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I understand that there are gland-specific hormone tests, such as:
- Secretin: for the pancreas; and
- Prolactin/ACTH: for the pituitary; and
- PTH: for the payathyroid, etc.
However, are there any "composite" blood panels that test the "entire gamut/spectrum" of organs/glands, similar to what composite metabolic panels do for your cell counts?
There are no composite tests that measure all the clinically important hormone producing glands. There are too many hormones produced by too many hormone producing cells/tissues in the body to test for all of them all at once (i.e. in a panel).
For illustrative purposes only… if you go to wikipedia they have a list of all hormones in the human body which is definitely far from complete! But it gives you an indication of just "how many" hormones there are and why testing for all of them is impossible in a panel.
Even with regard only to pancreatic hormones, there are several hormones produced (e.g. insulin, glucagon, somatostatin) that aren't necessarily a marker of the glands overall function (because they are not necessarily involved in the same function). Each of these hormones has different functions even though they are produced by the same gland.
Regardless, from a medical perspective you would never have a reason to test for all of them anyway. If you tested enough of them you'd find at least one of them that would - by chance - be abnormal.
Additionally, if you asked a handful of scientists to name fifty hormones there would be a lot of different hormones on each of their lists. The definition of hormone is vague, and we are learning more about new hormones every day. In the last decade we have learned that bile acids - chemicals predominately produced by the liver that are involved in dietary fat absorption - also act as hormones. There aren't clinical reasons to study all of these molecules just yet, but this demonstrates that it would be impossible to measure all of them all at the same time in one particular "panel".
Insulin in Blood
This test measures the amount of insulin in your blood. Insulin is a hormone that helps move blood sugar, known as glucose, from your bloodstream into your cells. Glucose comes from the foods you eat and drink. It is your body's main source of energy.
Insulin plays a key role in keeping glucose at the right levels. If glucose levels are too high or too low, it can cause serious health problems. Glucose levels that are not normal are known as:
- Hyperglycemia, blood glucose levels that are too high. It happens when your body doesn't make enough insulin. If there's not enough insulin, glucose can't get into your cells. It stays in the bloodstream instead.
- Hypoglycemia, blood glucose levels that are too low. If your body sends too much insulin into the blood, too much glucose will go into your cells. This leaves less in the bloodstream.
Diabetes is the most common cause of abnormal glucose levels. There are two types of diabetes.
- Type 1 Diabetes. If you have type 1 diabetes, your body makes little or no insulin at all. This can cause hyperglycemia.
- Type 2 Diabetes. If you have type 2 diabetes, your body may still be able to make insulin, but the cells in your body don't respond well to insulin and can't easily take up enough glucose from your blood. This is called insulin resistance.
Insulin resistance often develops before type 2 diabetes. At first, insulin resistance causes the body to make extra insulin, to make up for ineffective insulin. Extra insulin in the bloodstream can cause hypoglycemia. But insulin resistance tends to get worse over time. Eventually, it decreases your body's ability to make insulin. As insulin levels drop, blood sugar levels rise. If levels don't return to normal, you may get type 2 diabetes.
Other names: fasting insulin, insulin serum, total and free insulin
Hormone Imbalance Introduction
What Are Hormones?
Hormones are the body’s chemical messengers. They carry vital information to the cells through blood. Typically, hormones affect only certain cells, or target cells, through receptors. They are produced by the endocrine glands and travel through the bloodstream to various tissues and organs. Each hormone has its own specific goal, carrying a key message to certain parts of the body. For example, the pineal gland produces and releases the melatonin hormone. This circulates through the bloodstream and cerebrospinal fluid around the brain where receptors will detect these hormones. Higher melatonin levels signal to the body that it's time for rest.
The body's hormones are essentially responsible for controlling and balancing nearly every major system. Hormones impact your growth and development, control your mood, determine how you'll handle stress, and influence how the body breaks down food. Hormone testing is the best way to determine if your hormone levels are adversely affecting your health.
What are the Different Types of Hormones?
Endocrine glands are located throughout the body. These glands include the:
- Hypothalamus: controls thirst, hunger, sleep, sex drive, moods, body temperature, and the release of other hormones
- Parathyroid: controls calcium
- Thymus: controls the adaptive immune system
- Pancreas: controls blood sugar levels
- Thyroid: controls heart rate and calorie burn
- Adrenal: controls stress and sex drive
- Pituitary: controls growth
- Pineal: controls sleep
- Ovaries, in women: controls female sex hormones
- Testes, in men: controls male sex hormones
There are several different types of hormones in the body. When you have a hormonal imbalance, you may have a problem in one of more of these glands. The specific hormone that's imbalanced will determine the signs and symptoms that you experience as a result. Some of the major hormones found in the body include:
- Estrogen: controls sex drive in both men and women, and regulates the menstrual cycle in women
- Progesterone: influences the body's changes through pregnancy
- Testosterone: controls sex drive in both men and women
- Cortisol: controls stress
- Melatonin: control's the body's circadian rhythm and sleep cycles
- Serotonin: controls sleep cycles, appetite, and mood
- Growth hormone: controls the reproduction of cells and their subsequent growth
- Leptin: controls appetite, signaling when you're full
- Ghrelin: controls appetite, signaling when you're hungry
- Insulin: responds to sugar in the bloodstream
If your hormones are well-balanced, you will thrive. An imbalance, however, is something you cannot afford to ignore.
