(18-03-2015, 07:26 PM)Rihana Wrote: I was going for a blood test to check the hormones ranges but I came to know that days are not the same for all the hormones. So I searched and found some theory but not the exact answer, following is the little bit info:
FSH - Day 3rd of the menstrual cycle?
ESTRADIOL - Day 3rd?
PROGESTERONE - Day 21 or 7 days after ovulation
ANDROGENS - Day 21 approx ?
PROLACTIN , TSH, CORTISOL, FREE T3, FREE T4 - I didn't get any info about these yet!
Please help!
Hi Rihana,
I see what you mean about the different theories. My take is personal preference, meaning the theories from when to collect and why. I'll list what I understand the theories to mean, from that it's your call on the best approach, sorry....that's about the best I can tell yah. (These statements are from different sources). One other thing:
Quote:Many medications—including estrogen, certain types of birth control pills, and large doses of aspirin—can affect total T4 test results and their use should be discussed with the health practitioner prior to testing. In general, free T4 levels are not affected by these medications.
Reference values are dependent on many factors, including patient age, sex, sample population, and test method, and numeric test results can have different meanings in different labs.
Progesterone test may be order when:
Interpretation of progesterone test results depends on the reason for testing and requires knowledge of the point at which a woman is in her menstrual cycle or pregnancy. Progesterone levels usually start to elevate when an egg is released from the ovary, rise for several days, and then either continue to rise with early pregnancy or fall to initiate menstruation.
http://labtestsonline.org/understanding/...e/tab/test
Prolactin testing may be ordered when:
A person has symptoms of a prolactinoma, such as unexplained headaches, visual impairment, and/or unexplained breast nipple discharge
A woman is experiencing infertility or irregular menstrual periods
http://labtestsonline.org/understanding/...n/tab/test
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A day 3 FSH and/or Oestradial test is one which measures the hormones which occur on day 3 of a menstrual cycle. This should fall within certain parameters, and if the result is outside these parameters, then the diagnosis will be poor.
FSH is one of the most important hormones involved in the menstrual cycle, and the main hormone involved in producing eggs. If a test done shows an elevated level of FSH, even when the woman is relatively young, it shows that the body has entered premature menopause and would find it very difficult to conceive a baby.
http://www.mumsnet.com/Talk/conception/a...st-results
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Normally, Day 3 estradiol levels should be low because your ovaries are quiet at this time. Elevated levels of Day 3 estradiol tend to indicate a problem with ovarian reserve. When Day 3 estradiol levels are used to assess ovarian reserve, they are measured in conjunction with the Day 3 FSH level.
By measuring a woman's baseline FSH on day 3 of the cycle (we do it on day 2, 3, or 4), we get an indication as to whether she has normal "ovarian reserve". We are looking at how hard her body needs to "step on the gas" early in the menstrual cycle to get a follicle growing
An elevated basal E2 level (> 100 pg/mL) in the absence of a cyst could be a sign of diminished ovarian reserve. A high E2 level will in turn suppress the FSH level, which will then appear to be falsely “normal”.
FSH is released in a pulsatile manner by the pituitary. There is therefore a wide variation in the basal FSH level from one cycle to another (inter cycle variability). Generally, the highest FSH level is the most predictive of ovarian reserve.
9) An elevated FSH level does predict the chance of pregnancy. However, it does not predict ovarian response to fertility drugs. A patient with a high FSH level may respond normally to ovarian stimulation. Other parameters like antral follicle counts and anti-mullerian hormone (AMH) levels are better predictors of ovarian response.
10) Along with the FSH level, we will usually draw an estradiol (E2) level. Generally, the E2 level should be less than 100 pg/mL. An E2 level can be elevated due to the presence of a cyst. We therefore will do an ultrasound along with blood tests at the time of screening.
http://www.nlm.nih.gov/medlineplus/ency/...003445.htm
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Some practical problems with the day 3 FSH test:
There cut off values used to say that egg quantity is good, OK, or poor is laboratory dependent. For example, and FSH of 11 in one laboratory may reflect good ovarian reserve - whereas a level of 11 in another lab using a different assay may indicate diminished ovarian reserve. See below for more.
What is Estradiol?
Estradiol is the steroid hormone that is produced by the cells lining the ovarian follicles in response to FSH, and the very high levels of estradiol within the leading follicle nourish and mature the egg. Some estradiol reaches the blood to cause the lining of the uterus to grow, the secretion of ovulatory cervical mucus, and to provide feedback to the brain and pituitary that another cohort of follicles has been recruited and is growing. The level of FSH then falls due to negative feedback by estradiol.
Why measure around Day 2?
