Best Practices for Specimen Collection - Hormone Supplementation

 Lylen Ferris, ND | October 29, 2024

When testing hormones via saliva or urine, it is essential to follow best practices to ensure the collected sample will provide results that reflect the patient’s physiology. When patients test while using hormone therapies, collection becomes a bit more nuanced. To ensure results that reflect tissue response to hormone therapies, correct dosage intervals must be adhered to. 

Enclosed in every collection kit is a 2- sided survey where patients can fill out symptoms and current hormone supplementation. While the symptom survey page is entirely optional, the supplementation survey alerts the lab to implement supplementation ranges (when applicable) for salivary hormone reports and adding additional information about pre-menopausal ranges in supplementing post-menopausal women (when applicable) for HuMap reports.  

Reviewing the hormone supplementation survey with your patients before collection can help them fill out the survey properly. This article will review that section to ensure understanding.  

Section 1 of the survey gathers information on what hormones are in use, and how they are administered (i.e. oral, cream, patch, sublingual, IM, etc.). The header looks like this: 


Conjugated Estrogens - This refers primarily to Premarin (conjugated equine estrogen). It is not referring to bioidentical estradiol or Bi-Est. 

Estradiol + Progestin - This column refers to birth control pills, contraceptive rings, or conventional hormone replacement therapy that includes an estrogen and a progestin (synthetic progestogen). If you are taking bioidentical progesterone and estradiol, please do not mark this column. 

Progestin only - This column refers to contraceptive options that are progestin only, i.e. hormonal IUDs, Depo injections, or the Opill. If you are taking bioidentical progesterone, do not mark this column. 

Estrone (E1) - Rarely prescribed, estrone is a component of Tri-Est formulations. 

Estradiol (E2) - This refers to bioidentical estradiol, one component of Bi-Est. This is usually administered in patches or creams, but is sometimes given orally, in pellet form, or via vaginal suppository. 

Estriol (E3) - A component of Bi-Est. Typically given in a cream, vaginal suppository, or rarely a pill. 

Progesterone (P4) - Mark this column if you take bioidentical progesterone. Progesterone can be administered orally, sublingually, or in a cream. If you are getting a synthetic progestin in a birth control pill, or you use an IUD, do not mark this column. 

Testosterone (T) - If you take testosterone of any kind (oral, patch, cream, pellet or injection), mark it here. 

DHEA - Fill in if you are using DHEA or 7-keto DHEA. 

Corticosteroid - Glucocorticoid medications like hydrocortisone, Prednisone, Dexamethasone, etc. are noted here, as are hydrocortisone creams used for skin conditions. Asthma inhalers can contain corticosteroids, and rarely lip balm. 

Pregnenolone - Any pregnenolone containing product should be noted here. 

Thyroid - If you take T4, T3, or glandular thyroid, please make note of it here. 

Melatonin - Any melatonin containing product can be noted in this column. 

The Doctor’s Data Clinical Education team has created handouts that providers can share with their patients to ensure best practices when collecting saliva and urine. These handouts are archived on the Doctor’s Data website in the News and Knowledge/Materials and Resources section and are also linked here for your convenience.  


 
 
 

Elevating Patient Care: Mastering the Nuances of BHRT

Presented by Ruth Hobson, ND

November 13, 2024 at 12 PM Pacific

Session is approximately 60 minutes with Q&A

As integrative practitioners, we understand that hormone prescribing is not a one-size-fits-all approach. The complexity of individualized medicine can be challenging, which is why a strong foundation in laboratory assessment and hormone knowledge is essential for ensuring your patients' success.

In this webinar, Dr. Ruth Hobson will delve into the intricacies of hormone prescribing, covering topics such as BHRT, dosage adjustments, and so much more.

Learning Objectives:

  • Summarize nomenclature used to describe hormone therapies
  • Discuss common options for hormone replacement therapy, including trademarked and compounded options.
  • Describe advantages and disadvantages of various routes of administration (i.e. oral, topical, injectable).
  • Review what the current research says about HRT and health outcomes.
  • Discuss best practices for specimen collection to capture the true picture of a patient's response to hormone therapy.
  • Create treatment plans based on salivary hormone testing of males and females.
 
 

Nutritional Considerations from a Microbiome Perspective

Presented by Jeannie Gorman, MS, CCN

November 14, 2024 at 9 AM Pacific

Session is approximately 60 minutes with Q&A

Your gut microbiome is a dense and complex assembly of organisms - both friendly and unfriendly. The benefits of eliminating dysbiosis and maintaining the right balance of gut bacteria include: improved digestion, cardiometabolic, immune and metabolism function, reduced inflammation, improved cognition and mood. With so many therapeutic diets in circulation, how can the patient's diet influence their overall condition within the context of their microbiome health?

Learning Objectives:

  • Recognize the critical dietary needs of the gut microbiome
  • Analyze popular diets to objectively assess key dietary elements
  • Evaluate the influence of diet through the lens of objective gut microbiome markers
  • Gain a clear understanding of the Doctor's Data GI360™ profile in practice to optimize clinical outcomes
  • Describe how this knowledge can be used to develop precision-based targeted microbiome therapies and nutritional strategies for optimal gut health.

Presented in partnership with Rupa Health


 

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Long-Term Effects of Hormone Therapy on Ovarian Cancer Incidence and Mortality: Insights from the WHI Trials | 06/25/2024

Estrogen Metabolism and Prostate Health: Treatment Approaches for Functional Medicine Providers | 05/28/2024

ACOG Modernizes its Perspective on Menopausal Hormone Therapy and Breast Cancer | 04/30/2024

Targeting Estrogen Metabolism and the Gut Microbiome to Support Endometriosis | 03/26/2024

New Testosterone Trial in Men (TRAVERSE) Promising for Cardiovascular Health | 02/29/2024

The Microbial World of the Breast: Exploring Its Distinctive Terrain in Wellness and Illness | 01/30/2024

Serum Steroid Hormone Testing Enough Evidence to Challenge the Status Quo? | 01/04/2024

Feeding the Microbiome for Optimal Health - Got Beans? | 11/28/2023

Clearing up common misconceptions about transdermal hormones and how to monitor therapy | 10/31/2023

Strategies to Modulate the Aromatase Enzyme | 9/26/2023


FDA Approves First Oral Postpartum Depression Treatment Targeting GABA-A Receptors | 8/30/2023

Opill: The First FDA Approved OTC Birth Control Pill | 8/1/2023

16-OH E1 A Key Player in Bone Density | 6/26/2023

How Plants Support Estrogen Metabolism | 5/30/2023

What's the Link Between Bone Health and Hormones? | 4/25/2023

A Gut Microbiome Alternative to Injectables for Weight Loss | 3/28/2023

Acne Vulgaris in Adult Women: Clinical Understanding Through an Altered Androgenic Lens | 2/28/2023

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Disclaimer: All information given about health conditions, treatment, products, and dosages are for educational purposes only and do not constitute medical advice.

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