So now you know how testing works, now you might want to know the most common, uncommon reasons for testing, and what symptoms you should be watching for...

Pure Prescriptions, Inc. tests six different hormones - Estradiol, Progesterone, Testosterone, DHEA, Cortisol, and most recently Estriol. You have a choice of testing any of these hormones in any combination.

The term "Estrogen Dominance" is less related to the amount of circulating estrogen and more related to the ratio of estrogen to progesterone in the body. Menopause and PMS are not the result of estrogen deficiency; although, estrogen levels do decline during the latter phases of a woman's reproductive cycle. More relevant is that the estrogen levels drop by approximately 40% at menopause or during periods of stress while progesterone levels plummet by approximately 90% from premenopausal levels. It is the relative loss of progesterone that causes the majority of symptoms termed estrogen dominance. The disproportionate loss of progesterone begins in the latter stages of a woman's reproductive cycle, when the luteal phase of the menstrual cycle begins to malfunction. The malfunction is initiated when the corpus luteum, the primary source of progesterone, begins to lose its functional capacity. By about age 35, many of these follicles fail to develop creating a relative progesterone deficiency. As a result, ovulation does not always occur and progesterone levels steadily decline. It is during this period that a relative progesterone deficiency, or what has become known as Estrogen Dominance, develops.

Typical Symptoms of Estrogen Dominance Include:

•  Irritability/Mood Swings
•  Depression
•  Irregular Periods
•  Heavy Menstrual Bleeding
• Vaginal Dryness
• Water Retention
•  Sleep Disturbance
•  Hot Flashes
•  Headaches
•  Fatigue
•  Short-term Memory Loss
•  Weight Gain

Declining testosterone levels are commonly seen in men beginning in the fourth decade of life. Suboptimal or low testosterone levels in males are often associated with symptoms of aging and are referred to as "Andropause" or male menopause.

Testosterone is an important anabolic hormone in men. It increases energy, prevents fatigue, helps maintain normal sex drive, increases strength of all structural tissues such as skin/bone/muscles; including the heart and prevents depression and mental fatigue. Testosterone deficiency is often associated with symptoms such as night sweats, insulin resistance, erectile dysfunction, low sex drive, decreased mental and physical ability, lower ambition, loss of muscle mass and weight gain in the waist. The primary cause of this increase in girth is visceral fat, not excessive subcutaneous fat (fat under the skin).

The visceral fat cells are the most insulin resistant cells in the human body. As a person ages hormone levels change in favor of insulin resistance. The insulin levels rise while progesterone, growth hormone and testosterone decline. The visceral fat cell begins to collect more fat in the form of triglycerides. A vicious cycle is initiated, which if not interrupted with natural hormone balancing will lead to abdominal obesity, diabetes and high cholesterol levels. This phenomenon is known as "Metabolic Syndrome". In males, metabolic syndrome results in lower testosterone levels, however, in females metabolic syndrome results in high testosterone levels and a phenomenon known as Polycystic Ovarian Syndrome (see below).

Stress management, exercise, proper nutrition, dietary supplements, and androgen replacement therapy have all been shown to raise androgen levels in men and help counter male metabolic syndrome symptoms. The "trick" is to know how much testosterone is required for each individual male. This is where knowing the salivary testosterone levels come into play. Initial salivary testing and following salivary monitoring are crucial for determining the most optimal prescription.

Metabolic Syndrome and Polycystic Ovarian Syndrome (PCOS) in females results in the same visceral fat pattern, insulin resistance and triglyceride formation as in males, however, the female patients with PCOS and metabolic syndrome had high levels of testosterone and often DHEA. This results in a typical symptom pattern seen in women with metabolic syndrome - acne, increased facial and body hair, hair loss on the head, trunkle obesity and infertility. Salivary testosterone and DHEA levels are diagnostic for this syndrome and follow up testing is key for monitoring treatment. It is important to note that women do not need to have their ovaries to have metabolic syndrome. The adrenal glands in women who have a predisposition to metabolic syndrome can produce above normal levels of testosterone and DHEA.

Low levels of DHEA are seen in evolving "Adrenal Gland Fatigue" (hypoadrenia). As acute stress becomes more chronic, the constant demand by the body for adrenal gland hormones begins to wear out the adrenal glands and DHEA and cortisol levels fall. It is for this reason that DHEA is often measured in combination with cortisol levels. Cortisol is a hormone produced by the adrenal glands in response to stress and blood sugar levels. Cortisol secretion has a diurnal rhythm. Normal cortisol levels should be highest one hour after waking in the morning and drop gradually throughout the day. Measuring the diurnal rhythm with 4 cortisol levels throughout the day gives a very accurate measure of adrenal gland function and their ability to cope with stress. Adrenal fatigue occurs in stages. The stage at which a patient is at can be determined by looking at the diurnal cortisol graph and DHEA levels. Symptoms of evolving adrenal gland fatigue include fatigue, sleep issues, inability to cope with stress, anxiety, nervousness, irritability and allergies.

Hypothalamic Pituitary Axis (HPA) Dysregulation is due to chronic stress with the resultant excess cortisol production and down regulation of cortisol receptors in the hypothalamus. In other words the negative feedback loop that normally shuts down the production of ACTH release is blunted and cortisol production by the adrenal glands is uncontrolled. If this continues, hypoadrenia always evolves. The symptoms of HPA and hypoadrenia are essentially identical but salivary testing easily distinguishes the two. This is crucially important as treatment of each can be very different.

Measuring cortisol and DHEA levels will also diagnose complex diseases such as Addison's Disease and Cushing's Syndrome. Addison's disease occurs when the adrenal glands do not produce enough of the hormones cortisol and DHEA. The disease is also called adrenal insufficiency, or hypocortisolism. It has however, no relationship to end stages of "adrenal gland fatigue" described above. The two illnesses have very different mechanisms of action. Most cases of Addison's disease are caused by autoimmune destruction of the adrenal cortex. Symptoms include chronic fatigue, weight loss, loss of appetite, muscle weakness, and hyperpigmentation of the skin.

Cushing's Syndrome results in excessive production of cortisol by the adrenal glands. Symptoms include rapid weight gain of face, trunk and back of neck, hirsutism, depression, anxiety and panic attacks.

To set up an appointment with Dr. Chad Larson to see which hormone test is right for you, please call 1.800.860.9583 to set up a consult time.