At this time, estradiol is at its lowest so FSH should be at its highest. If the estradiol level on Day 2 is > 200pmol/l, then follicle growth will have already started, and the measurement of the FSH is not reliable because the raised estradiol will have already started to suppress the FSH level. This commonly happens in older women. From a functional point of view, early follicle growth may mean the endometrium does not have enough time to develop before ovulation occurs, leading to asynchronicity between the egg and the endometrium , and hence a reduced chance of implantation.
Day 21 Progesterone Measurement
The corpus luteum is the gland formed in the ovary from the ovulated follicle(s). It makes progesterone and and estradiol that is secreted in to the blood and causes the lining of the uterus to become secretory. Blood level of progesterone in the middle of the luteal phase > 30nmol/l suggest that the endometrial effect of the progesterone is likely to be sufficient to assist an embryo implanting in the uterus. This progesterone in the blood also feeds back to the pituitary to ensure that little FSH is produced. There is no value in measuring the hormones FSH, LH and E2 at the same time as a Day 21 progesterone because their interpretation is not of any value if the progesterone is raised, as it should be in the mid-luteal phase.
Why Day 21?
This day is chosen on the assumption that the women are having a 26-30 day cycle, and luteal phase is normal and lasts about 10-14 days after ovulation. Thus, assuming ovulation is between Days 12-16 , Day 21 is the middle of the luteal phase when the production of progesterone from the corpus luteum gland peaks in an ovulatory cycle (and if there was then pregnancy, the HCG would prevent the corpus luteum from then dying and it would produce even more progesterone). If ovulation has occurred later than Days 12 – 16, then the progesterone check would be better done a few days later so as to strike the middle of the luteal phase. Conversely, if ovulation has occurred earlier than Day 12, an earlier progesterone test at about Day 18 is required.
Progesterone levels should be interpreted with respect to the number of days before the onset of the next period. Luteal function ( and hence ovulation) cannot be assumed if the period starts < 5 days later or > 9 days after the blood test.
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http://www.fda.gov/MedicalDevices/Produc...126079.htm
An elevated basal E2 level (> 100 pg/mL) in the absence of a cyst could be a sign of diminished ovarian reserve. A high E2 level will in turn suppress the FSH level, which will then appear to be falsely “normal”.
FSH is released in a pulsatile manner by the pituitary. There is therefore a wide variation in the basal FSH level from one cycle to another (inter cycle variability). Generally, the highest FSH level is the most predictive of ovarian reserve.
9) An elevated FSH level does predict the chance of pregnancy. However, it does not predict ovarian response to fertility drugs. A patient with a high FSH level may respond normally to ovarian stimulation. Other parameters like antral follicle counts and anti-mullerian hormone (AMH) levels are better predictors of ovarian response.
10) Along with the FSH level, we will usually draw an estradiol (E2) level. Generally, the E2 level should be less than 100 pg/mL. An E2 level can be elevated due to the presence of a cyst. We therefore will do an ultrasound along with blood tests at the time of screening.
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I like this collection time PDF.
http://www.zrtlab.com/component/docman/d...ons?Itemid=
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http://thyroid.about.com/od/gettestedand...htests.htm
2. Test for Free T3 and T4 - One thing that is seldom included when TSH blood levels are tested is the free T4 and T3 blood level test. This should always be included when testing for thyroid dysfunction, in order to receive a complete and accurate thyroid profile.
3. Test the Following at the Same Time:
Adrenal Levels
Cortisol Levels
DHEA Levels
DHEA to Cortisol Ratio
Saliva Cortisol Testing should also be included in order for your doctor to gain insight into your diurnal (daily) output of cortisol.
4. Test Adrenal and Thyroid Levels at the Same Time - It’s important to remember that having high levels of cortisol could block the effects of the thyroid hormone in your body and it could be a major contributing factor to the inability of your thyroid to make and secrete optimal levels of thyroid hormone. Because of this, testing of your adrenal and thyroid levels should be done at the same time.
5. Take Vitamin and Mineral Supplements w/Adaptogens – these have shown remarkable results in helping to lower cortisol levels and improve other effects of stress on body tissues (including brain function). Whenever stress response is a contributing factor, these nutrients should be used as part of your overall health management strategy.
6. Add in Thyroid Support Supplements – can bolster thyroid function and improve the conversion of T4 to T3 (T3 is the most active form of thyroid hormone). This thyroid supplement combination could be the only supplement needed when TSH levels are between 2 to 4 mU/L. When TSH levels are above 4mU/L, you will most likely need thyroid hormone replacement (ideally, dessicated thyroid).
If your thyroid levels are such that you require prescribed thyroid replacement therapy, additional thyroid support supplements will help your prescribed medication to work better. It’s important to speak with your holistic or naturopathic health professional about taking this in conjunction with your existing prescribed replacement therapy, as it can make a big difference in your health and wellbeing.
http://www.meschinohealth.com/ArticleDir...ort_Part_2
