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Discover Essential Insights with specialized hormone testing

© 2016 Genova Diagnosticse,mp,essence_trifold,031016

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11-Deoxycortisol

Corticosterone

PregnanediolPregnanetriol

THS

a-THF

THF

THE

2-MeO

(E1+E2)2-O

H (E1+E2)

16a-OH

(E1)

4-OH

(E1+E2)4-M

eO (E1+E2)

Etiocholanolone

Androsterone

Androstanediol

11β-OH

-Androstenedione

Adrenosterone

11-OH

-Androsterone

11-OH

-Etiocholanolone

11-Keto-A

ndrosterone11-K

eto-Etiocholanolone

Cholesterol

Pregnenolone

Progesterone17-O

H-Progesterone

17-OH

-Pregnenolone

Androstenedione

DH

EAA

ndrostenediol

Estrone (E1)

Estriol (E3)

Estradiol (E2)

DH

T

Testosterone

Aldosterone*

Cortisol

Cortisone

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SexHormones

Thyroid

Adrenals

Sex Hormone Assessment Imbalances in estrogen, progesterone and testosterone are common in patients with peri/menopausal or andropausal symptoms, and are associated with a host of sex-hormone related issues. Risk is also increased for systemic problems such as osteoporosis, heart disease and dyslipidemia, immune dysfunction, and hormone-dependent cancers.

Assessment of sex steroid metabolism provides insight into the body’s ability to optimally process endogenous sex hormones as well as bioidentical hormone therapy. Key metabolite ratios can help the clinician identify potential areas of concern in hormone production and metabolism that can impact the risk for hormone-related disease.

Sex hormones move through the body’s steroidogenic pathways (graphic, back page) depending on the optimal functioning of numerous key enzymes. These enzymes are impacted by a variety of factors – drugs, foods, supplements, disease states – that can either up-regulate or down-regulate their activity.

Targeting the endocrine system to identify imbalances that create symptoms in pa-tients may be an important first clinical consideration. Genova Diagnostics offers a variety of hormone testing profiles that examine core components of the endocrine system – adrenal, thyroid and sex hormone function. Ultimately, a diagnostic approach that supports better understanding of the interrelationship of these components translates into more effective therapeutic interventions.

The Endocrine Pyramid

Thyroid Assessment While thyroid hormone production is centrally regulated (hypothalamus-pituitary-thyroid or HPT axis), thyroxine (T4) from the thyroid gland is peripherally transformed in liver and kidney cells into its active T3 form and reverse T3 (rT3). Thyroid symptoms may occur due to problems with peripheral conversion (reflected by T3 and rT3 levels) and/or with immune system interference in the form of auto-antibodies (reflected by anti-thyroglobulin and anti-thyroidal peroxidase antibodies).

Adrenal assessment is useful in suspected thyroid dysfunction, as stress (via cortisol production) has been shown to inhibit TSH secretion, render target tissues less sensitive, and inhibit the conversion of T4 to T3.

Adrenal Assessment The adrenal glands provide a critical foundation for developing and maintaining overall health & well-being. This is increasingly evident in research demonstrating the negative health effects of chronic stress and sustained elevation of cortisol levels.

Imbalances in the adrenal hormones, cortisol and DHEA, can adversely affect:

• Mood

• Sleep

• Immune Defense

• Thyroid Function

• Weight Control

• Resistance to Stress

• Energy

• Cardiovascular Health

The adrenal glands provide a critical foundation for

developing and maintaining overall health & well-being

Thyroid dysfunction may occur even when the HPT

axis is operating adequately

Assessing the metabolism of sex hormones and

steroidogenic precursors gives insight into underlying

hormonal imbalances that can affect a wide range of

body functions

ASHEVILLE • ATLANTA • LONDON 800.522.4762 • www.gdx.net

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Adrenal Dysfunction• Feeling tired for no reason• Having trouble waking, even with reasonable sleep• Feeling rundown or overwhelmed• Experiencing difficulty bouncing back from stress or illness• Feeling more alert and energetic in the evening

Mood Imbalance• Having little interest or pleasure in usual everyday activites• Noticing significant weight loss or weight gain• Feeling loss of energy• Experiencing fuzzy thinking

Thyroid Dysfunction• Changes in energy or mood• Unexplained weight loss or weight gain• Hair loss, dry skin, and/or brittle nails• Menstrual irregularities

Sex Hormone Imbalance• Having insomnia• Experiencing memory problems• Feeling lethargic• Having reduced sex drive

Patients often present with a variety of common complaints that may have hormone imbalance as their root cause. Genova Diagnostics provides diagnostic tools that support the busy practitioner across an array of clinical issues and symptoms, such as:

Why choose hormone testing?

