Interpreting Your Hormone Lab Results
Hormones are complex substances that rule many bodily functions, from mental to sexual and even intestinal. Whether in men or women, they arise from the endocrine system, and their measure by blood test reveals crucial information about your health status.
In men, hormones like testosterone are responsible for maintaining their hair’s lushness and shine, muscular shape, bones and sexual drive. In women, hormones such as estrogen regulate their menstrual cycle and prevent acne and body hair growth.
With hormones controlling so many organic processes, imbalances may cause health problems such as acute hair loss, fatigue, depression, weight loss or gain, infertility, and erectile dysfunction.
Whether to diagnose or monitor, hormonal lab tests are the perfect tool to check your current hormone levels by measuring them through your blood. Yet, while many physicians easily read the results, patients like you are probably unaware of what the values really mean. Below you will find a guide on reading your lab results and interpreting them in an easy non-medical way.
Hormones and reasons why they get out of control
Hormones are chemical substances produced in different body parts that, acting as messengers, reach target organs or tissues where they influence their functioning. Each hormone molecule fulfils a particular function, allowing the human body to function according to the stimuli it receives.
There are more than fifty kinds of hormones in your body, and the most important ones include:
- Thyroid derivatives and related ones: thyroxine (T4), triiodothyronine (T3) and thyroid-stimulating (TSH).
- Hormones deriving from the reproductive organs: Prostate-specific antigen (PSA), testosterone, progesterone, estradiol and dihydrotestosterone.
- Others: insulin, erythropoietin, renin, cortisol, and growth hormone.
Hormones can get out of control for many reasons, such as taking medications, eating disorders, stress, reproductive organs problems such as ovarian cysts or endometriosis, injuries or genetics. Sometimes it happens due to natural ageing, as in menopause, andropause and menstruation, and sometimes it can be due to conditions that make your glands not work correctly.
Typical symptoms of male hormonal imbalances include:
- Low or lack of sex drive.
- Weight gain, especially in the belly.
- Hair loss.
- Mood swings.
- Depression or anxiety.
- Changes in heart rate.
- Dry skin or excessively oily skin.
- Unexplained fatigue and tiredness.
- Cognitive decline.
Typical symptoms of female hormonal imbalances include:
- Hair growth in atypical areas, such as the cheeks or neck.
- Unexplained acne.
- Breast pain.
- Night sweats.
- Hair loss.
- Trouble falling asleep.
- Irregular menstrual cycles.
You must recognize the symptoms of hormonal imbalances to work with your doctor accordingly. Remember, the sooner you start treatment, the better the outcomes and quality of life.
Reading your hormonal lab results
Whether you had a female or male hormone profile done, there are certain things you need to know before going into the results.
There are standard abbreviations whose meaning depends on the laboratory test done. Most abbreviations stand for the international unit of measurement, and you can find them in the reference range line just after the result.
Among the most used:
- cmm: Cells per cubic milliliter
- fL (femtoliter): Fraction of one-millionth of a liter
- g/dL: Grams per deciliter
- mcg/dL: Micrograms per deciliter
- mg/dL: Milligrams per deciliter
- mmol/L: Millimoles per liter
- ng/mL: Nanograms per milliliter
- pg/mL: Picograms per milliliter
The reference range
Laboratory test results can be numerical, qualitative (positive, negative) or comments and interpretations. Usually, the numerical results are compared with reference intervals, the values expected in a healthy person. Comparing the results with the reference range makes it possible to know whether any value exceeds what is considered normal.
Don’t be afraid if your lab result exceeds the reference values. Even some people with in-range results are symptomatic. Also, it is normal to have results above or below the reference values, especially when the difference is slight.
Reference ranges may differ between laboratories also, mainly due to operational and sample processing differences. So you will probably have in-range results in one lab and out-of-standard results in another.
The male hormonal profile
The male hormone panel is based on measuring blood levels of testosterone (either free or total), the prostate-specific antigen, and estradiol.
The prostate-specific antigen (PSA)
Prostate-specific antigen, or PSA, is a protein produced by normal and malignant cells of the prostate gland, and its testing measures its levels in a man’s blood.
The PSA blood levels are often increased in men with prostate cancer. However, other non-cancerous (benign) conditions cause the same, such as prostatitis (inflammation of the prostate) and benign prostatic hyperplasia (BPH).
Results are generally reported in nanograms of PSA per milliliter of blood (ng/ml), and you must consult a doctor for any value outside the reference range, either too low or too high.
Although it is found in both men and women, testosterone primarily controls behaviour, sexual desire and muscle gain, as well as the amount of sperm in men.
Testosterone travels through the blood in two ways, protein-bound or not, and this makes a difference in its laboratory measurement:
- Free testosterone: Free testosterone is the one not bound to proteins.
- Total testosterone: It measures both protein-bound and non-protein-bound testosterone.
Testosterone testing can diagnose several problems, including decreased sex drive, infertility, erectile dysfunction, testicular tumors, and early or delayed puberty in boys.