What is a Hormonal Imbalance?
A hormonal imbalance occurs when your hormones are not produced at the proper levels. You can have many different types of hormonal imbalances. Sometimes, the imbalance means a deficiency in the given hormone while in other times, there might be an overflow. The kind of hormone that is imbalanced will play a major role in determining how the sign and symptoms will manifest and what would be the associated risks involved.
Though there are a few common life transitions that can cause a hormonal imbalance, such as menopause or pregnancy, you can struggle with such a problem at any point in your life. Both men and women can experience hormonal imbalances. Children, adolescents, adults, and the elderly may also find their hormones out of balance.
Because hormones and their functionalities are so varied, there's no one single way to detect a hormonal imbalance. A wide range of issues can indicate that something is amiss with your hormones. This is one of the reasons why your best bet is to get tested occasionally, especially when you start developing uncommon symptoms.
Common Symptoms of a Hormonal Imbalance?
Hormonal imbalances can cause many different symptoms. Some common issues to look out for include:
- Unexplained weight gain or weight loss
- Change in the frequency of bowel movements
- Sensitivity to heat and cold
- Increased or decreased heart rate
- Muscle weakness, tenderness, stiffness, or pain
- Pain, stiffness, and swelling in the joints
- Dry skin or skin rashes
- Thinning hair
- Depression, anxiety, or irritability
- Difficulty concentrating
- Unexplained sweating
- Changes in appetite or thirst
- Changes in heart rate
- A bulge in the neck
- Puffy face
Many symptoms of a hormonal imbalance can be misleading. For example, both weight gain and weight loss can be symptomatic of a hormonal imbalance. So, it's really difficult to just rely on symptoms to understand which specific hormone is the root of the problem. This is when getting tested becomes handy.
If you're having trouble falling asleep, you may have low progesterone levels that are usually in charge of helping you fall asleep. On the other hand, high progesterone levels could be problematic as well, as these will make you feel sleepy even if you're getting enough rest.
Low melatonin gives your body a signal that it's time to rest. Low estrogen can give you night sweats that can be unbearable for many.
If you're struggling with any symptom of a possible hormone imbalance, you need to get tested. Your hormone levels will depict the root cause of the symptoms you are experiencing and, you will be able to target them properly.
Natural Ways to Support Healthy Hormones
While you should always speak to your doctor if you have hormonal imbalance, he might not have to give you any kind of medication to restore the balance. This is particularly true if the imbalance is caused by something like diet or stress. In general, people who have the following criteria are at higher risks of developing hormonal imbalances:
- Being overweight or obese
- Consuming an excessive amount of alcohol
- Being exposed to pesticides and toxins
- Experiencing high stress levels
- Not sleeping enough
Many of these risk factors are easily controlled when you're mindful of your diet, exercise routine, and daily habits. If you quit smoking, moderate your drinking, or avoid exposure to pesticides, you can help reduce your risk factor for hormonal imbalances and naturally keep them moderated.
Changing the way you eat can go a long way towards improving your hormonal balance. For example, when you exchange carbohydrates for healthy fats, like coconut oil and avocado, you can lower your body’s inflammation and help maintain your hormone at the right levels. Consuming enough proteins will help control the ghrelin hormone that makes you feel hungry. This gives you the feeling of fullness and then, you will stop eating at the appropriate time and maintain a healthy weight.
While eating too much soy can lead to an overabundance of estrogen, this same food can be beneficial if you're battling low estrogen levels. Flaxseed and red clover contain phytoestrogens as well. Balancing your need for estrogen with your consumption of it may help you manage minor imbalances naturally, and without the use of medication.
Some people oppose the fact that apoptogenic herbs or essential oils can help you maintain balanced hormone levels. Essential oil therapy may help with various factors that would impact your hormone levels. You can use essential oils to fall asleep better, which will help you ultimately keep your cortisol levels under control. Essential oils may also help you with stress, which is another contributor to high cortisol levels.
Exercise is a great way to naturally manage your hormone levels. Regular physical activity will help you control your insulin levels. It may also help you manage stress as well as battle obesity, which are themselves contributors to imbalanced hormones. When you pick to have a healthy lifestyle, you are bringing your hormones back on tract. However, in some cases, these hormonal imbalances might be due to more severe causes. In that case, your physician might feel obliged to start you on medications.
Testing for a Hormonal Imbalance
There are numerous types of tests for your doctor to choose from in order to detect a hormonal imbalance. Your symptoms will surely put him in the right direction. So, you do need to fully disclose to your doctor about your signs and symptoms for him to order the right hormones to be tested.
A blood test is one of the most common ways to test hormone levels. This test can detect testosterone, estrogen, cortisol, and thyroid levels. You should order a test that's specific to your gender, as a women's hormone test will look for different levels of sex hormones than a men's test. A simple saliva test can detect several types of hormones as well. With a saliva test, you can look at your estradiol, progesterone, and testosterone levels.