What sample type should I use?Serum• Highly sensitive evaluation for primarily bound circulating hormones• Quick, in-office collection• Single sample• Excellent evaluation for bioidentical oral HT• Well represented in the medical peer-reviewed literature

Saliva• Highly sensitive evaluation for unbound ( free, bioavailable) hormones• Convenient, at-home collection• Single sample or sequential samples collected throughout the day or month• Optimal method to evaluate diurnal patterns of cortisol and melatonin• Evaluates for cycle abnormalities• Good baseline evaluation of primary sex hormones

Urine• Highly sensitive evaluation for unbound (free, bioavailable) hormones and their metabolites• Convenient, at-home collection• 24-hour for patients on HT or First Morning Void (FMV) collection • Evaluates the balance of primary sex hormones (estrogens, progesterone, and testosterone)• Provides a robust evaluation of sex hormone metabolites• Excellent for assessing hormone baseline levels and for monitoring any form of bioidentical HT

BIOMARKERSSALIVARY HORMONES URINARY HORMONES SERUM HORMONES

Adrenocortex™ Menopause™ * Menopause Check Plus™

Menopause Plus™ *

One Day HormorneCheck™ *

Rhythm Plus™ * Rhythm™ * Male Hormones Plus™

Comprehensive Melatonin Profile *

Cortisol, Salivary

Complete Hormones™ *

Essential Estrogens™ FMV/24Hr

Estrogen Metabolism Assessment

Estronex® Profile *

Hormonal Health™

Male Hormonal Health™ *

Estrogen Metabolism Assessment

ComprehensiveThyroid Assessment ‡

11-Hydroxy-androsterone

11-Hydroxy-etiocholanolone

11-Keto-androsterone

11-Keto-etiocholanolone

2-Hydroxyestrone + 2-Hydroxyestradiol [2-OH(E1+E2)] also reported separately

16α-Hydroxyestrone (16α-OH E1)

4-Hydroxyestrone + 4-Hydroxyestradiol [4-OH(E1+E2)] 4-OHE1 only

2-Methoxyestrone + 2-Methoxyestradiol [2MeO(E1+E2) 2-MeOE1 only

4-Methoxyestrone + 4-Methoxyestradiol [4MeO(E1+E2)] 4-MeOE1 only

Anabolic/Catabolic Balance

E/A: 5β/5α Ratio

2-OH (E1+E2) / 16α-OHE1

2-OH (E1+E2) / 2-MeO (E1+E2) 2-OHE1 / 2-MeOE1

Anti-TG

Anti-TPO

Androstanediol

Androsterone

Cortisol +

Creatinine

Dihydrotestosterone (DHT)

DHEA

Estradiol (E2)

Estriol (E3)

Estrone (E1)

Estrone Sulfate

Etiocholanolone

Free T3 +

Free T4

Insulin-Like Growth Factor 1 (IGF-1)

Melatonin

Progesterone

Pregnanediol

Pregnanetriol

Prostate Specific Antigen (PSA)

Reverse T3*

Sex Hormone Binding Globulin (SHBG)

Testosterone

Tetrahydrocortisol, THF

Tetrahydrocortisone, THE

Tetrahydrodeoxycortisol

allo-Tetrahydrocortisol, a-THF

TSH

Add-On Androstenedione

Add-on Bone Resorption

Add-On Follicle Stimulating Hormone

Add-On Luteinizing Hormone

Add-On Prolactin

Add-On Vitamin D

* NOT AVAILABLE IN NEW YORK

+ Add-On for this test only