtime sample. The testing company cautioned, in their commentary on my results, that I should be concerned about the bedtime level, and take steps to lower it.

Apologies for the link I'm about to give but I wanted you to look at the diagram part way down on the right called 'Steroid Hormone Synthesis Pathways'

http://www.youthfulagingcenter.com/adrenal-fatigue.html

1. You need cholesterol to make your hormones

2. Your DHEA is low - I'd be asking why? Look at the pathway. Very often the body 'steals' pregnenalone to make cortisol sacrificing progesterone and maybe in your case DHEA. I am not knowledgeable on DHEA so the other reason could be that your body's breaking the DHEA down to make more oestrogens or testosterone? You can only figure this out when you have the full picture.

---
For more information on my health/genetic situation and why I do not at present have a doctor or health insurance, this thread explains: http://forums.phoenixrising.me/inde...-i-would-be-grateful-for-some-guidance.23975/

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Thank you Plum for your response!

I am not concerned about PCOS, as far as I know.

This is the main reason I know FSH and LH are tested. Testing them alone could hint at a problem with your hormones but you wouldn't know which ones without testing your hormones.

Issues related to cancer?

Are these ALL the 4 hormones that start with "e" on my list, or which ones are the estrogens? (I really am ignorant about this stuff! Feel free to speak to me like I'm a toddler. )

I am not sure when it comes to the various oestrogens - I would google each one and see what it says - they are probably various parts of the same pathway and some will be more useful to know about than others. If you're worried about oestrogen and cancer I would do them all.

On my Genova saliva sample they tested oestradiol. Looking at my results as well I can tell you this:

On day 21 my sample was almost normal.

Day 3 and 11 I was normal

Day 23 and 26 normal

I took 12 samples in total.

Day 5,12 and 28 oestradiol only was low.

Day 8 progesterone only was low.

4 samples from the middle of my cycle had low progesterone and oestradiol.

Despite my oestradiol levels being LOW on a number of days I am still Oestrogen dominant due to LOW progesterone. I think testing one just one day of your cycle can only give a snapshot and if you're lucky it will flag up something. I would also be careful with testing blood - saliva is more beneficial for these things. Look up functional testing as saliva shows what is currently available for use by your body if my memory is correct.

I would also go and look into signs and symptoms of oestrogen dominance. I think the majority of women have it. This is largely due to xenoestrogens in out surroundings and diet. I work really hard to eliminate them but still have symptoms so I keep working!

With the cortisol results I described at the start of this post, do you think I could have a progesterone issue?

YES! And stage 1 adrenal fatigue I would guess although I do not know about DHEA in relation to all this.

I have learned that ovarian/endometrial cancer is hard to detect through imaging studies or manual exams, and very hard to diagnose without a surgical biopsy, and I couldn't afford that (plus, just having a surgery, even if there is no cancer found, has a risk of complications and stress on the body) so I'm trying to do what I can on my own to see what I might be dealing with here.

This is the sort of thing I was talking about - non-invasive and I know it's available in the US too. http://www.wholisticmedical.co.uk/thermal_imaging.php

Thank you for mentioning that - those sample reports do give a lot of information oftentimes.

 

[Bluebell]

I appreciate your input and perspective, Plum.

Your DHEA is low - I'd be asking why? Look at the pathway. Very often the body 'steals' pregnenalone to make cortisol sacrificing progesterone and maybe in your case DHEA. I am not knowledgeable on DHEA so the other reason could be that your body's breaking the DHEA down to make more oestrogens or testosterone? You can only figure this out when you have the full picture.

Yes, something is going on regarding my "normal" cortisol and very low DHEA. Getting a snapshot of my sex hormones might give some clues, if any of them are also out of whack.

I do not know if cancer in the body uses up (or prevents the formation of) DHEA for some reason. When reseaching DHEA I saw these quotes:

"...most, if not all, cancer patients present with low DHEA levels. Often a 40-year-old individual may present with DHEA quantities of an 80-to-90 year old patient." http://www.townsendletter.com/AugSept2010/cancerprofile0810.html

"Most cancer patients and those who are developing cancer have low DHEA blood levels." http://caprofile.net/CAProfile1.html

"A host of studies suggest that the lower a person's level of DHEA, the greater his risk of death....
Low DHEA predicts breast cancer more accurately than any other known marker. Women with breast cancer consistently have lower-than-normal DHEA readings.
Research has pinpointed low DHEA levels as a marker for many degenerative diseases and accelerated aging.
The hormone has been implicated as a contributing factor in a host of health problems, including Alzheimer's disease, autoimmune disease and other immunological disorders, cancer, chronic fatigue syndrome, diabetes, heart disease, high cholesterol, memory problems, obesity, osteoporosis, and stress disorders."
http://www.anti-agingmd.com/dhea.html

I personally would want to get a month view of the whole thing.

I understand your reasoning with this.
The fact that hormone levels change daily is why I didn't get any sex hormone tests 6 weeks ago when I had a lot of other tests done, because I had read that a one-time test of female hormones on a woman who is still menstruating is pretty limited in what it can show.
And, at the time, it didn't occur to me that I might have sex-hormone problems (which, in retrospect, I should have suspected).

I am not sure when it comes to the various oestrogens - I would google each one and see what it says - they are probably various parts of the same pathway and some will be more useful to know about than others.

Last night I did this. It appears that estriol (E3) is not relevant to me -- it's more for pregnancy-related issues. Estrone (E1) and Estradiol (E2) are relevant. Total estrogens is just a combined look at E1 and E2.

Most female hormone panel tests at privatemdlabs only include E2, but there is only one panel test that does both E1 and E2 -- it is the "advanced female hormone panel" with a list price of $160, and it is what Ema recommended to me.

That panel does not include FSH, LH, DHT, SHBG, pregnenolone, or prolactin, so I was wondering if any of those would be important to add on. I've looked into each one online, but it's hard to know, with my lack of medical knowledge, how relevant they would be for me.

I read last night that testing prolactin might give me some relevant information, because it can show if there is a prolactin-producing tumor of the pituitary gland. They said that this sort of tumor can also press on the optic nerve and cause vision disturbances -- and I have had a damaged optic nerve and reduced vision for the last 6 months.

...as I look around these lab test shopping sites, I wish I could buy so many of the tests (organic acids, neurotransmitters, stool sample investigation....) There is so much information available these days.

 

[Bluebell]

Thanks for everyone's advice!

I ended up going with this panel at privatemdlabs: http://www.privatemdlabs.com/lab_te...ults&show=1859&category=14&search=female#1859
$159.99 list price (then a 15% discount coupon)
Dehydroepiandrosterone (DHEA) Sulfate
Estradiol
Estrogens (Total), Serum
Estrone
Testosterone (Free), Serum with Total Testosterone
Progesterone

I had considered testing some other hormones as well, particularly pregnenolone, FSH/LH, and prolactin, but I decided to see what these results will be, then go from there.

The results will be posted in this thread: http://forums.phoenixrising.me/inde...-i-would-be-grateful-for-some-guidance.23975/