If your doctor is concerned about a particular gland in your body, he or she might order an ultrasound. This can be the case of testing the pituitary gland, uterus, testicles, ovaries, and thyroid. An X-ray or MRI will offer further opportunities for imaging. Depending on the results of prior tests, additional types of testing might often be needed to have a better diagnosis. A biopsy of a problematic gland can help your healthcare provider find issues with that specific gland.
A sperm count may provide more information in case a man is worried about having certain symptoms surfacing. Women, on the other hand, might need a pap smear. Lumps, cysts, and other abnormalities in reproductive organs can help your doctor diagnose issues that are impacting your hormone balance, as well as posing a risk on your overall health status.
So, when you have doubts and worries about some symptoms that could be bothering you, your first step would be to test the hormone levels. According to the results, you might need further testing to clearly identify the underlying cause of such an imbalance to pursue the right treatment.
Treatment for a Hormonal Imbalance
There are many different treatment options for hormonal imbalances. The treatment you ultimately be given will depend on which hormone exactly is unbalance as well as the underlying cause of the imbalance. Sometimes, a life event might cause such a fluctuation in your hormones, such as menopause. In that case, your treatment would be short term one. However, if you have a genetic disorder that causes a lifelong hormonal imbalance, you will need to pursue a more prolonged course of medications.
Hormone therapy is a common treatment for hormonal imbalances. Women who are witnessing uncomfortable menopausal symptoms may choose estrogen therapy. Testosterone therapy is a common choice for men with low testosterone levels or adolescents facing delayed puberty. Taking thyroid hormones can help individuals with hypothyroidism. Such hormone replacement therapies may come in the form of pills, patches, or even injections. Your doctor will help you choose the appropriate dosage by checking your hormone levels test results. This is how he will determine the right amount of supplemented hormone you will need to recreate the balance.
There are different types of hormones that might be used for these therapies. Bioidentical hormones are synthesized in a lab. They are chemically identical to those naturally produced by the body. For instance, a chemical extracted from soy or yams is used to create a synthetic hormone that has the same molecular structure as the one found in our body. Though these hormones are manufactured in a lab, they're can be a perfect match to the hormones that you are deficient in.
Bioidentical hormones can be produced by pharmaceutical companies using different doses. Examples include bi-estrogen which is 50 to 80 percent estriol combined with estradiol, or tri-estrogen which is 10 percent estrone, 10 percent estradiol, and 80 percent estriol.
Natural hormones do not come from a lab. They are naturally occurring chemicals that originate from a plant or animal source. While some patients prefer the idea of a hormone that's not synthesized, it's important to understand that natural hormones don't offer the exact match that bioidentical hormones do.
Another kind of replacement hormone is the compounded hormone. These drugs are tailored according to every person’s needs. This way patients get a customized blend of hormones that will provide exactly what they needed. While these offer a custom approach to hormone therapy, they have drawbacks. There is no clinical testing for these compound blends and no dosing consistency with such individualized treatments.
If you suspect having hormonal imbalances then, your best bet would be to address the issue as early as possible. You may be surprised to find out how beneficial a hormone therapy can be for such an issue as fatigue. Understanding your hormone balance can provide you with the first step toward a healthier future.
At Health Testing Centers we make hormone testing easy by allowing you to avoid the hassle of visiting your doctor. We provide hormone testing, including Doctor's oversight, using the same labs that your doctor utilizes. Test results are not a part of your permanent medical record and are securely delivered to you, saving time and money.
Fast, accurate, clear lab results without doctor visit
100% satisfaction guarantee
Private and confidential
Carefully designed by our physicians these panels provide a thorough analysis of your hormonal health, helping identify health concerns before they progress into chronic or life-threatening conditions.
Featured Hormone Tests and Packages
This hormone testing panel for men measures levels of Free and Total Testosterone, DHEA-S and Estradiol.
This hormone testing panel for women measures levels of Free and Total Testosterone, DHEA-S and Total Estrogen.
Measures hormone levels for Free and Total Testosterone, DHEA-S and Estradiol, Sensitive, Estrogen, HGH, IGF-1, SHBG, Parathyroid Hormone, Progesterone, and Pregnenolone.
Measures hormone levels for Free and Total Testosterone, DHEA-S and Estradiol, Estrogen, HGH, IGF-1, SHBG, Parathyroid Hormone, Progesterone, and Pregnenolone.
This Ayumetrix test measures the level of Cortisol in the body throughout the day through 4 saliva samples.
The Female Hormone Replacement Therapy Panel may be used to measure and determine specific hormone levels during hormone replacement therapy.
This Ayumetrix at home test kit may be used to measure the levels of Estradiol (E2), Testosterone, and Progesterone.
This at home saliva test kit may be used to measure 11 different hormones in your body. This kit requires two saliva collections.
This at home saliva test kit may be used to measure 10 different hormones in your body plus 4 separate cortisol levels. This test kit requires four saliva collections.
