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Expanded Premenopause Hormone Profile: BHD #208
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GI Effects Complete Profile
GI Effects is unlike any other stool analysis profile, going beyond the standard parameters for identifying gastrointestinal disorders.
The GI Effects Profile uses DNA analysis to identify microbiota including anaerobes, a previously immeasurable area of the gut environment. DNA assessment is specific and accurate, avoids the pitfalls of sample transport, reports results as specific numbers, and is more sensitive than classic laboratory methods.
Why Use Stool Analysis?
Gastrointestinal function is important for general health. The intestinal tract contains significant amounts of bacteria; some beneficial, some neutral, and some harmful. Balancing beneficial microbial flora in the gut is key to proper digestion, efficient nutrient usage, and ridding the body of waste and pathogens. Poor digestion and malabsorption can lead to immune dysfunction, nutritional insufficiencies, mental/emotional disorders, and autoimmune diseases.
More Details
More info – http://www.metametrix.com/test-menu/profiles/gastrointestinal-function/dna-stool-analysis-gi-effects?t=downloads Advantages of the GI Effects Stool Profile * Greater Accuracy Microbial DNA analysis improves the accuracy of results and includes both aerobes and anaerobes. Anaerobes comprise over 95% of the bacteria in the gut and are difficult to detect with old culture methods. * Antibiotic resistance genes DNA analysis detects organisms possessing genes that give rise to antibiotic resistance, offering clinicians a superior tool for effective patient management. * Single Sample Collection Culture methods require multiple collections, whereas the GI Effects Stool Profile requires only one sample collection leading to improved patient compliance! * Eliminates Errors in Transport Sample transport is a source of significant error in culture analysis due to the change in microbial balance from the time of collection. Using DNA analysis, the specimen is placed in a fixative tube that stops microbial growth and offers a highly accurate snapshot of the microbial balance in the gut. * Increased Sensitivity GI Effects detects as few as 5 cells per gram – a 5000-fold increase in sensitivity over microscopy for parasite detection. * A Better Value No reflex or add-on costs for additional testing! Why Use Stool Analysis? Gastrointestinal function is important for general health. The intestinal tract contains significant amounts of bacteria; some beneficial, some neutral, and some harmful. Balancing beneficial microbial flora in the gut is key to proper digestion, efficient nutrient usage, and ridding the body of waste and pathogens. Poor digestion and malabsorption can lead to immune dysfunction, nutritional insufficiencies, mental/emotional disorders, and autoimmune diseases. Metametrix offers the Complete GI Effects profile for the most thorough look at the gut microbiome. Continuing our commitment to innovation “PCR is the best developed and most widely used nucleic acid amplification strategy…These techniques have sensitivity unparalleled in laboratory medicine, have created new opportunities for the clinical laboratory to have an effect on patient care and have become the new “gold standards” for laboratory diagnosis of several infectious diseases.” -Manual of Clinical Microbiology, 8th Edition, Vol. 1, page 235, 2003
Functional Adrenal Stress Profile w/ sIgA x 4, #205-S
4 Cortisol, 2 averaged DHEA-S, 1 Estradiol, 1 Estriol, 1 Testosterone (AM), 1 Melatonin (bedtime), 1 Progesterone (bedtime)
How it Works
Saliva samples are collected over the course of one day. This should be on a typical day. This profile can be added on to any Functional Adrenal Stress Profile. Correlating each sIgA with individual cortisol samples greatly enhances the ability to apply the data relative to adrenal health, immunity, and lifestyle factors. Collection times are the same as the Functional Adrenal Stress Profiles.
