Hormone Clinic Profile, Women
The Hormone Clinic Profile for Women includes a DHEAs, Testosterone Total & Free, TSH, Free T4, Free T3, Estradiol, IGF-1 and Progesterone.
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DHEA,s is utilized to work up women with infertility, amenorrhea, or hirsutism to identify the source of excessive androgen; aid in the evaluation of androgen excess (hirsutism and/or virilization), including Stein-Leventhal syndrome and adrenocortical diseases, including congenital adrenal hyperplasia and adrenal tumor. DHEA-S is not increased with hypopituitarism. It is low in Addison disease.
An androgen, a male sex hormone that is present in the blood of both men and women, Dehydroepiandrosterone sulfate (DHEAS) aids in developing male secondary sexual characteristics at puberty, and can be metabolized by the body into more potent androgens, such as testosterone and androstenedione, or changed into the female hormone estrogen. DHEAS is produced by the adrenal cortex, which is the outer layer of the adrenal glands, with smaller amounts being produced by the woman's ovaries and man's testes. DHEAS secretion is controlled by the pituitary hormone adrenocorticotropic hormone (ACTH) and other pituitary factors. Since DHEAS is primarily produced by the adrenal glands, it is a marker for adrenal function. Adrenal tumors, hyperplasia, and cancers can lead to the overproduction of DHEAS. Elevated levels may not be noticed in adult men, but can lead to amenorrhea and visible symptoms of virilization.
Testosterone Total & Free: Testosterone is a steroid hormone (androgen) that is produced by special endocrine tissue (the Leydig cells) in the male testes. Its production is controlled and controlled by luteinizing hormone (LH), which is manufactured in the pituitary gland. Testosterone works within a negative feedback mechanism, so as testosterone increases, LH decreases, while increased LH causes decreased testosterone. Testosterone levels are diurnal and peak in the early morning hours (about 4:00 to 8:00 am), and have the lowest levels in the evening (about 4:00 to 8:00 pm). Levels increase after exercise as well, but decrease with age. Nearly two-thirds of testosterone circulates in the blood bound to sex-hormone binding protein and slightly less than one-third is bound to albumin. A small percent circulates in the blood as free testosterone. The concentration of free testosterone is very low, normally <2% of the total testosterone concentration. In most women and men, >50% of total circulating testosterone is bound to sex hormone-binding globulin, SHBG, and most of the remaining is bound to albumin. Routinely available assay methods that are used to measure total testosterone are not sensitive enough to accurately quantitate the free testosterone fraction directly. Free testosterone is estimated in this particular test by a direct, analogue radioimmunoassay method. This assay uses a labeled testosterone analogue that has a low binding affinity for both albumin and SHBG but is bound by antitestosterone antibody used in the assay. Since the analogue is unbound in the plasma, it then competes with free testosterone for binding sites on an antitestosterone antibody that is immobilized on the surface of the polypropylene tube.
Thyroid-stimulating Hormone (TSH) is used to diagnose a thyroid disorder in someone with symptoms, screen newborns for an underactive thyroid, monitor thyroid replacement therapy in people with hypothyroidism, diagnose and monitor female infertility problems, help evaluate the function of the pituitary gland (occasionally), and screen adults for thyroid disorders, though expert opinions vary on the benefits of screening and at what age to begin.
Tri-iodothyronine (T3) normally represents only approximately 5% of the thyroid hormone and like thyroxine is almost entirely bound to the carrier proteins, with only 0.25% of the total being in the free state. Measurement of free T-3 is of value in confirming the diagnosis of hyperthyroidism, when an elevated free or total thyroxine level is found. Abnormal total and free tri-iodothyronine concentrations can appear in T3 toxicosis, in the presence of normal thyroxine levels. Free T3 levels are not affected by carrier protein variation.
Free T4 is the active form of thyroxine and is thought to be a more accurate reflection of thyroid hormone function. The free T4 test is thought by many to be a more accurate reflection of thyroid hormone function and, in most cases, its use has replaced that of the total T4 test. A total T4 or free T4 test is primarily ordered in response to an abnormal TSH test result. Sometimes the T4 will be ordered along with a TSH to give the doctor a more complete evaluation of the adequacy of the thyroid hormone feedback system. These tests are usually ordered when a person has symptoms of hyperthroidism or hypothyroidism.
Estradiol is the primary reproductive hormone in nonpregnant women. This steroid hormone plays an important role in normal fetal development and in the development of secondary sexual characteristics in females. Estradiol influences the maturation and maintenance of the uterus during the normal menstrual cycle. Levels of estradiol steadily increase during the follicular phase of the menstrual cycle in association with the growth and development of the ovarian follicle. As the follicular phase proceeds, estradiol exerts a negative feedback control on the pituitary, resulting in a drop in FSH levels. Near the end of the follicular phase, there is a dramatic increase in estradiol levels. At this point, the feedback of estradiol on the hypothalamus becomes positive and produces the midcycle surge of LH which immediately precedes ovulation. After ovulation, estradiol levels initially fall abruptly, but then increase as the corpus luteum forms. At the end of the cycle, levels fall off in anticipation of the initiation of the next follicular phase. During pregnancy, the placenta produces estradiol. Estradiol levels are generally low in menopause due to diminished ovarian production. Estradiol levels can also be dramatically elevated in germ cell tumors and tumors of a number of glands in both men and women.
Estradiol levels are routinely used to monitor ovulation induction to stimulate follicle development in patients being treated by assisted reproductive techniques.Estradiol levels can be used to calibrate the exogenous gonadotropin administration and have been found to correlate with follicle size. The pattern of estradiol secretion during the cycle can be used to predict the outcome of the ART protocol.
Insulin-Like Growth Factor (IGF-1): Somatomedin-C (SC) which is produced in the liver in response to stimulation by growth hormone secreted by the pituitary gland is an insulin-like growth factor level that is used to evaluate disturbances of growth and to monitor treatment with growth hormones.
A Progesterone test measures the amount progesterone in a blood sample. Progesterone, a female hormone produced by the ovaries during ovulation, helps prepare the lining of the uterus (endometrium) to receive the egg if it becomes fertilized by a sperm. If the egg is not fertilized, progesterone levels will drop and menstrual bleeding begins. During pregnancy, the placenta produces high levels of progesterone as well, starting near the end of the first trimester and continuing until the baby is born. Levels of progesterone in a pregnant woman are almost 10 times higher than they are in a woman who is not pregnant. Certain types of cancer cause abnormal progesterone levels in men and women.
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