The Testosterone Replacement Therapy Panel or TRT Panel, may be used to measure and determine specific hormone levels during Testosterone replacement therapy.
Hormone Lab Tests (A-Z)
This test measures the level of 17 Hydroxyprogesterone ( 17-OH Progesterone) in the blood.
The ACTH test measures the levels of the adrenocorticotropic hormone in the body.
This test measures the level of Aldosterone in the blood.
This test measures the level of AMH in the body.
This test measures both ADH and osmolality in the blood. THIS TEST IS AVAILABLE ONLY AT LABCORP.
Measures the level of cortisol to assess for adrenal or pituitary disorders
Measures the level of cortisol in a 24 hour urine sample to assess for adrenal or pituitary disorders.
Measures the level of cortisol at two separate times during the day to assess for adrenal or pituitary disorders
Measures the level of Cortisol through a saliva sample collected within 30 minutes of waking.
This Ayumetrix test measures the level of Cortisol through a saliva sample collected within 30 minutes of waking.
This test measures the level of Cortisol in the body throughout the day through 4 saliva samples.
Measures the level of the steroid DHEA in the body.
Measures the level of the DHEA sulfate hormone to assess adrenal function.
This Ayumetrix test is used to measure the level of the steroid DHEA in the body through a saliva sample.
Measures the level of DHT (Dihydrotestosterone) in the body.
Measures the level of estradiol to help assess fertility.
This Ayumetrix at home test kit is used to measure the level of Estradiol in the body through a saliva sample.
Measures the level of estradiol with increased sensitivity for men and post-menopausal women.
Measures the amount of estrogen hormones to help assess fertility and related issues.
This test is used to measure the level of estrone in the body.
Measures the level of FSH, a hormone that affects reproduction.
Measures FSH and LH to help assess fertility.
Measures the amount of growth hormone to evaluate pituitary function.
Measures IGF-1 to evaluate pituitary function
This test is used to measure IGFBP-3 in the blood.
This test is used to measure the level of leptin in the blood.
Measures luteinizing hormone (LH) to help assess fertility.
Measures the amount of parathyroid hormone and calcium. PTH helps regulate calcium, vitamin D, and phosphorus levels in the blood and bones.
Measures the amount of intact parathyroid hormone to evaluate parathyroid function and abnormal calcium levels.
This test measures the amount of pregnenolone in the blood.
Measures the level of progesterone to help assess fertility.
This Ayumetrix test measures the amount of unbound Progesterone in the body through a saliva sample.
Measures prolactin, a hormone important during pregnancy and while breastfeeding.
PSA test measures the level of prostate-specific antigen (PSA) to evaluate prostate function in men.
Measures the level of freely circulating prostate-specific antigen (PSA) to evaluate prostate function in men age 40 and older
This is a blood test measures the level of serotonin in the blood.
Measures the level of sex hormone-binding globulin.
Measures the amount of freely circulating triiodothyronine (T3) to evaluate thyroid function.
Measures the total amount of triiodothyronine, T3, to evaluate thyroid function.
Measures the amount of free thyroxine (T4) to evaluate thyroid function.
Measures the total level of testosterone, including the small portion circulating freely in the body.
Measures the level of testosterone circulating freely in the body.
This test measures the level of Bioavailable Testosterone (Free and Weakly Bound) along with Total Testosterone levels. AVAILABLE AT QUEST DIAGNOSTICS ONLY.
This test measures the level of Bioavailable Testosterone (Free and Weakly Bound) along with Total Testosterone levels. AVAILABLE AT LABCORP ONLY.
This Ayumetrix at home test kit is used to measure the level of Testosterone in the body through a saliva sample.
This testosterone test measures the total level of testosterone in the body.
Measures the amount of thyroid peroxidase (TPO) antibodies to help understand the cause of thyroid disorders.
Measures the amount of thyroid-stimulating hormone (TSH) to evaluate thyroid function
The Thyroxine Total (T4 total) measures the level of a key thyroid hormone, T4, in the blood.
This TBG test is used to measure the level of Thyroxine-Binding Globulin in the blood to further evaluate thyroid function.
Measures the amount of thyroid-stimulating hormone (TSH) and free thyroxine (T4) to evaluate thyroid function
Hormones and Your Health
Reviewed By: Dr. Kurt Kloss, MD
Last Reviewed Date: Jan 13, 2020
Last Modified Date: Jan 13, 2020
Published Date: Jul 29, 2017
What is a hormonal imbalance?
When the endocrine system is functioning smoothly, its precise and timely release of hormones works to promote optimal health and function. The glands in this system assist in nearly every critical bodily function. So, if there is a problem with one or more glands, hormonal imbalance can occur, causing a variety of problems - some serious. These changes can be detected by a hormone imbalance test, opening the door to treatment that can ease or eliminate hormonal imbalance symptoms.
What is the cause of hormonal imbalance?