More Details
This profile is clinically indicated to evaluate an individual’s ability to adapt to environmental, mental, emotional, and physiological stressors; to determine the efficacy of DHEA therapy; to assess rest and recovery relative to morning and bedtime Cortisol; and bedtime levels of Melatonin and Progesterone. The Functional Adrenal Stress Profile plus V provides an adrenal rhythm and a DHEA-S -to-Cortisol ratio. Abnormal adrenal rhythm can negatively influence energy production; immune system health; skin regeneration; muscle and joint function; bone health; sleep quality; and liver, pancreas and thyroid function. Adrenal dysfunction may be associated with the following symptoms: excessive fatigue; chronic stress and related health problems; dizziness upon standing; weakness; hypoglycemia; nervousness; irritability; depression; inability to concentrate; confusion; poor memory; low blood pressure; insomnia; premenstrual tension; sweet cravings; headaches; alcohol intolerance; excessive hunger; alternating diarrhea and constipation; sternocleidomastoid/trapezius pain and spasms; epigastric discomfort; poor resistance to infection; food and/or inhalant allergies; dyspepsia; tenderness in adrenal area; migraine headaches; low body temperature; and diminished sex drive. Estrogens and Testosterone are included in this profile to further evaluate the efficacy of DHEA therapy. Since DHEA can convert to Estrogens and/or Testosterone, the use of DHEA may be contraindicated if Estrogens and/or Testosterone levels are elevated. Conversely, if Estrogens and/or Testosterone levels are depressed, DHEA and/or other therapeutic measures may be indicated. Bedtime Cortisol, Melatonin, and Progesterone levels are indicators for rest and recovery and are indicated for anyone with sleep disorders. SUMMARY: Evaluating the Cortisol circadian (24-hour) rhythm along with DHEA-S provides an accurate assessment of adrenal function and can reveal maladaptation to stressors. Saliva (free fraction) testing determines the bioactive level of these hormones at the cellular level, thereby providing a functional assessment of the effects of environmental and physiological stressors. Mucosal Immunity Profile Highlights * Measures sIgA, the primary measurement for first line immune defense (mucosal immunity) * Can determine possible infections, reactions to foods, and environmental toxins * Can be correlated with the Functional Adrenal Stress Profile to compare sIgA with each cortisol level to further enhance the interpretation relative to lifestyle (clinical and subclinical sources of chronic stress), adrenal function and first-line immunity. Overview An overall deficiency of sIgA (low sIgA average) indicates increased risk for infections, reactions to foods and environmental toxins. An overall increase of sIgA (high sIgA average) indicates an acute response to infection, i.e. bacteria, parasites, viral, yeasts, or fungal. Lifestyle factors can dramatically affect sIgA output therefore correlating the 1-Day Patient Diary with the test results provides greater clinical relevance, enhances patient compliance, and health care outcomes. Selective Diseases in Secretory IgA Deficiency * Autoimmune achlorhydria, pernicious anemia, villous atrophy * Infectious Clostridium, Giardia, Cryptosporidium parvum, Helicobacter pylori, Salmonella * Inflammatory celiac, Crohn’s, ulcerative colitis * Neoplastic lymphoma, stomach adenocarcinoma How it Works Saliva samples are collected over the course of one day. This should be on a typical day. This profile can be added on to any Functional Adrenal Stress Profile. Correlating each sIgA with individual cortisol samples greatly enhances the ability to apply the data relative to adrenal health, immunity, and lifestyle factors. Collection times are the same as the Functional Adrenal Stress Profiles.
Intestinal Barrier Function Screen: BHD #304
Overview
The Intestinal Barrier Function Screen uses a single saliva sample to assess the level of secretory immunoglobulin A (sIgA) and the levels of free IgA and IgM to combined dietary proteins (wheat/gliadin, corn, soy, cow’s milk, egg); aerobic bacteria (Escherichia coli and E. enterococcus); anaerobic bacteria (Bacteroides fragilis and Clostridium perfringens); Candida albicans yeast.
