Prostate-specific Antigen (PSA) Hormone Blood Test Panel
PSA plus Testosterone Total & Free and Estradiol.
PSA Hormone Panel includes:
Prostate-specific Antigen (PSA): Most men have PSA levels under four (ng/mL) and this has been used as the cutoff for concern about risk of prostate cancer. Men with prostate cancer usually have PSA levels higher than four, although cancer is a possibility at any PSA level. Reports state that men who have a prostate gland that feels normal on examination and a PSA less than four have a 15% chance of having prostate cancer, and those with a PSA between four and 10 have a 25% chance of having prostate cancer and if the PSA is higher than 10, the risk increases to 67%.
Testosterone Total & Free: Test for Evaluating hirsutism and masculinization in women; evaluating testicular function in clinical states where the testosterone binding proteins may be altered.(obesity, cirrhosis, thyroid disorders) High free testosterone in men and women can have significant impacts on health and behavior.
Testosterone is believed to play an important role in bone and muscle strength and libido in women. 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.
The Estradiol assay is usually ordered for the investigation of fertility of women of reproductive age and for the support of in vitro fertilization. Small amounts of Estradiol are produced by men. 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.
A small amount of estradiol is produced by the male testes. Elevated levels in males can lead to gynecomastia. Increased estradiol levels in males may be caused by increased body fat, resulting in enhanced peripheral aromatization of androgens. Levels in men can also be increased by excessive use of marijuana, alcohol, or prescribed drugs, including phenothiazines and spironolactone. 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.
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