Values are the key to diagnosis. A high testosterone level may suggest a testicular or adrenal gland tumor. A low value may be related to hereditary and chronic disease or a pituitary gland problem.
Like testosterone, estradiol is a sex hormone that regulates sperm production, sex drive and erectile function in men. Blood levels are lower than in women, with an average value of up to 50pg/ml.
This test is usually employed to diagnose males with developing female traits, as in gynecomastia or Klinefelter syndrome.
The female hormonal profile
The female hormone profile mainly includes blood measurements of progesterone and estradiol.
Progesterone is an essential sex hormone produced by the ovaries. It is part of the last phase of the menstrual cycle, helps the uterus get ready to hold a fertilized egg, and prepares the breasts for breastfeeding. Also, it is a significant precursor to testosterone.
Therefore, its blood measurement helps diagnose:
- Causes of infertility.
- Find out ovulation days.
- Find out the risk of miscarriage.
- Monitor high-risk pregnancies.
- Diagnose an ectopic pregnancy (when the egg grows outside the uterus).
Progesterone blood levels are low at the beginning of the menstrual cycle and increase progressively after ovulation. If you do not become pregnant, the levels drop, and the cycle continues. But if you do, progesterone levels increase dramatically to keep the uterus and pregnancy going.
If your progesterone levels are high, this could mean pregnancy, ovarian cysts, abnormal abdominal pregnancy, adrenal gland abnormalities or ovarian malignancy.
Conversely, if your progesterone is lower than expected for a healthy woman, this may suggest an ectopic pregnancy, infertility or miscarriage. Thus, you may experience mood swings, headaches, and an irregular menstrual cycle.
Estradiol is a form of estrogen, a sex hormone both in women and men, produced by the ovaries, breasts, and adrenal glands.
It is essential for bone and joint health in females, and helps control how fat is distributed in their bodies. The placenta also produces some estradiol during pregnancy, as well as the liver, brain and skin.
This test is performed to:
- Monitor how your ovaries are functioning.
- Diagnose ovarian tumor.
- Treat symptoms resulting from too little or too much estradiol production.
- Diagnose menstrual cycle disturbances.
- Monitor the body’s response to hormone therapy.
Out-of-range blood levels may be related to:
- Problem with genes, such as Klinefelter syndrome or Turner syndrome.
- Early puberty in girls.
- Decreased ovarian function.
- Lack of periods in women (amenorrhea).
- Acute weight loss due to fat loss.
Please note that average values may vary among women depending on their menstrual cycle phase.
As mentioned above, testosterone is also found in women and is a significant indicator of ovarian or adrenal gland problems.
In women, testosterone is expected to be low, between 15 to 70 ng/dL (or 0.5 to 2.4 nmol/L). However, it may be above the reference values when there are symptoms such as acne and oily skin, hair loss, hair growth or irregular menstrual periods.
In women, testosterone blood levels are measured to diagnose or rule out hormonal imbalances and start hormone-regulating treatment to revert these symptoms.
Blood tests that both men and women undergo
There are blood tests that both men and women can have, such as complete blood count (CBC) and lipid profile. We will focus on the complete blood count.
Complete blood count(includes Differential and Platelets)
Also known as a hemogram, this test measures all the cells that travel through your blood.
The CBC provides insight into your overall health and can diagnose various health problems, from blood diseases, such as anemia or leukemia, to infections.
It takes into account white blood cells (which fight infection), red blood cells (which carry oxygen), platelets (cells that stop bleedings), hemoglobin, and hematocrit (ratio of red blood cells to plasma).
Why is this test performed?
- To monitor your overall health.
- To diagnose an infection.
- To diagnose blood diseases. As in leukemia or anemia.
- To control a disease. If you have been diagnosed with a disorder that affects your blood cell count, your doctor may use CBC to monitor your disease.
What do my results mean?
White blood cell count: An elevated white blood cell count may mean an infection, especially when there are symptoms such as malaise, headache, fever, or a blood disease such as leukemia.
In leukemia, the count is above or below the reference values. When above, it is usually more than expected for a person with an infection.
Red blood cell count, hemoglobin and hematocrit: Each measure a different aspect of red blood cells. When all three are below the reference, you likely have anemia, a condition with weakness, fatigue and tiredness that sets in over time due to nutritional deficiencies, irregular bleeding or other health problems.
If, on the other hand, the count is high, you may have a heart condition or polycythemia vera, an uncommon type of blood cancer that causes your bone marrow to make too many red blood cells.
Platelet count: A platelet count lower (thrombocytopenia) or higher (thrombocytosis) than average hides a disease or is a side effect of a medication. Low platelets often cause unexplained bleeding, while very high platelets are related to numbness and pain in the hands and feet, dizziness, and weakness.
Although this guide describes points to keep in mind when reading laboratory results, it does not replace a physician’s knowledge and expertise in reading laboratory tests.
Whether you have had a hormonal test or a CBC, you should consult a medical doctor for any out-of-average values to look for the underlying cause and act accordingly with medical treatment.