- Sample: Saliva
- See mucosalbarrier.com for expanded information
More Details
Background The lining of the gastrointestinal tract, from the mouth to the anus, is covered by a mucosal barrier, which provides our first line immune defense against pathogens and a mechanism for proper processing of food antigens. The mucosal barrier contains specific immune defenses including mucosal antibodies. A healthy mucosal barrier defense contains sufficient antibodies and responds to normally encountered antigens and deals with them appropriately. All of the dietary proteins, yeasts, and bacteria used in this test are normally found in the human body or diet. IgA is the predominant antibody quantitatively in the mucosal immune system. Physiology This test measures total sIgA production which helps determine whether there is an appropriate mucosal immune response. Secretory IgA Level * This is an important indicator of the strength of mucosal immunity and can help to establish the validity of other Ig values. * If total sIgA is elevated an infection exists and further testing is recommended to determine its type. * If total sIgA is low it can indicate compromised mucosal immunity, however, it is a measurement at a point in time; it needs to be looked at over time and correlated with cortisol rhythm and lifestyle. IgA and IgM to antigens in the Dietary Protein, Yeast, Aerobic & Anaerobic Bacteria Compartments * The immune system should have “normal” recognition of these antigens and process them appropriately. * If all reported results are < ref range , then the mucosal barrier is totally shut down, regardless of the level of sIgA. This means that there is effectively no mucosal immune response to antigens that present and also indicates severe intestinal permeability “leaky gut”. * Assessing the levels of antibodies to foods is important in determining the cause of possible chronic gastrointestinal inflammation. Such inflammation can be accompanied by symptoms, or it can be subclinical. If immune markers to dietary proteins are elevated, it is important to do further testing to determine which food the mucosal immune system is reacting to. * If IgA is elevated in the yeast compartment it means that Candida is attempting to invade the intestinal mucosa. * Determining the levels and ratio of bacterial groups to each other helps assess digestive and absorptive function. The ratios of the levels of the same specific immune marker for aerobic and anaerobic bacteria (i.e. IgA aerobic/IgA anaerobic) should be about one to one. If these ratios are >2 or <0.5, then a dysbiotic condition exists. Specific infections should be ruled in or ruled out. However, dysbiosis can result from a course of antibiotic therapy without proper efforts to recolonize the gut. * If one or more of the antibodies in each compartment (dietary proteins, yeast, aerobic bacteria and anaerobic bacteria) is elevated then the gut is leaky and proteins (antigens) are entering the general circulation. Clinical Use The evaluation of the intestinal mucosa as a selective filter can be regarded as an essential tool in assessing overall health status. The Intestinal Barrier Function Screen (BHD #304) can be used as an immunological indicator of intestinal mucosal integrity and an index of gastrointestinal physiology. This test is especially effective for differential diagnosis in complex and refractory cases. It can assist in both directing further testing and tailoring therapeutic protocols more precisely. It also is sufficiently comprehensive to be used either in initial screening or as follow-up. Conditions Assessed Conditions that may be assessed include an abnormal ratio of aerobic-to-anaerobic bacteria, pathogen or yeast overgrowth, intestinal mucosal immune dysfunction, systemic immune deficiency, autoimmunity, food allergy, gluten enteropathy, malabsorption, and “leaky gut.” Logical Sequence of Testing The logical sequence of using this test as an initial or a follow-up test is determined by a variety of individual considerations, including the patient’s chief complaint, the array of signs and symptoms, the chronicity of the condition, the tests previously taken, and the judgment of the practitioner. Technical assistance is available from BioHealth Diagnostics’ support staff.
Functional Adrenal Stress Profile: BHD #201
Overview
The Functional Adrenal Stress Profile requires a series of four time specific saliva collections (morning, noon, afternoon and nighttime) during a typical day on which cortisol is measured to establish its circadian rhythm. Additionally, the sulfated form of DHEA (DHEA-S) is measured on the noon and afternoon samples and the average of those results is reported. Assessing the cortisol rhythm and DHEA-S average is a critical first step in new patient evaluation as well as a fundamental component in follow-up studies.
