Which Hormones You Should Get Tested If You Have Acne & By Which Methods


Last week I talked about why you should get your hormones tested if you have acne. This time I promised you I’d tell you which ones to get tested and by which methods.

So first of all, let’s talk about the main hormones that are useful to know about if you have acne.

They are:

  1. Progesterone
  2. Estrogen (specifically estradiol)
  3. Testosterone
  4. DHEAS
  5. DHT
  6. Cortisol
  7. Luteinizing Hormone (LH)
  8. Prolactin
  9. Insulin

Why You Want to Test These Hormones If You Have Acne

Progesterone that is too low compared to estrogen (or progesterone that is normal with estrogen that is too high) is a very common issue that can lead to acne as it increases androgen activity in the skin. This ramps up acne production.

A low progesterone to estrogen ratio is a clue that an estrogen dominance type treatment & supplement plan will work better for you.

Testosterone, DHEAS, and DHT are androgens and these can directly lead to acne, so one or all of them being high is something to look out for.

High androgens are a clue that an androgen based treatment & supplement plan will work better for you.

Note: Androstenedione is also an androgen that frequently shows up as high for women with acne, although androstenedione seems to almost always be high when found alongside a low estrogen/progesterone ratio and is likely caused by this imbalance. That means this kind of acne responds better to an estrogen dominance type treatment than an androgen based treatment.

Cortisol (your stress hormone) levels are useful to know to determine if stress is a big root cause of your acne.

Luteinizing hormone (LH) and prolactin are useful for knowing whether or not you should take certain herbs as treatment. In particular, Vitex chasteberry should not be used if your LH is high but good if your prolactin is high.

Insulin resistance can be a root cause of androgen based acne, so particularly if you have high testosterone or are diagnosed with PCOS, getting your insulin tested can definitely be useful.

Testing Your Hormones with Blood Testing

The most common testing method for hormones is serum blood testing. This is what you can get done through your regular doctor.

Blood tests measure what’s called bound hormone — it’s attached in the blood to SHBG (sex hormone binding globulin). When a hormone is bound, it can’t be used at a tissue’s receptor site. But hormones acting on receptor sites in tissue are what actually create symptoms.

So in essence, it is not a very good reflection of what is actually causing you symptoms.

Time and time again, I hear from women who clearly have a gamut of hormonal symptoms and a blood test that says everything is completely normal. Which is obviously not true.

However, blood testing can be useful for some things. Testosterone tends to be better tested through blood. And blood testing is where you’re going to find out about your LH and LSH and prolactin.

So if you can get a blood test from your doctor, then great. Do it.

But I don’t think it gives the full picture. So I’d also recommend getting a saliva or urine test done.

Testing Your Hormones with Saliva Testing

Saliva testing tests more of the free, unbound hormone that is available to your tissue’s receptor sites. This means it more accurately reflects your symptoms.

Saliva tests generally test all the hormones I mentioned above, except for LH, prolactin, and insulin.

The bad news is that regular doctors don’t do it and it needs to be paid for privately through a lab or natural practitioner of some sort. They usually go for around $150.

The kits can be mailed to you wherever you live, as long as you can send them back via courier with two day shipping.

It’s also easy to do — just spit in some test tubes.

Testing Your Hormones with Urine Testing

Urine testing is like saliva testing, except it usually tests more hormones.

It may also be slightly more accurate especially if collected over a 24 hour period, and is more stable if it’s a dried urine test (which means better if you live internationally and need to mail it back in — you have more time).

But, it’s also more expensive. And you also need to do it through a natural practitioner who offers it.

An example of this is the DUTCH test. This is a great test. If you can afford it and can find someone who does it and knows how to interpret it for acne patterns, then I’d recommend this.

For the most part though, a basic saliva test that tests the hormones I listed will do a great job. I find myself recommending this the most.

Getting Your Insulin Tested

If you wanted to see if you were insulin resistant, you would get this done through your regular doctor with a test called “Fasting Glucose Level”.

However, doctors can often be living with tunnel vision, and they may be resistant to letting you do it unless you are overweight, have been diagnosed with PCOS, or have a history of diabetes in your family.

If you have good reason to believe your acne might be tied to blood sugar levels, then push to get the test done. If not, keeping your blood sugar levels stable is a great acne strategy regardless.

Other Things to Be Aware Of with Testing Hormones for Acne

Note that getting your hormones tested when you’re on hormonal birth control is pretty useless. The synthetic hormones in it completely suppress and override your natural hormones.

Since hormone testing tests your natural hormones, it will likely say everything is low across the board and not give you anything too useful.

Another thing to note with saliva or urine testing is that it is very important to have someone who understands acne and the testing to help you interpret them. It’s pretty useless to get back a test, have no idea what it means or what to do with the info, and have your money be wasted.

Ideally the natural practitioner who you run it through will know how acne works and give you some good advice.

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