General Information About Hormones

Hormones are messengers, which are central to the body's functions and determine how people feel physically and emotionally. Optimal hormone levels and proper hormonal balance are necessary to maintain health. Hormones impact virtually every major system and organ in the body.

With increasing age, hormone levels begin to drop. This decrease, which plays an important role in the aging process, can at times interfere with muscle development, skin health, sexual function, sleep patterns, and cognitive as well as emotional processes, thereby reducing the overall sense of well being. Hormone imbalances have been associated with heart disease, sexual dysfunction, osteoporosis, behavioral and neurodegenerative disorders, certain types of cancer and other serious health conditions.

When hormone levels are insufficient or out-of-balance, health problems can result. Often, these health problems are minor in nature, but over time may become serious, debilitating and occasionally life threatening. Monitoring hormone levels via saliva assays can determine if reported symptoms are associated with hormonal imbalances or a specific hormone deficiency.

Successful and timely identification of hormonal imbalances may result in necessary lifestyle modifications, guide hormone therapies, and can play a significant role in diagnostic and therapeutic decision making processes.

Androstenedione --A building block for Testosterone playing an important role in tissue repair an growth.

This precursor of Testosterone plays a vital role in accelerating tissue growth and repair. Secreted by the testis, ovary, and adrenal cortex, it is of weaker biological potency than Testosterone. Androstenedione has become popular among athletes for its beneficial effects on tissue resilience and its role in the conversion of adipose tissue to muscle. Recently, the FDA has regulated Androstenedione as a controlled substance.

As the precursor of Testosterone, Androstenedione helps boost and maintain Testosterone levels. This is of significance in men approaching middle age, whose natural production decreases as a function of the aging process, resulting in low energy and fatigue, loss of muscle mass and bone density, depressed mood and reduced sex drive.

Cortisol -- Cortisol plays an important role in the immune system response and the response to stress.

The secretion of Cortisol is pulsatile, and its production follows a characteristic circadian rhythm, with a peak level in the early morning followed by a steady decline to reach the lowest level by midnight. Cortisol plays a vital role during times of stress. Proper Cortisol balance enables the organism to tolerate the daily challenges of life, and an adequate Cortisol response is essential for survival. Cortisol exhibits powerful anti-inflammatory effects and is involved in protein-, fat- and carbohydrate metabolism as well as the response to acute and chronic stress. If the adrenal glands are not working properly, Cortisol production will be affected. Lack of Cortisol can lead to fatigue, allergies and arthritis. Conversely, excess Cortisol has a catabolic effect on the body, causing breakdown of bone and muscle and, if persisting over a period of time, may even lead to fatigue, general weakness, and emotional problems.

Cortisol is central to many physiologic processes, and chronic Cortisol imbalance has been associated with weight gain, muscle and joint pain, insomnia and premature aging. Salivary Cortisol measurement reflects the free or bioavailable Cortisol concentration in plasma and offers a convenient way to assess a patient’s corticoid status or the efficacy of various forms of therapeutic corticoid substitution36.

DHEA/DHEA-S -- A building block for hormones and closely associated with aging.

DHEA is a hormone closely associated with aging, peaking at approximately age 25. Thereafter, circulating DHEA levels decrease by as much as 95% around the age of 85 years. This gradual decline in DHEA levels coincides with a decline of the immune system’s ability to resist sickness and age-related diseases.

The full scope of DHEA’s effects is the subject of on-going investigation. It has been established that an important function of DHEA is to balance the effects of Cortisol11, which improves the body’s ability to cope with stress. Various diseases such as cardiovascular disease, AIDS, autoimmune diseases, Alzheimer’s dementia, thyroid disease and diabetes have been associated with low circulating DHEA levels. It has been suggested that increasing DHEA levels via exercise, meditation, proper diet and DHEA supplementation may ameliorate certain health conditions linked to low DHEA levels. It may prove beneficial to evaluate the levels of DHEA and Cortisol in conjunction, as both hormones exhibit a similar diurnal rhythm and operate in concert. While the DHEA t-1/2 is 30 minutes, DHEAS has a half-life (t-1/2) of several hours and exhibits significantly less variation, making it a useful biochemical marker.

DHEA-S’ ease of measurement and the above mentioned absence of short term fluctuations provide a reliable means for evaluating abnormal adrenal androgen secretion and aid in the differential diagnosis of chronic adrenal hyperfunction.

While DHEA and DHEA-S are biologically less active than the other androgens, DHEA-S is the most abundant derivative of adrenal androgen secretion. DHEA has been shown to exhibit anti-proliferative and anti-mutagenic effects, and several in vivo studies have confirmed DHEA as an anti-cancerogenic and anti-obesity agent.