- Sample required: 4 vials with 3 mL each of saliva
- Lab reporting time: 3 – 4 business days
More Details
Physiology Cortisol, which is best known for stimulating gluconeogenesis, is essential for normal glycogenolysis. Cortisol affects the heart, vasculature, blood pressure, water excretion, and electrolyte balance. It mobilizes protein stores in all tissues except the liver; it mobilizes fatty acids from adipose; it is the precursor of cortisone and acts as an anti-inflammatory; and it is the primary hormone directing immune function. Cortisol can stimulate or inhibit gene transcription, promote apoptosis, and affect bone metabolism and calcium dynamics. It affects behavior, mood, neural activity, and a variety of central nervous system biochemical processes. Cortisol affects the eyes, gastrointestinal tract, reproductive function, and the production and clearance of other classes of hormones. It is a major marker of the complex control loops regulating the sex hormones. The general effect of excess cortisol is usually stimulatory and catabolic; a deficiency of cortisol usually results in a slowing of physiology. The salivary free fraction of the adrenal cortisol output is reported because of its high clinical correlation to accurately assess adrenal function. To determine the cortisol circadian rhythm, four individual cortisol levels is taken at specified intervals throughout the day: in the morning between 6 and 8 a.m., between 12 and 1 p.m., in the late afternoon around 4 or 5 p.m., and at nighttime between 10 p.m. and 12 a.m. In the presence of stressors, the body almost immediately attempts to increase cortisol levels. This increase is associated with both endocrine and autonomic responses in preparing the body to defend itself normally. However, elevated cortisol levels for extended periods negatively affect virtually every aspect of physiology. For example, it becomes more difficult to maintain proper blood sugar levels; to slow down for rest, recovery, and repair; to get good quality sleep; to balance other hormones; to maintain mucosal immune integrity; to maintain bone mass, to produce effective general immune function; to effectively regulate inflammatory processes; or to detoxify the body. Without proper intervention, continued high adrenal stimulation can lead to adrenal exhaustion and lowered cortisol levels. Eventually adrenal or cardiac failure can occur. DHEA is the major precursor of testosterone and the estrogens. It becomes active at puberty. In this profile, the more stable, sulfated form of DHEA, DHEA-S is measured, providing a more reliable measure of DHEA levels than measuring DHEA directly. DHEA is an important modulator of many physiological processes. It promotes the growth and repair of protein tissue (especially muscle), and acts as a counter-regulatory agent to cortisol, negating many of the harmful effects of continued excess cortisol. When increased demand for cortisol is prolonged, DHEA levels decline. DHEA then is no longer able to balance the negative effects of excess cortisol. Depressed DHEA levels serve as an early warning of potential adrenal exhaustion. In fact, adrenal exhaustion is evidenced by an elevated ratio of the sum of the four cortisol measurements to the DHEA-S average. (The ideal level of the aforementioned ratio is 5 or 6:1) A chronic imbalance between adrenal stimulation and cortisol and/or DHEA output is associated with a multitude of both clinical and subclinical systemic disorders. Chronically depressed DHEA output results in an imbalance in sex hormones. Abnormal cortisol and/or DHEA values (either elevated or depressed) result in a decrease in the activity of the immunocytes that produce secretory IgA (sIgA). SIgA provides a mucosal first-line immune defense against virtually every pathogen, including parasites, protozoa, yeasts, fungi, bacteria, and viruses. SIgA also provides a normal immune response to regularly encountered food proteins. Dysfunctional mucosal immunity is associated with an increased risk of infections and of adverse food reactions. Clinical Use The degree and timing of cortisol imbalances provide the healthcare professional with valuable insights into the nature of causative stressors, and allow the practitioner to formulate remedial protocols (refer to BioHealth’s Adrenal and Metabolic Interpretive Guide). Readily identifiable inducers of increased adrenal stimulation include stressors such as tissue damage, inflammation, pain, and mental or emotional stress. Other significant physiological stressors can be subclinical, and include intolerance to the gliadin fraction of gluten protein, lactose or sucrose intolerance, glycemic dysregulation, delayed food sensitivity, and infection with viruses, bacteria parasites and/or other pathogens. Additional testing may be necessary to rule out the possibility of these and other factors interfering with digestion and absorption and creating inflammation and stress on adrenal glands. These types of problems could impede absorption and assimilation of essential nutrients, and the maintenance of normal blood sugar. Chronic dysfunction of any of these processes is a sufficient cause of adrenal exhaustion. Physiological pathways, organs, or systems identified as being the major cause of some other disorder may concurrently serve as causative agents in adrenal exhaustion. In most cases, regardless of the priority given to another pathway, organ, or system as being dysfunctional–and virtually regardless of the condition identified–adrenal exhaustion resulting from excessive stress must be addressed and rectified in order to restore normal physiology or function. Conditions Assessed Conditions that may be assessed include adrenal exhaustion, often misdiagnosed as hypothyroid, but may include a hypothyroid condition as well; systemic hyper- or hypo-excitability, whether of suspected neural or hormonal origin, including suspected thyroid, pancreatic, and sex hormone disorders; states of immunodeficiency; and states of abnormal physiological response to any of a variety of stimuli including foods in the normal diet. Logical Sequence of Testing The logical sequence of using this test as an initial or as a follow-up test is determined by a variety of individual considerations, including the patient’s chief complaint, the array of signs and symptoms, the chronicity of the condition, the tests previously taken, and the judgment of the practitioner. Technical assistance is available from BioHealth Diagnostics’ support staff.
