We’ve all had routine blood tests—to check our cholesterol levels, blood glucose, thyroid hormone and other important health indicators. But there’s a lot that you could be missing.

To get a fuller picture: Talk to your doctor about blood tests that check levels of hormones that are often overlooked. As chemical messengers that affect virtually every function in your body, these hormones play a crucial role in everything from your immune system and brain health to your sex drive, mood and energy levels.

The problem is, such hormone levels are usually tested only when a problem is suspected. But many integrative-health experts now recommend annual testing (or a schedule recommended by your practitioner) of specific hormone levels for adults over age 30, especially to learn more about…*  

• Cortisol is the King Kong of hormones—levels of all other hormones can be affected, in one way or another, by one’s cortisol levels.

Commonly known as the “stress hormone,” cortisol is released from the adrenal glands in response to psychological and/or physical stress. Constant worrying and rushing through life can raise your cortisol levels. Physical stressors, such as pain and overexercising, also can elevate cortisol.

Over time, high cortisol levels can result in increased blood sugar, decreased or imbalanced immune function, decreased bone formation and impaired memory.

Worse: If cortisol levels remain too high for too long, levels can then drop too low. Symptoms of low cortisol include extreme fatigue, muscle weakness and depression.

• Testosterone plays a critical role in male sexual development and function, but it also promotes brain function and increases muscle mass and energy levels…and it boosts libido in both sexes. Low testosterone in men has been linked to type 2 diabetes, heart disease and higher death rate.

As we age, testosterone naturally drops in men and women. But low testosterone also can be due to such factors as chronic stress and obesity…and the use of certain drugs, including opioid painkillers and corticosteroids (such as prednisone).

Important: Men and women should be sure to get testosterone levels tested before using a testosterone replacement.

Symptoms of low testosterone in men include erectile dysfunction, mood changes, fatigue, insomnia, high blood pressure, low libido, joint aches and pains, loss of body hair and poor concentration. In women, low testosterone can lower mood and libido and reduce muscle mass, bone density and energy.

Note: When practitioners test testosterone levels, they should also test levels of another type of testosterone called dihydrotestosterone (DHT). When elevated, DHT can cause prostate swelling in men and male-pattern baldness, which also can occur in women.

• Estrogen influences sexual development and reproductive and sexual health in both women and men. In women, overly high levels of estrogen may cause estrogen–related cancers, such as endometrial and breast cancers. In men, estrogen levels can elevate too much as they grow older—often as testosterone production declines, particularly with weight gain.

For men, high estrogen is linked to gynecomastia (breast enlargement), weight gain and the development of diabetes. Because high estrogen is usually related to low testosterone in men, they will tend to feel weaker, irritable and weepy.

Especially among women after menopause, low estrogen is very common. It might also be seen in women with very low body fat or certain medical disorders. Over time, low estrogen in women can lead to osteoporosis, heart disease and/or stroke. Symptoms include decreased libido, hot flashes, night sweats, depression, anxiety, memory problems, headaches and fatigue.

• Progesterone is the companion hormone to estrogen. It’s also needed to counterbalance the effects of estrogen. Low progesterone can result from chronic stress, lack of exercise and/or poor diet. Over time, it can contribute to increased risk for heart disease in men and women…and increased risk for uterine fibroids, endometriosis and breast and ovarian cancers in women.

In addition, low progesterone is thought to be related to premenstrual syndrome (PMS) symptoms in women, including painful menstrual cramps. It also may be related to an increased risk for infertility and miscarriage.

Symptoms of low progesterone in women and men include anxiety, depression, insomnia, fatigue, loss of libido and mood swings. Men also may have gynecomastia and erectile dysfunction.

• DHEA (dehydroepiandrosterone) is produced mostly in the adrenal glands and is a building block material that can be used to create estrogen and testosterone. DHEA is important for the immune system, and it plays a role in insulin sensitivity and fat metabolism—both key factors in diabetes.

DHEA levels can fall due to aging or chronic stress. In men and women, symptoms include fatigue, muscle and joint pain, weight gain, trouble sleeping, low libido, poor memory and depression.


Testing for these hormones is one of the best preventive measures people can take, in my opinion, because it can identify the impact that stress may be having on you.

If any of your hormone levels falls outside the “normal” range, talk to your doctor about next steps. Lifestyle changes—especially including stress-management techniques (such as meditation, yoga and/or deep-breathing exercises)…sufficient sleep…and appropriate levels of exercise, which help relieve stress and improve testosterone levels—support hormone health. Note: Excessive exercise often leaves you feeling very tired, and you may get sick more often.

In some cases, however, medical treatment (such as hormone replacement therapy) may be needed. In addition, there are supplements (see below) that can be used to support better hormone balance and levels. To ensure that your health-care provider is knowledgeable about optimizing your hormone profile, consider seeing a naturopathic physician. To find one near you, check The American Association of Naturopathic Physicians, Naturopathic.org.


Even though lifestyle measures, such as those described earlier, are useful, some people may need certain over-the-counter (OTC) supplements that can help support and rebalance hormones.

Before beginning self-treatment, consult your doctor on dosing and to make sure that a supplement you are considering will not interact with a medication or another supplement you may be taking. Supplements that can be useful for…

Cortisol and DHEA: Relora. Helps lower cortisol. And as cortisol decreases, DHEA will start to be restored. It also reduces stress-related carbohydrate cravings.

Ashwagandha. Restores balance in cortisol, whether high or low, as well as supports DHEA and thyroid hormone balance. Caution: It may increase the effects of hypnotics and sedatives (such as barbiturates). Use only with physician approval if you have a thyroid disorder or if you take a blood thinner or antiplatelet drug.

Testosterone: Eurycoma longifolia. Also known as tongkat ali and Malaysian ginseng, this herb helps improve the testosterone-to–cortisol ratio in men and women.

Saw palmetto. Eases symptoms of prostate swelling.

Estrogen: Rhapontic rhubarb. Used for hot flashes and other menopausal symptoms.

Progesterone: Chasteberry. Good for symptoms associated with low progesterone, such as PMS. Caution: Do not use if you are pregnant or breast-feeding, or if you have a hormone-sensitive condition, such as breast cancer or uterine fibroids.

*Normal ranges for these hormones vary depending on a person’s age, sex and the laboratory where the blood samples were tested. 

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