Hormonal imbalance causes vary according to the specific hormones involved. However, in general, they are caused by changes in or dysfunction of a hormone-producing gland. For instance, a thyroid gland that isn't functioning correctly may produce too much thyroid hormone, accelerating body metabolism, or too little. Thyroid dysfunction can be caused by autoimmune diseases, thyroid nodules, medications or, rarely, thyroid cancer, among other potential causes. Imbalances in male or female sex hormones, such as estrogen, progesterone and testosterone, can be caused by age-related changes, such as menopause and andropause, as well as genetic disorders, stress, nutritional issues, or medications. Excessive stress, poor diet, aging and certain medications can contribute to imbalances in cortisol and other adrenal hormones.
What is hormonal imbalance in men?
The most common hormonal imbalances in men are related to testosterone levels. Men may experience low levels of testosterone due to disorders, like hypogonadism, a condition in which the testes cannot produce an adequate supply of testosterone. More commonly, aging is the underlying cause, with testosterone production gradually diminishing over time, beginning around age 40. For some men, levels fall so low that the body's basic needs for the hormone cannot be fulfilled, which can lead to many of the symptoms listed above. Other factors that can contribute to low testosterone levels include excessive stress, poor diet, obesity and regular, excessive alcohol use.
What are common symptoms of hormonal imbalance?
Again, that depends to some degree on the specific hormones that are out of balance. That said, here are general symptoms that may be experienced:
- Fatigue – Frequent in all common types of hormonal imbalance.
- Irritability – Common in those affected by imbalances in female, male, and stress hormones.
- Mood swings – common in sex hormone imbalances.
- Weight changes – High levels of thyroid hormones can cause weight loss, while low thyroid levels and imbalances in female hormones, male hormones or stress hormones typically cause weight gain.
- Muscle loss – Most common with male and female sex hormone imbalances.
- Reduced bone density – Thyroid and sex hormone imbalances can cause bone loss.
- Increased sensitivity to heat or cold – Abnormally high levels of thyroid hormones can cause heat intolerance, while low levels can make a person over-sensitive to cold.
- Hot flashes and/or night sweats – Very common with female hormone imbalances as well as low testosterone.
- Sexual disinterest or dysfunction – Most common with male and female sex hormone imbalances.
- Infertility – Can occur with sex hormone disturbances.
- Skin changes – The skin can be affected by all common hormone imbalances. Changes can include severe skin dryness, skin thinning, oily skin and acne outbreaks.
- Hair loss – Often seen with thyroid problems or low testosterone.
- Anxiety/depression – Can occur with all common imbalances.
- Heart rate changes or palpitations – Thyroid dysfunction, sex hormone imbalance and stress hormone imbalance can all cause these symptoms.
- Rising cholesterol levels – Low thyroid hormone levels, low testosterone and estrogen/progesterone imbalances can cause cholesterol levels to rise.
- Memory problems – Can occur in all common hormone imbalances.
- Poor focus/concentration – Common symptom of any hormone imbalance.
How can I balance my hormones?
If you have been diagnosed with a hormonal imbalance, your doctor can advise you on ways of bringing your body back into proper balance. Typical treatments for improved hormonal balance include hormone replacement therapy and lifestyle changes, such as dietary changes, stress management and exercise. In the case of thyroid dysfunction, medications and/or surgical intervention may be necessary to restore health levels of thyroid hormones.
Is there a blood panel lab test that measures all the hormone-producing glands? - Biology
To determine the cause of calcium imbalances to evaluate parathyroid function to diagnose and differentiate between primary, secondary, and tertiary hyperparathyroidism to diagnose hypoparathyroidism during surgery for hyperparathyroidism to confirm removal of the gland(s) causing the problem
When calcium blood levels are higher or lower than normal when you are having surgery for hyperparathyroidism when your healthcare practitioner wants to determine how well your parathyroid glands are functioning
A blood sample drawn from a vein in your arm
Current practices do not require fasting. PTH levels peak during sleep hours and are lowest during mid-morning to late afternoon hours, the period when most samples are drawn. There may be seasonal fluctuations in PTH due to its inverse relationship with vitamin D. Talk to your healthcare practitioner about sample timing.
You may be able to find your test results on your laboratory's website or patient portal. However, you are currently at Lab Tests Online. You may have been directed here by your lab's website in order to provide you with background information about the test(s) you had performed. You will need to return to your lab's website or portal, or contact your healthcare practitioner in order to obtain your test results.
Lab Tests Online is an award-winning patient education website offering information on laboratory tests. The content on the site, which has been reviewed by laboratory scientists and other medical professionals, provides general explanations of what results might mean for each test listed on the site, such as what a high or low value might suggest to your healthcare practitioner about your health or medical condition.
The reference ranges for your tests can be found on your laboratory report. They are typically found to the right of your results.
If you do not have your lab report, consult your healthcare provider or the laboratory that performed the test(s) to obtain the reference range.
Laboratory test results are not meaningful by themselves. Their meaning comes from comparison to reference ranges. Reference ranges are the values expected for a healthy person. They are sometimes called "normal" values. By comparing your test results with reference values, you and your healthcare provider can see if any of your test results fall outside the range of expected values. Values that are outside expected ranges can provide clues to help identify possible conditions or diseases.
