Indications

• Adverse changes in the blood lipid profile

• Androgen deficiency

• Depression

• Erectile dysfunction

• Irritability

• Loss of muscle mass and strength

• Low libido

• Low testosterone levels

• Lypogonadism

• Metabolic syndrome

• Osteoporosis

• Prostate cancer prevention and treatment

• Sleep disturbances

• Weight gain

Overview

This test measures analytes E2 (estradiol), T (testosterone), DS (DHEAS) and Cx4 (cortisol) in saliva and PSA, TSH, fT3 (free T3), fT4 (free T4) and TPOab in bloobspot.

When patients have hormone-related symptoms, it is usually not a clear-cut case of one hormone level being abnormal, or even one hormone system. In fact, because of the role that hormones play as chemical messengers to wake up the genome in specific target tissues throughout the body, it makes sense that all hormone systems work in concert with each other to maintain a state of balance. This could be likened to the instruments in an orchestra playing together in harmony; when one instrument is off key or playing too loudly or softly (analogous to too much or too little hormone), the overall harmony is affected. In a similar manner, the adrenal, thyroid, and sex hormones work in harmony, and when one or more of the hormones in any one system become unbalanced, this affects the harmony or balance of the whole system.

As men age, their levels of testosterone begin to decline, usually beginning around the mid-40s. This heralds what is

commonly known as andropause, the male counterpart to menopause. While this is a natural part of aging, the decline in testosterone production by the testes can be more precipitous in some men than others.

Priced lower than the sum of the individual tests, this provide a more economical method to assess a patient’s overall hormonal status, giving a better picture of the hormone imbalances that are causing symptoms.

Some hormones (estradiol, progesterone, testosterone, DHEA-S and cortisol) can be determined in either blood spot or saliva, and so your choice depends on which of these is the most suitable for the individual patient.

Practical

Specimen requirements:

Saliva + Dried bloodspot (DBS)

Average processing time:

14 ±6 days

Research

• Araujo AB, O’Donnell AB, Brambilla DJ, Simpson WB, Longcope C, Matsumoto AM,McKinlay JB. Prevalence and incidence of androgen deficiency in middle-aged and older men: estimates from the Massachusetts Male Aging Study. J Clin Endocrinol Metab. 2004;89:5920-6.

• Carruba G. Estrogen and prostate cancer: an eclipsed truth in an androgen-dominated scenario. J Cell Biochem. 2007;102:899-911.

• Elmlinger MW, Dengler T, Weinstock C, Kuehnel W. Endocrine alterations in the aging male. Clin Chem Lab Med. 2003;41:934-41.

• Endogenous Hormones, Prostate Cancer Collaborative Group, Roddam AW, Allen NE, Appleby P, Key TJ. Endogenous sex hormones and prostate cancer: a collaborative analysis of 18 prospective studies. J Natl Cancer Inst. 2008;100:170-83.

• Magri F, Cravello L, Barili L, Sarra S, Cinchetti W, Salmoiraghi F, Micale G, Ferrari E. Stress and dementia: the role of the hypothalamic-pituitary-adrenal axis. Aging Clin Exp Res. 2006;18(2):167-70.

• Mulligan T, Frick MF, Zuraw QC, Stemhagen A, McWhirter C. Prevalence of hypogonadism in males aged at least 45 years: the HIM study. Int J Clin Pract. 2006;60:762-9.

• Risbridger GP, Bianco JJ, Ellem SJ, McPherson SJ. Oestrogens and prostate cancer. Endocr Relat Cancer. 2003;10:187-91.

• Risbridger GP, Ellem SJ, McPherson SJ. Estrogen action on the prostate gland: a critical mix of endocrine and paracrine signaling. J Mol Endocrinol. 2007;39:183-8.

• Selby C. Sex hormone binding globulin: origin, function and clinical significance. Ann Clin Biochem. 1990;27:532-41.

• Tindall DJ, Rittmaster RS. The rationale for inhibiting 5alphareductase isoenzymes in the prevention and treatment of prostate cancer. J Urol. 2008;179:1235-42.