What Blood Tests to Order for your Hormones

When going to your doctor to request blood hormone panels, you may be met with some resistance. From my experience, doctors do not like to order labs that are of no use. Meaning, if you don’t have a symptom and are simply curious of our levels, they are going to be less inclined to test.

But what if you DO have symptoms (click here for a hypothyroid symptoms checklist) and your doc DOES order labs, but they come back “NORMAL”? Now there is the issue. We’ve researched the important lab values you may want to consider taking to your doc so you both can see what is going on and why. Let’s first start with your thyroid.

Thyroid Hormone Tests to get Tested

The thyroid system is really kind of the idle of our engine, if you want to think of it that way, like if you pull up to a stop sign in your car and it’s idling there. If the idle is too low, then the car’s going to be shaking and it’s not going to run correctly, but if the idle is too high, the life of the engine is going to be shorter. It’s going to burn itself out more quickly. So it’s important to know where we are running. Here is the list of blood markers to request for your thyroid:

Total t3 / t4 (tells us how much the gland is producing)

Free t3 / t4 (tells us the conversion of the bound hormone into useable free hormone)

TSH (thyroid stimulating hormone: Anything >1 is hypothyroid, but if it’s <1 doesn’t mean you don’t have hypothyroidism. Value can fluctuate due to acute and chronic stress, infection, blood sugar, excessive T4 medication)

Reverse t3 (inactive form of T3 that inhibits T3 function)

TBG (thyroxine binding globulin)

TPOAb (thyroid peroxidase antibody: <35 IU/mL)

TGAb (thyroglobulin antibody: <20IU/mL)

CRP and/or IL-6 (cytokines that are produced by immune cells – will tell us if you have an inflammatory condition or infection)

Deciphering your Thyroid Test Results

=> If TSH is high and  free t3 / t4 are normal, the doctor will right you off as having nothing wrong. If this is the case, hand them this study: https://www.ncbi.nlm.nih.gov/pubmed/16148345  to discuss optimal ranges of TSH and what a value higher than 2.5 means!

=> If Total t3 / t4 are normal, but free t3 / t4 are low, then something outside the thyroid gland is happening. Inflammation and stress can impair that conversion. On top of that, poor gut health can impair it as well because 20% of T4 is converted into T3 in the gut. Healthy gut microbes can convert inactive T4 into T3 sulfate, which can then be recovered as active T3 by an enzyme called intestinal sulfatase. If you aren’t converting T4 to T3, then inflammation from food and environment should be your first place to look. A great resource for this information is the “Adrenal Thyroid Revolution.”

=> your antibodies (TGAb and TPOAb) are high, then unfortunately you have Hashimotos. Be aware that your doctor will likely right you off as having an autoimmune condition forever and that there is no scientific proof that diet and lifestyle changes can make a difference in your outcome. This is ENTIRELY untrue because there most definitely is scientific proof that diet and lifestyle changes MAY lower antibodies and reverse the condition. If you are diagnosed with Hashimotos, please arm yourself with books and resources – the Hashimotos Protocol is one of my favorites.

Next let’s look to see what your adrenal and sex hormones are up to.

Sex Hormones and Adrenal Hormones to get Tested

Total and Free Testosterone

Estrogen (test should be taken day 3 of cycle)

Progesterone (test should be taken 7 days post ovulation – if possible)

Prolactin (women only – values above 10-12ng/mL could cause lack of ovulation)

DHEA (click here to know more)

SHBG (is increased by thyroid hormone and estrogen levels – click here to know more)

Cortisol (4 point salivary cortisol test to examine the absolute values and rhythm across the day)

Insulin (fasting insulin should be <5 microIU/mL otherwise possibly insulin resistant)

Hemoglobin A1c (high levels indicate insulin resistance)

Vitamin D (low levels are associated with hypothyroidism and inflammation)

B12 (could mean an inability to absorb Vit B12)

Alt and ast  (liver enzymes that will indicate overtraining / excessive protein breakdown)

Ferritin (low levels could indicate hair loss and iron deficiency)

Deciphering your Sex and Adrenal Hormone Test Results

Some of the most common results you may see as a woman include:

=> high estrogen / low progesterone – this may be referred to as estrogen dominance and typically means you have a high recirculating level of estrogens that can’t be cleared from your body. If you have been on hormonal birth control for several years or exposed to a high level of xenoestrogens, a liver detox along with addressing the motility of your digestion is key here. A great resource for balancing your progesterone levels is “Period Repair Manual” and “The Hormone Cure.”

=> high testosterone / low estrogen / low progesterone – if you have high androgens along with lack of ovulation, we would consider PCOS to be at work here. If you also have high insulin and fasting blood glucose you will want to work on decreasing simple carbs in your diet, eating every 3-4 hrs and never skipping meals, lifting weights on a regular basis, and decreasing caffeine and stress. A great resource for PCOS is called “8 Steps to Restore Your PCOS.”

=>high and/or low cortisol – depending on your to exposure to stress and cortisol, you could be experiencing stage 1,2 or 3 of adrenal fatigue. A great resource for explaining adrenal fatigue and correcting it is called “The Cortisol Connection.”

Remember this about Getting your Hormones Tested

In the end, hormones are changing on a daily and even hourly basis, so remember that these values are simply snapshots in time. Do your best to research on your own so when you work with a doctor (we recommend you find and naturapath or integrative medicine doctor) you can be a champion and CEO of your own health. Let us know if you have any questions!


  1. “Thyroid+Tests.” Dr. Westin Childs | Thyroid & Health Supplements That Work, www.restartmed.com/?s=thyroid%2Btests.
  2. “Hormone Testing” Dr. Westin Childs | Thyroid & Health Supplements That Work, www.restartmed.com/?s=thyroid%2Btests.
  3. “SHBG” Dr. Westin Childs | Thyroid & Health Supplements That Work, www.restartmed.com/?s=thyroid%2Btests.
  4. “High DHEA levels” Dr. Westin Childs | Thyroid & Health Supplements That Work, www.restartmed.com/?s=thyroid%2Btests.

1 thought on “What Blood Tests to Order for your Hormones”

  1. What do you know about hormones, such as (no) libido? I’m 44 and I’ve had a TON of tests done because I have no ”desire.” My physician says all my tests including testosterone, estrogen etc are normal and I’m not premenopausal. Now what?
    Thanks, Brandi

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