While accuracy of laboratory testing has significantly evolved over the past few decades, some lab-to-lab variability can occur due to differences in testing equipment, chemical reagents, and techniques. This is a reason why so few reference ranges are provided on this site. It is important to know that you must use the range supplied by the laboratory that performed your test to evaluate whether your results are "within normal limits."
For more information, please read the article Reference Ranges and What They Mean.
Parathyroid hormone (PTH) helps the body maintain stable levels of calcium in the blood. It is part of a feedback loop that includes calcium, PTH, vitamin D, and, to some extent, phosphorus (phosphate) and magnesium. Conditions and diseases that disrupt this feedback loop can cause inappropriate elevations or decreases in calcium and PTH levels and lead to symptoms of hypercalcemia or hypocalcemia. This test measures the amount of PTH in the blood.
PTH is produced by four button-sized parathyroid glands that are located in the neck behind the thyroid gland. Normally, these glands secrete PTH into the bloodstream in response to low blood calcium levels. The hormone works in three ways to help raise blood calcium levels back to normal (two are direct and one is indirect):
- PTH directly promotes the release of calcium from bones into the bloodstream.
- It directly acts on the kidneys to reduce the elimination of calcium in the urine while promoting the elimination of phosphorus in the urine.
- The indirect effect stimulates the kidneys to convert vitamin D from the inactive to the active form, which in turn increases the absorption of calcium from food in the intestines.
As calcium levels begin to increase in the blood, PTH normally decreases.
Parathyroid hormone itself is composed of 84 amino acids (sometimes called PTH (1-84)). Intact and fragmented hormone is present in and secreted by the parathyroid gland. The intact hormone represents a smaller fraction, but its portion is increased when calcium levels are low and decreased when calcium levels are high.
Once released into the bloodstream, PTH has a very short life span levels fall by half in less than 5 minutes due to uptake and cleavage in the liver and kidneys. The fragments are referred to as C-terminal fragments and are variably sized, missing anywhere from 6 amino acids to more than half the N-terminal portion of the molecule. C-terminal fragments have a longer half-life, exist in much higher concentrations, and are eventually cleared by the kidneys.
Although it was originally thought that the C-terminal fragments were inactive, it now appears that certain fragments may have biologic activities that are able to oppose those of intact PTH.
The so-called intact PTH is the most frequently ordered parathyroid hormone test. It is used to help diagnose the cause of a low or high calcium level and to help distinguish between parathyroid-related and non-parathyroid-related causes. It may also be used to monitor the effectiveness of treatment when an individual has a parathyroid-related condition. PTH is routinely monitored for people with chronic kidney disease or who are on dialysis.
A calcium test is almost always ordered along with a PTH test. It is not just the level in the blood that is important but the balance between calcium and PTH and the response of the parathyroid glands to changing levels of calcium. Usually, healthcare practitioners are concerned about either severe imbalances in calcium regulation that may require medical intervention or persistent imbalances that indicate an underlying problem.
PTH levels can be used to monitor people who have conditions or diseases that cause chronic calcium imbalances or to monitor those who have had surgery or another treatment for a parathyroid tumor.
A PTH test may be ordered when a test for calcium is abnormal. It may be ordered when someone has symptoms associated with increased calcium, such as:
PTH may also be ordered when a person has symptoms associated with decreased calcium, such as:
A healthcare practitioner may order a PTH test along with a calcium test at intervals when someone has been treated for a disease or condition that affects calcium regulation, such as the removal of a parathyroid tumor, or when a person has end-stage renal disease.
Sometimes, an intraoperative PTH test will be ordered when someone who has hyperparathyroidism is undergoing surgery to have abnormal parathyroid tissue removed to ensure removal of all of the abnormal glands, which can occasionally vary in number and location.
A healthcare practitioner will evaluate both calcium and PTH results together to determine whether the levels are appropriate and are in balance as they should be. If both PTH and calcium levels are normal, then it is likely that the body's calcium regulation system is functioning properly.
Low levels of PTH may be due to conditions causing increased calcium or to an abnormality in PTH production causing hypoparathyroidism.
Excess PTH secretion may be due to hyperparathyroidism, which is most frequently caused by a benign parathyroid tumor. In rare cases, it may be caused by cancer.
The table below summarizes results that may be seen:
|Normal||Normal||Calcium regulation system functioning normally|
|Low||High||PTH is responding correctly may run other tests to check for other causes of decreased calcium|
|Low||Normal or Low||PTH not responding correctly probably have hypoparathyroidism and secondary hypocalcemia|
|High||High||Parathyroid gland producing too much PTH may do imaging studies to check for hyperparathyroidism|
|High||Low||PTH is responding correctly may run other tests to check for non-parathyroid-related causes of elevated calcium|
Calcium - PTH Relationship
- If calcium levels are low and PTH levels high, then the parathyroid glands are responding appropriately, producing appropriate amounts of PTH. Depending on the degree of hypocalcemia, a healthcare practitioner may investigate a low calcium level further by measuring vitamin D, phosphorus, and magnesium levels.
