![[personal profile]](https://www.dreamwidth.org/img/silk/identity/user.png){kind=small}
Entry tags:
more info on hormones, labs & testing
[Silly me. I thought I'd just go ahead and order those 2 tests I had decided on, and get it over with, with little ado. But no no no, my mental "am-i-really-sure-this-is-how-i-want-to-proceed" circuit hadn't yet been satisfied enough.]
"Estrogen" is actually an umbrella term for at least 3 hormones: estradiol (E2), estrone (E1), and estriol (E3).
Current Status of Salivary Hormone Analysis - a paper from 2008.
Summary: Although saliva has not yet become a mainstream sample source for hormone analysis, it has proven to be reliable and, in some cases, even superior to other body fluids. Nevertheless much effort will be required for this approach to receive acceptance over the long term, especially by clinicians. Such effort includes the development of specific and standardized analytical tools, the establishment of defined reference intervals, and implementation of round-robin trials. ...
Aetna's Clinical Policy Bulletin: Salivary Hormone Tests - has a lot of good info. Currently Aetna only covers these tests for diagnosing Cushing's syndrome. The bulletin explains why the tests are not covered for conditions such as menopause, osteoporosis, or depression.
..
Monoamine transmitters include catecholamines and tryptamines (serotonin and melatonin).
Catecholamines include epinephrine (adrenaline), norepinephrine (noradrenaline) and dopamine.
"Neurotransmitter tests" are available, which are done via urine samples. There is debate whether these tests are at all useful or not. Some arguments mention that the chemicals being tested are actually produced throughout the body, not only in the brain. For example:
Approximately 90% of the human body's total serotonin is located in the enterochromaffin cells in the alimentary canal (gut), where it is used to regulate intestinal movements
Therefore, the urine levels may not correlate with the levels in a specific part of the body such as the brain.
Neurotransmitters excreted in the urine as biomarkers of nervous system activity: validity and clinical applicability. - a paper from 2010. The conclusion indicates that urine testing has promise, but that more research will be required for its use in relation to CNS (Central Nervous System) issues.
Validity of urinary monoamine assay sales under the "spot baseline urinary neurotransmitter testing marketing model" - paper from 2011. The conclusion states that as of yet, no "original research scientific peer-reviewed paper" has even been published regarding spot baseline urine sample use for neurotransmitter testing, and encourages the companies which are marketing the tests, to publish their research.
Yet the 2009 paper Urinary Neurotransmitter Analysis as a Biomarker for Psychiatric Disorders states "Urinary neurotransmitter analysis has a breadth of data to support its usefulness in clinical practice." and mentions studies going back to the 1950s. A 1986 study that found that depressed subjects with melancholia had high urinary levels of normetanephrine, whereas depressed subjects without melancholia and subjects with dysthymic disorder had levels comparable with controls.
It appears that the *type* of urine test done is significant - using a single small sample versus a sample of all urine produced during the day, or perhaps over multiple days.
Urinary neurotransmitter testing: considerations of spot baseline norepinephrine and epinephrine" - this paper from 2011 states:
"The reported laboratory test results for urinary serotonin, dopamine, norepinephrine, and epinephrine, obtained on different days from the same subjects, differed significantly and were not reproducible.
Spot baseline monoamine assays ... are of no value in decision-making due to this day-to-day variability and lack of reproducibility."
..
Many of the laboratories that provide testing kits indicate that they are "CLIA-certified".
CLIA - "a program which sets standards and issues certificates for clinical laboratory testing".
CLIA website - has more info. This page has links to PDF files which list laboratories that have been convicted of fraud and abuse (etc), and ones which have had their certifications suspended, limited, or revoked, along with the reasons. There's a separate file for each year.
"Estrogen" is actually an umbrella term for at least 3 hormones: estradiol (E2), estrone (E1), and estriol (E3).
Current Status of Salivary Hormone Analysis - a paper from 2008.
Summary: Although saliva has not yet become a mainstream sample source for hormone analysis, it has proven to be reliable and, in some cases, even superior to other body fluids. Nevertheless much effort will be required for this approach to receive acceptance over the long term, especially by clinicians. Such effort includes the development of specific and standardized analytical tools, the establishment of defined reference intervals, and implementation of round-robin trials. ...
Aetna's Clinical Policy Bulletin: Salivary Hormone Tests - has a lot of good info. Currently Aetna only covers these tests for diagnosing Cushing's syndrome. The bulletin explains why the tests are not covered for conditions such as menopause, osteoporosis, or depression.
..
Monoamine transmitters include catecholamines and tryptamines (serotonin and melatonin).
Catecholamines include epinephrine (adrenaline), norepinephrine (noradrenaline) and dopamine.
"Neurotransmitter tests" are available, which are done via urine samples. There is debate whether these tests are at all useful or not. Some arguments mention that the chemicals being tested are actually produced throughout the body, not only in the brain. For example:
Approximately 90% of the human body's total serotonin is located in the enterochromaffin cells in the alimentary canal (gut), where it is used to regulate intestinal movements
Therefore, the urine levels may not correlate with the levels in a specific part of the body such as the brain.
Neurotransmitters excreted in the urine as biomarkers of nervous system activity: validity and clinical applicability. - a paper from 2010. The conclusion indicates that urine testing has promise, but that more research will be required for its use in relation to CNS (Central Nervous System) issues.
Validity of urinary monoamine assay sales under the "spot baseline urinary neurotransmitter testing marketing model" - paper from 2011. The conclusion states that as of yet, no "original research scientific peer-reviewed paper" has even been published regarding spot baseline urine sample use for neurotransmitter testing, and encourages the companies which are marketing the tests, to publish their research.
Yet the 2009 paper Urinary Neurotransmitter Analysis as a Biomarker for Psychiatric Disorders states "Urinary neurotransmitter analysis has a breadth of data to support its usefulness in clinical practice." and mentions studies going back to the 1950s. A 1986 study that found that depressed subjects with melancholia had high urinary levels of normetanephrine, whereas depressed subjects without melancholia and subjects with dysthymic disorder had levels comparable with controls.
It appears that the *type* of urine test done is significant - using a single small sample versus a sample of all urine produced during the day, or perhaps over multiple days.
Urinary neurotransmitter testing: considerations of spot baseline norepinephrine and epinephrine" - this paper from 2011 states:
"The reported laboratory test results for urinary serotonin, dopamine, norepinephrine, and epinephrine, obtained on different days from the same subjects, differed significantly and were not reproducible.
Spot baseline monoamine assays ... are of no value in decision-making due to this day-to-day variability and lack of reproducibility."
..
Many of the laboratories that provide testing kits indicate that they are "CLIA-certified".
CLIA - "a program which sets standards and issues certificates for clinical laboratory testing".
CLIA website - has more info. This page has links to PDF files which list laboratories that have been convicted of fraud and abuse (etc), and ones which have had their certifications suspended, limited, or revoked, along with the reasons. There's a separate file for each year.