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Hormone Panels
Estradiol
Estriol
Estrone
Progesterone
Testosterone
DHEA
Cortisol
Melatonin

     
TESTOSTERONE

Testosterone is an anabolic steroid synthesized primarily by the testes in males, the ovaries in females, and adrenal glands in both sexes. Testosterone is synthesized from androstenedione, a product of dehydroepiandrosterone (DHEA) and progesterone, both of which are products of pregnenolone and cholesterol.

At puberty, and throughout most of the reproductive years, approximately 10-20 times more testosterone is synthesized in males than in females. In males at puberty, the much higher level of testosterone is responsible for the development of male external genitalia and secondary hair patterns, stimulation of spermatogenesis, stimulation of anabolic activity leading to increased muscle mass, and behavioral changes. In pubescent females, testosterone effects are more subtle but equally important for proper musculo-skeletal development, general anabolic activity, and libido. In both sexes, testosterone enhances aerobic metabolism and increases protein synthesis.

Testosterone decreases with age in both men and women. Testosterone replacement has been used to treat some postmenopausal symptoms, especially lack of libido in women who have received chemotherapy. It has also been used effectively in the treatment of anemia and the weakness and muscle wasting syndrome associated with AIDS. Recent research on the effects of testosterone on aging demonstrates a gain in lean body mass and a possible decline in bone loss when used in elderly patients.

Since testosterone can have significant side effects (acne, hirsutism, deepening voice, and clitorimegaly) measurement of levels can help define a deficiency and allow titration of therapy without risking toxicity.

Interpretation of Results

There is significant diurnal variation in testosterone levels in both men and women. It is important to note the time of day clinical samples are collected.

Salivary testosterone represents the unbound serum fraction, therefore levels are lower than serum levels. Patients using transdermal testosterone creams may have very high salivary testosterone levels.

Age and Sex Specific Ranges for Testosterone in Saliva
(Unsupplemented A.M. Ranges in pg/ml)
Age Female Range Male Range
20 - 29 17 - 52 42 - 145
30 - 39 15 - 44 53 - 114
40 - 49 13 - 37 41 - 104
50 - 59 12 - 34 36 - 96
60 - 69 12 - 35 32 - 86
70 - 79 11 - 34 31 - 81
80 +


Male Hormone Panel
The Male Hormone Panel measures testosterone, di-hydro-testosterone (DHT) and DHEA. It is recommended for males of all ages with concerns of: low libido, hair loss, fatigue, loss of muscle mass, depression, prostate trouble, acne. For men supplementing testosterone, it is advisable that estradiol be monitored, as excess conversion of testosterone to estradiol in males has been linked to prostate cancer.

Menopause Panel - Basic
The Menopause Profile measures Estradiol, Progesterone, Testosterone, and DHEA. The Menopause Profile is recommended for peri or postmenopausal women experiencing hormone-related problems, including: mood changes, hot flashes, heavy menses, weight gain, low libido, insomnia, headaches, fatigue, bone loss, hair loss, or difficulty concentrating.

Menopause Panel - Extended
The Menopause Panel - Extended measures Estrone, Estradiol, Estriol, Progesterone, Testosterone, and DHEA. It is the same as the Menopausal-Basic Panel, plus Estriol, and Estrone. The Menopause Panel - Extended is recommended for peri and post menopausal women that are currently using estriol or estrone (Hormone Replacement Therapy). This test can also be used to monitor breast cancer risk. Several epidemiological studies have shown that women who have an increased amount of estriol in relation to estradiol and estrone, have a decreased risk of developing breast cancer.

Cycling Female Panel - Extended
The Cycling Female Panel - Extended measures Estradiol and Progesterone five times over a one month period, and Testosterone. Test results are reported graphically so peaks and depressions can be easily identified. The Cycling Female Panel - Extended is designed to uncover more complex problems associated with hormone imbalance among cycling females.

References

  1. Zumoff B, Strain GW, Miller LK, Roser W: 24 hour mean plasma testosterone concentration declines with age in normal premenopausal women, J Clin Endocrinol Metab 1995 April;80(4):1429-30
  2. Tennekoon KH, Karunanayake EH: Serum FSH, LH, and testosterone concentrations in fertile men: effect of age, Int J Fertil 1993 March-April;38(2):108-112
  3. Rabkin JG, Rabkin R, and Wagner G: Testosterone replacement therapy in HIV illness, Gen Hosp Psychiatry 1995 Jan; 17(1):37-42
  4. Dorfman RI, Shipley RA: Androgens, John Wiley and Sons Inc. New York 1959:116-118
  5. Dabbs JM, Salivary testosterone measurements: Collecting, storing and mailing saliva samples, Physiology & Behavior 1990;49:815-187
  6. Johnson SG, Joplin GF, Burrin JM: Direct Assay for Testosterone in Saliva: Relationship with a Direct Serum Free Testosterone Assay. Clin Chim Acta 1987;163:309-318
  7. Dabbs JM: Salivary Testosterone Measurements: Reliability Across Hours, Days, and Weeks. Physiol Behav 1990;48:83-86
  8. Dabbs JM, Hargrove MF: Age, Testosterone and Behavior Amone Female Prison Inmates. Psychosom Med 1997;5:477-480