- If calcium levels are low and PTH levels are normal or low, then PTH is not responding properly and the person tested probably has hypoparathyroidism. Hypoparathyroidism is a failure of the parathyroid glands to produce sufficient PTH. It may be due to a variety of conditions and may be persistent, progressive, or transient. Causes include an autoimmune disorder, parathyroid damage or removal during surgery, a genetic condition, or a severe illness. Those affected will generally have low PTH levels, low calcium levels, and high phosphorus levels.
- If calcium levels are high and PTH levels are high, then the parathyroid glands are producing inappropriately high amounts of PTH. A healthcare practitioner may order X-rays or other imaging studies to help determine the cause and evaluate the severity of hyperparathyroidism. Hyperparathyroidism is a group of conditions characterized by an overproduction of PTH by the parathyroid glands that is separated into primary, secondary, and tertiary hyperparathyroidism. (See Parathyroid Diseases for more on this.)
- If calcium levels are high and PTH levels are low, then the parathyroid glands are responding properly, but a healthcare practitioner is likely to perform further investigations to check for non-parathyroid-related reasons for the elevated calcium, such as rare mutations in calcium receptors or tumors that secrete a peptide that has PTH-like activity and increases calcium concentration, which in turn decreases PTH.
Currently, the most prevalent assay for PTH is the intact PTH assay, which typically measures the whole molecule (PTH 1-84) and the larger fragments (predominantly PTH 1-74). While this assay is known as the "intact" assay, it measures large fragments that are slightly smaller than the truly intact hormone. There are less common but newer assays that detect only the whole molecule, which has the greatest bioactivity. The "intact" and "whole or bioactive" assays have different reference ranges, but typically their results yield similar interpretations. The effects of fragmentation and disease are still being studied, and there are instances when the two assays may yield a different interpretation.
Drugs that may increase PTH levels include phosphates, anticonvulsants, steroids, isoniazid, lithium, and rifampin.
Parathyroid cancers may be associated with familial hyperparathyroidism and MEN- I syndromes.
Yes, if your calcium level changes slowly, you may not have any noticeable symptoms. In this case, the imbalance will most likely be detected by finding an abnormal calcium level during a regular health check, then checking your PTH level.
If you do not have enough vitamin D, your body will not be able to absorb calcium properly. Vitamin D regulates the intestinal absorption of calcium, while PTH regulates the activation of vitamin D. Too much or too little vitamin D can cause an imbalance in calcium metabolism. During winter months with less sun exposure, especially further from the equator, vitamin D levels are typically lower and PTH levels may therefore be higher. Diet and illness may affect the magnitude of these changes.
An "intraoperative PTH" is a PTH test done on a person while that person is undergoing parathyroid gland surgery. When someone has hyperparathyroidism, the usual treatment is surgery to remove an enlarged parathyroid gland or glands. About 85-90% of the time in primary hyperparathyroidism, only one abnormal parathyroid gland is present, but in the remaining cases (and in secondary and tertiary hyperparathyroidism), two or more of the glands are abnormal.
During surgery, it is important for the surgeon to make sure that all of the abnormal glands have been removed. If all are abnormal, typically three glands are completely removed along with part of the fourth, leaving behind just enough parathyroid tissue to prevent hypoparathyroidism.
One way to be sure that all of the abnormal tissue has been removed is to measure PTH before and after a suspected abnormal gland has been removed. If all of the abnormal tissue is gone, PTH levels will fall by over 50% within 10 minutes. To be useful, this requires that the laboratory be able to provide the test results quickly. This is often called rapid or intraoperative PTH measurement.
Other testing may include:
On This Site
Elsewhere On The Web
Sources Used in Current Review
2017 review completed by Mahesheema Ali, MSc, PhD.
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Is there a blood panel lab test that measures all the hormone-producing glands? - Biology
Hypertension, also known as high blood pressure, is a persistent elevation in blood pressure that puts additional strain on the heart. Over time, it can cause serious damage to the heart as well as other organs, such as the kidneys, brain, and eyes. About 46% of U.S. adults have high blood pressure.
Blood pressure (BP) is the force that blood exerts on the walls of the arteries. It depends on the strength and rate of the heart's contraction as it pumps blood and on the resistance to the flow of blood through the arteries. The amount of resistance depends on the elasticity and diameter of the blood vessels and the volume of blood flowing through them. The narrower the arteries and the more blood pumping through them, the higher the blood pressure will be. Maintaining a healthy lifestyle can help delay or prevent hypertension.
Blood pressure rises and falls during the day depending on a person's level of activity and physical and emotional stress. Largely controlled by the autonomic nervous system (the part of the nervous system that controls involuntary actions), BP is also affected by several different hormones, including angiotensin II, aldosterone and catecholamines.
Measuring BP takes into account two pressures, measured in millimeters of mercury (mm Hg). The first, systolic pressure, is the force exerted on the blood vessel walls when the heart is pumping blood. Diastolic pressure reflects the force present when the heart relaxes between beats. They are written as systolic over diastolic pressure. For instance, a blood pressure of 120/80 mm Hg or 120 over 80 corresponds to a systolic pressure of 120 and a diastolic pressure of 80.
A single measurement of blood pressure is not diagnostic. Typically, multiple readings are taken on different days and, if measurements are consistently high, a diagnosis of high blood pressure is made.