Mediator Release Test
One of the biggest stresses on the body can be food sensitivities!
The Mediator Release Test (MRT) is widely considered the most accurate and comprehensive blood test available for food and food-chemical reactions. The MRT looks for reactions to 150 different food and food additives. Many are surprised to find out that foods they consume on nearly a daily basis are those that they have the most severe reaction to.
MRT has helped thousands of individuals quickly and substantially improve, or even eliminate, many chronic health problems where inflammation is root of many problems, such as:
- Weight Gain
- Skin Problems
- Irritable Bowel Syndrome (IBS)
- ADD/ADHD
- Gastrointestinal Distress
- Acid Reflux
- Migraine and other headaches
- Depression
- Autism
- Fibromyalgia
- Chronic Fatigue
- Brain Fog
The test can help you realize that even foods or additives that are generally considered healthy like chicken, broccoli, cinnamon, oregano, spinach, apples, or salmon may be a trigger food for you that is causing internal stress and inflammation.
Armed with the information the MRT provides, you no longer need to guess about which foods to consume. Successful Health wants to provide you with the easiest road possible to reaching your health goals. The MRT and the information it provides is certainly a big step in that direction.
Included in This Program:
- MRT Blood Test Kit
- Result Reports and Recommendations
- MRT Guide
- 2 Phone Consultations
- Email Support.
Test kits are either given to you in-person or can be mailed out to you for mail return.
This program is available in-person or by phone and email.
Functional Adrenal Stress Profile plus V, #205
Functional Adrenal Stress Profile plus V, #205
- Turnaround: 3 – 4 days
- 4 Cortisol, 2 averaged DHEA-S, 1 Estradiol, 1 Estriol, 1 Testosterone (AM), 1 Melatonin (bedtime), 1 Progesterone (bedtime)
- Also available with ESTRONE added (ask for BHD #205E)
This profile is clinically indicated to evaluate an individual’s ability to adapt to environmental, mental, emotional, and physiological stressors; to determine the efficacy of DHEA therapy; to assess rest and recovery relative to morning and bedtime Cortisol; and bedtime levels of Melatonin and Progesterone.
The Functional Adrenal Stress Profile plus V provides an adrenal rhythm and a DHEA-S -to-Cortisol ratio. Abnormal adrenal rhythm can negatively influence energy production; immune system health; skin regeneration; muscle and joint function; bone health; sleep quality; and liver, pancreas and thyroid function.
Adrenal dysfunction may be associated with the following symptoms: excessive fatigue; chronic stress and related health problems; dizziness upon standing; weakness; hypoglycemia; nervousness; irritability; depression; inability to concentrate; confusion; poor memory; low blood pressure; insomnia; premenstrual tension; sweet cravings; headaches; alcohol intolerance; excessive hunger; alternating diarrhea and constipation; sternocleidomastoid/trapezius pain and spasms; epigastric discomfort; poor resistance to infection; food and/or inhalant allergies; dyspepsia; tenderness in adrenal area; migraine headaches; low body temperature; and diminished sex drive.
Estrogens and Testosterone are included in this profile to further evaluate the efficacy of DHEA therapy. Since DHEA can convert to Estrogens and/or Testosterone, the use of DHEA may be contraindicated if Estrogens and/or Testosterone levels are elevated. Conversely, if Estrogens and/or Testosterone levels are depressed, DHEA and/or other therapeutic measures may be indicated. Bedtime Cortisol, Melatonin, and Progesterone levels are indicators for rest and recovery and are indicated for anyone with sleep disorders.