A decrease in DHEA-S indicates an increased risk for coronary artery disease and adult men with high plasma DHEA-S levels are less likely to die of cardio vascular disease. DHEA has anti-inflammatory properties and has been shown to lower the levels of interleukin-6 and tumor necrosis factor alpha. This may explain the neuroprotective function of DHEA and DHEA-S in Alzheimer’s disease.

DHEA-S may be an important factor in labor induction and in some women, peri-menopause related changes in Estradiol may interact with low levels of DHEA to increase their risk of developing depression. DHEA-S levels have been significantly and inversely associated with depressed mood in older, postmenopausal women.

Dihydrotestosterone (DHT). -- A highly active form of testosterone that plays an important role in the development of various prostate disorders.

DHT is an end-point hormone that is derived exclusively from testosterone. As such, it cannot be converted to any of the more beneficial hormones. Excess DHT, like excess estradiol, appears to stimulate abnormal tissue proliferation in prostate and breast tissue. Testosterone is converted to DHT by the action of an enzyme called 5-alpha-reductase. A high level of this enzyme results in a higher level of conversion, and consequently, in increased growth of prostate tissue.

For men with BPH or Prostate Cancer, and women with Breast Cancer, it is important to keep DHT levels within their normal range.

Estrogens -- A common designation for Estradiol, Estrone and Estriol as a group.

The estrogens are a group of hormones synthesized by the reproductive organs, adrenal glands and adipose tissue in females and, in lesser quantities, in males. Estrogens are involved in the onset of ovulation and cause the thickening of the uterine lining and vaginal mucosa during a woman’s menstrual cycle. Estrogens are responsible for the female secondary sex characteristics and affect various other tissues including adipose tissue, the pelvic musculature, skin, blood vessels and bone.

The major estrogen secreted by the ovaries is 17 ß-Estradiol, which is converted to estrone. Estriol is the principal estrogen formed by the placenta during pregnancy. These three compounds, 17 ß-Estradiol, estrone, and estriol, account for most of the estrogenic activity in humans.

All estrogen hormones (17 ß-Estradiol, estrone and estriol) occupy the same estrogen receptor sites. 17 ß-Estradiol is the most potent and is converted to the weaker estrone, which in turn converts to estriol. Estrogens work in concert with progesterone to nourish and support the growth and regeneration of the female reproductive tissues as well as impart the characteristic female growth of breasts and distribution of body fat.

17 ß-Estradiol (Estradiol) -- Estradiol is the most potent human estrogenic hormone.

17 ß-Estradiol is produced in the ovaries, testes, placenta, adipose tissue and the adrenal cortex. 17 ß-Estradiol maintains the size and density of breast tissue and has a positive effect on skin thickness, collagen, water content, skin softness, and blood flow to the skin. It is also essential for bone formation.

In women, excessive levels may be associated with an ovarian or adrenal tumor. Low levels may indicate reduced function of the ovaries or pituitary gland as in menopause, anorexia nervosa or Turner's syndrome. In pregnant women, levels of 17 ß-Estradiol that are lower than expected may indicate an ectopic pregnancy.

In men, excessive levels may be associated with a tumor of the testes or adrenal glands. If the amount of 17 ß-Estradiol compared to testosterone increases, men can experience weight gain, enlarged breasts (gynecomastia), decreased libido, and many of the symptoms typically associated with low testosterone levels.

In both men and women, high levels of 17 ß-Estradiol can indicate cirrhosis, a serious disease of the liver.

Estriol -- Estriol plays a significant role in female reproductive health.

Estriol, a relatively weak estrogenic hormone, is a metabolite of 17 ß- Estradiol as well as Estrone, and constitutes the main estrogen secreted by the placenta during pregnancy. Estriol has been described as the estrogen most beneficial to the vagina and cervical tissue.

Together with progesterone, it is produced in large quantities during pregnancy and is the estrogen typically found in the urine of pregnant women. Estriol is the major estrogen produced in the normal human fetus. It is believed to be the safest of the three estrogens with regard to any potential carcinogenic effects. Research has demonstrated that women with breast cancer often exhibit reduced excretion of estriol.

It’s conversion from 17 ß- Estradiol and Estrone occurs mainly in the liver. Therefore, hepatic insufficiency can manifest itself, among other symptoms, in the form of reduced Estriol levels.


Estrone -- Estrone is an estrogenic hormone found in the body as a metabolite of Androstenedione and 17 ß-Estradiol.

Estrone mimics the effects of 17 ß-Estradiol, although it is less potent. In premenopausal women, 50% of Estrone is made by the ovaries and the remainder is biosynthesized from androstenedione in the adrenal glands and other organs. With the onset of menopause, Estrone replaces 17 ß-Estradiol as the major circulating estrogen. At that stage, most of the Estrone is made by the adrenal glands, and the normal ratio of Estrone to Estriol increases. Since adipose tissue constitutes another site of Estrone production, excess weight can significantly increase your Estrone level.