Usually, diastolic pressures will mirror systolic pressures, but as people age, the diastolic pressure tends to level out. Then, the form of hypertension that involves primarily the systolic pressure (called isolated systolic hypertension) becomes more common. In general, the greater the blood pressure for extended periods of time, the greater the potential for damage.
The classifications of blood pressure based on 2017 guidelines developed by the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines are summarized in the table below.
Blood Pressure Classifications
|Category||Systolic mm Hg (top number-force when heart is pumping)||Diastolic mm Hg (bottom number-force when heart is at rest)|
|Normal||Less than 120||and||Less than 80|
|Elevated||120-129||and||Less than 80|
|Hypertension Stage I||130-139||or||80-89|
|Hypertension Stage II||Equal to or greater than 140||or||Equal to or greater than 90|
These categories apply to most adults with no known illness at the time of testing and are based on an average of 2 or more blood pressure readings obtained on 2 or more occasions.
Though the above guidelines are important, they are not the only hypertension guidelines and currently there is no consensus on them. In 2014, experts appointed to the Eighth Joint National Committee (JNC 8) proposed a different set of guidelines and blood pressure goals and some physician groups continue to endorse these recommendations. The table below summarizes the new goals or target blood pressure readings for specific populations:
Blood Pressure Goals
|Category||Systolic and Diastolic blood pressure (mm Hg)|
|General population (older than or equal to 60 years old)||Less than 150/90|
|General population (younger than 60 years old)||Less than 140/90|
|Diabetic||Less than 140/90|
|Non-diabetic chronic kidney disease||Less than 140/90|
Given the significant differences in guidelines, it is important to talk to your healthcare practitioner about the blood pressure goals and treatments or lifestyle changes that best fit your individual situation.
Testing of Separate Body Parts
Because the autonomic nervous system involves almost every part of the body, it may be necessary to check how the autonomic nerves are working in one particular part rather than just the cardiovascular system.
A variety of eye drops might be used to assess the autonomic innervation of the eyes. Tearing of the eyes may be assessed by inserting a thin slip of soft paper at the corner of the eye to see how much moisture the paper absorbs. Bladder function can be assessed by a cisternogram, and the motility of gastrointestinal systems might be assessed by radiographic studies.
We've only described some of the many tests used to assess the autonomic nervous system. The truth is that dysautonomias are commonly under-recognized, and many institutions do not have any more than the basic bedside tests. This may partially be because most dysautonomias are due to problems that also affect other parts of the body in more obvious ways, which then limits the usefulness of further testing. For example, diabetes is a common cause of dysautonomia that is diagnosed by standardized blood tests for diabetes, rather than starting with the autonomic nervous system.
If a problem with the autonomic nervous system is suspected and confirmed, it is likely that more testing will be needed to determine the cause. Rather than trying to just treat the dysautonomic symptoms, addressing the core cause of the illness is the best way to get the autonomic nervous system back in balance.
Why Do I Need a Test?
Though you absorb phosphate in the intestines, it's filtered and removed through your kidneys.
Abnormal phosphate levels -- with symptoms such as bone problems, fatigue and weakness -- may point to a kidney disorder. Your doctor may also want you to get a phosphate test if they suspect:
- Issues with diabetes imbalances, such as Vitamin D or PTH, a hormone that helps balance calcium and phosphorus in your body
Since phosphate works so closely with calcium, doctors also use the test to determine whether your body is getting and using calcium the right way. Issues related to calcium can be a sign of low vitamin D, or they may include:
Adrenal hyperfunction indicates an excess of cortisol and adrenal activity. Adrenal hyperfunction is indicative of a loss of certain mineralcorticoid hormones, and consequently a loss in potassium through the urine. Adrenal hyperfunction can be a primary cause of hypertension (which quite often involves a loss of potassium and an increase in sodium in the blood and cells) as well as anxiety, irritability and headaches.
On a blood test, when potassium levels are decreased (about 4.0 or lower) and sodium is increased (greater than 4.2) and chloride levels are higher than 105, it is a sign of adrenal hyperfunction.
Because there is a loss of potassium from inside the cell, in the blood and in the urine, there is the tendency for metabolic acidosis. Hypertension, metabolic acidosis, adrenal hyperfunction and anxiety are very often seen together because of the chronic loss/deficiency of potassium intracellularly.
If your estradiol or estrone levels are higher than normal, it may be due to:
If your estradiol or estrone levels are lower than normal, it may be due to:
- , a condition that causes a woman's ovaries to stop working before she is 40 years old , a condition in which a woman's sexual characteristics don't develop properly
- An eating disorder, such as anorexia nervosa , a common hormone disorder affecting childbearing women. It is one of the leading causes of female infertility.
If you are pregnant and your estriol levels are lower than normal, it may mean your pregnancy is failing or that there is a chance your baby might have a birth defect. If the test shows a possible birth defect, you will need more testing before a diagnosis can be made.
Higher levels of estriol may mean you will be going into labor soon. Normally, estriol levels go up about four weeks before you start labor.
If you have questions about your results, talk to your health care provider.