SUMMARY: Evaluating the Cortisol circadian (24-hour) rhythm along with DHEA-S provides an accurate assessment of adrenal function and can reveal maladaptation to stressors. Salivary (free fraction) hormone testing determines the bioactive values at the cellular level, thereby providing a functional assessment of the effects of environmental and physiological stressors.
Premenopause Hormone Profile: BHD #207
- Sample required: 11 test tubes with 3 mL each of saliva
- Lab reporting time: 3 – 4 business days
Overview
This test is ideal for mapping female cycles that are 24 days or less or for data collection. This test uses 11 saliva samples to measure the rhythm of progesterone and one of the estrogens [namely, estradiol (E2)] over a complete menstrual cycle. Two measurements of testosterone are also taken. The results provide a mapping of the menstrual cycle to aid in the evaluation of metabolic imbalances associated with sex hormones.
More Details
Physiology The menstrual cycle involves the functional and structural uterine changes necessary for the development and fertilization of an ovum. The cycle is lunar in length, with 28 days usually listed as normal. Progesterone and estrogen act as leaders in the cycle, and the levels of other hormones–notably, the luteinizing and follicle-stimulating hormones–fluctuate in response to the changing levels of the first two. Both the physiology and morphology of the associated tissues normally fluctuate in a correspondingly predictable pattern within the cycle. The rhythm of each hormone has established norms, and the divergence of any hormone from these values can result in a cascade of compensations involving several other hormones. The effects of such a divergence from normal values can result in adverse changes in the physiology and morphology of target tissues, in other hormone systems not considered part of the menstrual cycle, and in behavior. Cholesterol forms pregnenolone in the adrenal glands. Pregnenolone then metabolizes into progesterone and DHEA. DHEA readily forms a sulfated metabolite, DHEA-S, which is the species usually measured because of its increased stability. Progesterone also forms cortisol, while DHEA forms testosterone and the three estrogens–estrone (E1), estradiol (E2), and estriol (E3). The progesterone-cortisol pathway acts as a metabolic balance for the DHEA-estrogen/testosterone pathway. All these hormones are either adrenal products or metabolites of adrenal products, giving them a close functional relationship to one another. If the metabolic supply of pregnenolone is adequate, the cycle can nevertheless become disordered when just a single pregnenolone metabolite remains outside its normal range. Because of its prominent and ubiquitous use in tissue cells, cortisol (a direct progesterone metabolite) is often at the heart of menstrual hormone metabolism. Balancing the menstrual hormones is important not only to normalize menstruation, but also to control many other physiological systems with anatomic and behavioral sequelae. Sites and processes seemingly distant and unrelated to menstrual function are involved. A very short list of factors strongly influenced by menstrual hormones includes maintaining the endometrium; promoting embryo and fetus survival; influencing the onset of breast, endometrial, and ovarian cancer; bone production; glycemia; cellular oxidation; blood clotting; psychological depression; phagocyte activity; serum cholesterol; and muscle mass. Clinical Use The task in reordering a disordered menstrual cycle lies not simply in restoring the levels of hormone output but in normalizing the timing and distribution of those levels as well. Notably, adrenal function helps to rebalance progesterone with the DHEA-estrogen/testosterone pathway, which promotes menstrual cycle normalization. Another intervention that is relatively mild yet highly effective is the measured administration of low doses of the immediate cortisol precursor, progesterone. Altering the daily dose of readily absorbable progesterone over the course of a cycle can result in the normalizing of estrogen levels, with subsequent normalization of the other menstrual hormones as well. Appropriate hormone levels generally lead to the normalization of menstrual physiology, anatomy, and behavior. This test maps the menstrual cycle to provide a basis for and to monitor hormone therapy. Conditions Assessed Conditions that may be assessed include suspected hormone imbalance, menstrual dysfunction, and possible causes of associated physiological, morphological, and psychological upset. Sequelae include emotional fragility, mood swings, anxiety, panic attacks, premenstrual syndrome (PMS), hot flashes, night sweats, bloating, excessive weight gain or loss, excessively high or low energy, chronic digestive upset, migraine headaches, repeated miscarriage, and infertility. Logical Sequence of Testing The logical sequence of using this test as an initial or as a follow-up test is determined by a variety of individual considerations, including the patient’s chief complaint, the array of signs and symptoms, the chronicity of the condition, the tests previously taken, and the judgment of the practitioner.