Because 17 ß-Estradiol and Androstenedione are both precursors to Estrone, the levels of these hormones should be checked when excessive or low levels of Estrone are detected.

Melatonin -- Melatonin is important in the regulation of many body rhythms, particularly those that effect the sleep cycle. These are known as circadian rhythms, and they regulate production of other hormones and control several biological functions.  

Supplemental melatonin can help to reset (synchronize) the body's circadian clock to and help support proper sleep cycles.  However, it usually takes a few weeks of use before its effects are felt.  Melatonin should only be taken at night before bedtime.  

Progesterone -- Progesterone is an important part of optimal health and well-being for men and women.

Progesterone is an important precursor hormone (building block) in the steroid biosynthesis pathway.

Progesterone affects tubal motility, the endometrium, uterine vasculature and parturition. In premenopausal women, Progesterone is produced in large amounts by the ovaries during the second half of the menstrual cycle and induces the cyclical changes in the uterine lining that allow implantation of the fertilized egg. Inadequate production of progesterone during this time is frequently coupled with excess estrogen, leading to estrogen dominance and its associated symptoms like infertility, PMS, mood swings, abdominal cramps and water retention.

Significantly increased Progesterone levels are observed in women with hydatidiform mole and pregnancies complicated by Rh isoimmunization, whereas Progesterone concentrations are lower in women with ectopic pregnancy and Progesterone deficiency from blighted ova.

In postmenopausal women, it has been suggested that the appropriate balance between Progesterone and the estrogens provides an optimal hormonal milieu, which may reduce the risk of cardiovascular disease, osteoporosis and other ailments.

Salivary Progesterone measurements accurately reflect serum levels of the free, bioavailable Progesterone fraction, and constitute an attractive diagnostic alternative for luteal phase insufficiency, long-term assessment of irregular cycles10, and various other conditions.

Estrogen dominance in men has been implicated as a significant factor in male breast cancer and prostatic disease including prostate cancer. The sharp rise in the incidence of these cancers appears to be closely linked to exposure to endocrine disruptors with estrogenic properties. In this context, Progesterone plays an important role in maintaining hormonal balance and health in men.

Testosterone -- An important hormone involved in musculoskeletal development, general health and libido.

Testosterone is an androgen, synthesized in greatest quantities in the testis, but also in the ovary and the adrenal cortex. In addition it may be produced in non-glandular tissues from precursors such as Androstenedione.

Less than 4% of circulating Testosterone is free and therefore bioavailable, as it remains unbound to serum proteins. While measurement of total Testosterone is usually considered satisfactory for most diagnoses, salivary Testosterone, which reflects the bioavailable fraction, offers a diagnostic advantage. Testosterone is secreted in bursts of approximately 1 pulse per hour. It exhibits a diurnal variation in adult men, with the highest concentration in the early morning, followed by a decrease throughout the day, reaching the lowest concentration during the onset of sleep.

In women, up to 50% of Testosterone production arises from peripheral conversion of Androstenedione to Testosterone, whereas 25% is secreted by the ovaries and 25% by the adrenal glands. As significantly elevated Testosterone may be indicative of an androgen producing tumor, measuring Testosterone, in particular bioavailable Testosterone, is an important test to rule out ovarian tumors. Excess Testosterone has undesirable side effects like acne, hirsutism, baldness and deepening of the voice. Measuring Testosterone levels in saliva represents a valuable tool for the assessment of these complaints.

In men, Testosterone accounts for the male secondary sex characteristics such as greater musculature, lower voice, and male hair growth patterns on face and body. Measurement of salivary Testosterone is a non-invasive and sensitive method for the serial monitoring of gonadal function in prepubertal and adolescent boys. As men approach middle age, they might suffer from Testosterone deficiency, which contributes to symptoms like fatigue, loss of muscle mass, depressed mood44 and low sex drive.

In both genders, Testosterone is essential for the proper development of bones and muscles, and plays an important role in libido and general health. Testosterone decreases with age and research regarding its effects on aging has demonstrated a gain in lean body mass and a possible decline in bone loss when used by elderly patients.

Luteinizing Hormone (LH) and Follicle Stimulating Hormone (FSH) - these hormones are produced by the pituitary gland.  They control the ovaries and ovulation in a female, and stimulate cells in the testicles to produce testosterone in a man.

In both men and women, this process is a closed loop negative feedback system with  FSH and LH acting together to control the levels of other hormones.  The pituitary detects circulating hormone levels, and LH and FSH secretion are adjusted as needed to maintain hormone balance. High or low levels of FSH or LH can indicate testicular failure in men and premature or missing menopause in women along with other conditions.