Written by: Jillian Foglesong Stabile MD, FAAFP, DABOM

Hormones are chemical signals that control the operations of almost all of the systems in your body. These vitally important chemicals are made in various endocrine glands that are located throughout the body. When hormones are imbalanced, it can significantly impact your health. If you've recently gotten your hormones tested or are considering doing so, you may be wondering how to interpret your hormone test results.

Understanding Hormone Test Results

Hormones can be tested by a variety of methods and are done for a variety of reasons. The most common reasons that hormones are tested are to screen for abnormalities, to determine if symptoms you are experiencing are related to a specific diagnosis, or to follow the effects of treatments.[1]

While blood levels are the most common way that hormone levels are measured, some hormones can be measured through saliva testing or either dried or liquid urine testing. Both of these tests are generally considered to be reliable for measuring a wide range of hormones.[2,3]

Thyroid Hormones

Thyroid hormones include thyroid stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3), thyroid peroxidase antibody, and thyroglobulin antibody, among others.[4] These hormones are made in both the thyroid gland as well as the hypothalamus and pituitary gland. Thyroid hormones are most commonly measured to diagnose thyroid disease or to monitor treatment in people with hypothyroidism or hyperthyroidism.

Normal ranges for thyroid hormones can vary by the lab and the methods used, but generally, the normal reference ranges are described below.[5]

Parathyroid Hormone

Parathyroid hormone is responsible for calcium and phosphate metabolism. Like thyroid hormone levels, the reference ranges can vary from lab to lab, but the normal range for intact parathyroid hormone levels is usually around 15 to 65 pg/mL.[6] Parathyroid hormone levels are often checked in response to abnormalities in calcium or phosphorus levels in the blood. Parathyroid hormone levels are also most useful when interpreted in combination with calcium and phosphorus levels when evaluating for abnormalities.

Reproductive Hormones

There are several reproductive hormones that can be checked to evaluate various health problems. Some of these include estrogen, progesterone, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and testosterone.

Estrogen and progesterone are traditionally thought of as female hormones. These are higher in people who are female or assigned female at birth (AFAB). Estrogen and progesterone are produced in both the testicles and ovaries. [7,8]

FSH and LH levels

Testosterone is also produced in both the ovaries and testicles. These levels are usually higher in men and people assigned male at birth (AMAB). Testosterone may be protein-bound or free.[9]

Average levels of reproductive hormones can vary by time of day and by phase of the menstrual cycle. This makes these levels much harder to interpret. The reference ranges for some of these hormones are listed below.[10-15]

Adrenal Hormones

The adrenal hormones most commonly tested are adrenocorticotropic hormone (ACTH) and cortisol. These hormones influence your metabolic response, blood pressure, blood sugars, inflammation levels, sleep-wake cycles, and how your body responds to stress.[16] The normal range for these hormones is as follows [17,18]:

• ACTH – 10-60 pg/mL
• Cortisol 3-20 mcg/dL

The levels of these hormones can vary by time of day.

Common Hormonal Imbalances and What They Indicate

If your results are out of range, you may wonder what health conditions this could indicate. Hormone testing can check for several common hormonal imbalances. The best way to determine whether your abnormal hormone levels could be contributing to your symptoms or other health concerns is to discuss them with a healthcare provider.

Thyroid Problems

Thyroid hormone abnormalities can indicate several problems. TSH levels that are too high indicate hypothyroidism, while low TSH levels suggest hyperthyroidism.[19,20] T3 and T4 levels may be elevated, low, or normal in thyroid disease. Abnormal thyroid peroxidase or thyroglobulin antibody levels can indicate autoimmune thyroid diseases such as Graves' disease or Hashimoto's' disease.[21]

Thyroid Function Chart

Thyroid disease can cause a number of symptoms, including [19,20]:

• Mood changes
• Fatigue
• Weakness
• Palpitations
• Swelling in the neck (goiter)
• Changes to hair or skin
• Voice changes
• Swelling in the face or legs
• Difficulty getting or staying pregnant
• Menstrual abnormalities
• Memory problems
• Bulging of eyes
• Bowel changes
• Feeling too hot or too cold most of the time

Thyroid diseases can make you feel unwell and can affect multiple aspects of your life.

Reproductive Hormone Problems

Reproductive hormone levels that are out of range can indicate a few different hormone abnormalities.

Polycystic ovarian syndrome (PCOS) is a condition that can cause irregular periods or difficulty conceiving. With PCOS, androgen hormone levels such as testosterone and DHEA-S can be elevated leading to abnormal facial and body hair.[22]

Menopause is another common cause of hormone imbalances. With menopause, the estrogen and progesterone levels will frequently be low while the FSH and LH levels rise.[23]

Menopause can cause hot flashes, mood swings, and vaginal dryness, but not everyone has symptoms.

Adrenal Problems

Adrenal hormone abnormalities may indicate one of several conditions [24]:

• Adrenal insufficiency or Addison's disease is associated with low cortisol and aldosterone levels
• Adrenal gland suppression is another form of adrenal insufficiency that is more common in people who have been on synthetic steroid hormones chronically
• Cushing syndrome is associated with high levels of cortisol
• Adrenal tumors
• Disorders of the adrenal hormones can cause several symptoms, including [24]:
• Central obesity with thin arms and legs
• Elevated blood pressure
• Elevated blood sugars
• Easy bruising
• Decreased energy levels
• Stretch marks
• Electrolyte abnormalities
• Weakness
• Confusion

Adrenal hormone levels can vary based on overall health status as well as the time of day they were drawn. For this reason, it is best to interpret the blood test results for hormones with the help of a healthcare provider.

Next Steps After Receiving Your Test Results

Once you've received your results, you may wonder what to do next. As previously mentioned, many of these hormone tests are best interpreted with the assistance of a healthcare provider.

Hormone imbalances can cause a wide variety of symptoms, and you may be able to mediate some of these symptoms with lifestyle changes including [25]:

• Managing your chronic health conditions
• Exercising regularly
• Maintaining a healthy balanced diet
• Managing your stress levels
• Maintaining a healthy weigh
• Getting adequate amounts of quality sleep
• Avoiding or minimizing alcohol use
• Stopping (or not starting) smoking
• Seeing your healthcare provider regularly for preventative health maintenance

What about supplements that support hormone health? Before starting any supplement, it's important to check with your healthcare provider. Supplements are generally not regulated by the Food and Drug Administration, so while many are safe for use, there is often not much scientific evidence to support their use.

Learn About Your Hormone Health With Everlywell

An imbalance in your hormones can have a significant impact on your life, and many hormone imbalances have symptoms that overlap with other conditions and diseases. If you are concerned about hormone imbalances, consider the Women's Health Test from Everlywell. This test, for women and people AFAB (assigned female at birth), will evaluate key female reproductive hormones such as progesterone, estrogen, and cortisol. We also offer a Men's Health Test for men and people AMAB (assigned male at birth).

Understanding hormone imbalances and hormone health often requires the benefit of a healthcare provider. At Everlywell, we're more than just an at-home lab testing company. If you're looking for more guidance on your hormone health, you can schedule a virtual visit with our certified healthcare providers. At Everlywell, we offer guidance on your schedule.

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