Expanded Premenopause Hormone Profile: BHD #208
- Sample required: 17 test tubes with 3 mL each of saliva
- Lab reporting time: 3 – 4 days
Overview
This test is ideal for mapping female cycles longer than 24 days or for data collection. This test uses 17 saliva samples to measure the rhythm of progesterone and one of the estrogens [namely, estradiol (E2)] over a complete menstrual cycle. The results provide a mapping of the menstrual cycle to aid in the evaluation of metabolic imbalances associated with sex hormones.
More Details
Physiology The menstrual cycle involves the functional and structural uterine changes necessary for the development and fertilization of an ovum. The cycle is lunar in length, with 28 days usually listed as normal. Progesterone and estrogen act as leaders in the cycle, and the levels of other hormones–notably, the luteinizing and follicle-stimulating hormones–fluctuate in response to the changing levels of the first two. Both the physiology and morphology of the associated tissues normally fluctuate in a correspondingly predictable pattern within the cycle. The rhythm of each hormone has established norms, and the divergence of any hormone from these values can result in a cascade of compensations involving several other hormones. The effects of such a divergence from normal values can result in adverse changes in the physiology and morphology of target tissues, in other hormone systems not considered part of the menstrual cycle, and in behavior. Cholesterol forms pregnenolone in the adrenal glands. Pregnenolone then metabolizes into progesterone and DHEA. DHEA readily forms a sulfated metabolite, DHEA-S, which is the species usually measured because of its increased stability. Progesterone also forms cortisol, while DHEA forms testosterone and the three estrogens–estrone (E1), estradiol (E2), and estriol (E3). The progesterone-cortisol pathway acts as a metabolic balance for the DHEA-estrogen/testosterone pathway. All these hormones are either adrenal products or metabolites of adrenal products, giving them a close functional relationship to one another. If the metabolic supply of pregnenolone is adequate, the cycle can nevertheless become disordered when just a single pregnenolone metabolite remains outside its normal range. Because of its prominent and ubiquitous use in tissue cells, cortisol (a direct progesterone metabolite) is often at the heart of menstrual hormone metabolism. Balancing the menstrual hormones is important not only to normalize menstruation, but also to control many other physiological systems with anatomic and behavioral sequelae. Sites and processes seemingly distant and unrelated to menstrual function are involved. A very short list of factors strongly influenced by menstrual hormones includes maintaining the endometrium; promoting embryo and fetus survival; influencing the onset of breast, endometrial, and ovarian cancer; bone production; glycemia; cellular oxidation; blood clotting; psychological depression; phagocyte activity; serum cholesterol; and muscle mass. Clinical Use The task in reordering a disordered menstrual cycle lies not simply in restoring the levels of hormone output but in normalizing the timing and distribution of those levels as well. Notably, adrenal function helps to rebalance progesterone with the DHEA-estrogen/testosterone pathway, which promotes menstrual cycle normalization. Another intervention that is relatively mild yet highly effective is the measured administration of low doses of the immediate cortisol precursor, progesterone. Altering the daily dose of readily absorbable progesterone over the course of a cycle can result in the normalizing of estrogen levels, with subsequent normalization of the other menstrual hormones as well. Appropriate hormone levels generally lead to the normalization of menstrual physiology, anatomy, and behavior. This test maps the menstrual cycle to provide a basis for and to monitor hormone therapy. Conditions Assessed Conditions that may be assessed include suspected hormone imbalance, menstrual dysfunction, and possible causes of associated physiological, morphological, and psychological upset. Sequelae include emotional fragility, mood swings, anxiety, panic attacks, premenstrual syndrome (PMS), hot flashes, night sweats, bloating, excessive weight gain or loss, excessively high or low energy, chronic digestive upset, migraine headaches, repeated miscarriage, and infertility. Logical Sequence of Testing The logical sequence of using this test as an initial or as a follow-up test is determined by a variety of individual considerations, including the patient’s chief complaint, the array of signs and symptoms, the chronicity of the condition, the tests previously taken, and the judgment of the practitioner.
