If you’re wondering about your estrogen status, or any hormone level imbalances that may be contributing to your current health concerns there are diverse options for testing just as there are a variety of options for treatment.
A thorough history and complete assessment of symptoms can lead a good practitioner down the right track of educated guesses, but when it comes to hormones it is particularly wise to aim before firing so that a tailored, specific treatment plan can be developed for that unique patient. And that’s where testing comes in.
Estrogen can be tested in a few ways using particular body fluids, each of which provides unique elements of understanding for consideration.
Blood or serum estrogen looks specifically at the most active form of estrogen, E2 or estradiol, and gives the total amount of hormone within the blood whether it is free for use by the cells or bound to a carrier protein. Think of the hormone as a person and cells as buildings: free hormones are like pedestrians able to go in and out of the buildings easily, while those bound to transport proteins are like people in a car. Passengers are only potential pedestrians and don’t tell us what is available to the cells (buildings) themselves.
Saliva looks at free hormone levels and therefore tells us what is available to the cells, and that can be a more useful consideration at a clinical level. Some saliva tests also allow for the assessment of E1 (estrone, considered to be the most dangerous estrogen), and E3 (estriol, seen as the most protective estrogen) as well as E2. Looking at these 3 primary forms of estrogen in relation to each other can be invaluable for well-rounded treatment of hormone-related concerns through a ratio called the EQ or estrogen quotient.
Urine testing allows us to see what the body, namely the digestion and detox pathways mentioned in Dr. Christiansen’s article on the estrobolome, are doing with the circulating estrogens. Are they being broken down into protective or dangerous metabolites, and what is the ratio between those various metabolites?
The test that is correct for you, right now, depends on your current health concerns and your short and long-term health goals. Discuss the options with your ND to ensure that the results determined by testing are relevant to your age, stage in life, family history, current symptoms, and ultimate goals for optimal wellness.