Hormone Testing at Home
A do-it-yourself guide
by Douglas Kalman MS, RD

Over the years, we've had such luminaries as Dan Duchaine and Brock Strasser describe how to make "home brew" versions of drugs and/or supplements. Without doubt, many people have followed the gospel and attempted to make their own GHB, Finiplex formulations, meal replacement shakes and even creatine candies. With all this pioneering, do-it-yourself spirit floating around, why not skip the doctor's office and test your hormone levels at home as well?

If your goal is to reach or exceed your potential when it comes to lifting and altering body composition, knowing your Testosterone and growth hormone levels can be valuable information. As we're beginning to learn, these numbers can even say a lot about our general health and well being.

After I asked TC his opinion on fabric patterns, he politely advised me to engage in a series of hormone tests. This article reflects what I learned along the way. I'll tell you what home testing of hormones can offer, why you should consider it and how to implement the testing if you choose to do so.

The old method of checking your T

By now, you're most likely familiar with the traditional method of determining Testosterone. This involves going to your physician, having blood taken and evaluated for Testosterone, free Testosterone or bioavailable Testosterone. The blood tests for the male hormone are rather simple to do and easily taken. Prior to having your blood tested, it's important to know the differences between T, free T and bioavailable T.

Testosterone ? The big T is secreted directly by the testes and indirectly via androstenedione by both the adrenal gland or peripheral conversion. It's the most potent of the androgenic hormones and the most reliable to correlate with hormone assay tests. Testosterone in the blood is largely bound to sex hormone binding globulin (SHBG) and to albumin. 98% of Testosterone is bound, while only 2% are free. Testosterone is decreased in primary and secondary hypogonadism (increased and decreased luteinizing hormone, respectively.) The normal male adult has between 260 to 1000 ng/dl Testosterone circulating in the blood.

Free Testosterone ? Free T is the small amount of Testosterone circulating that's unbound. Since blood Testosterone levels are dependent upon many factors, measuring free Testosterone levels more accurately assesses the level of bioactive Testosterone. It's a sensitive test, especially for women who suffer from mild hyperandrogenicity. Normal values for the adult male are 50 to 210 pg/ml or 1 to 2.7% free.

Bioavailable Testosterone ? Since 98% of circulating Testosterone is bound to SHBG, albumin and corticosteroid-binding globulin and 2% is considered unbound or free, the bioavailable portion is that which is free and loosely bound to albumin. Many medical conditions and medications can affect certain portions of Testosterone, thus testing bioavailable Testosterone in certain conditions gives a more accurate reading of "male power." Normal values in the male adult are 66 to 417 ng/dl or 12.3 to 63%.

Since many of us don't want to bother with going to a physician in order to have our hormonal levels tested, noninvasive methods are gaining favor amongst both adult males and even some doctors. However, it's important to have a complete physical and blood workup, especially if you're suffering from mild to moderate depression, sudden weight gain, loss of libido or other such conditions. An interesting note is that many physicians who'll prescribe Testosterone replacement will do so when they measure your total Testosterone and find it to be below 400 ng/dl.

Uh, please spit into this vial

A few years back, Great Smokies Diagnostic Laboratory in North Carolina introduced salivary testing for hormones. Since then, many laboratory companies and pharmacies have also embraced this method of hormone testing. Many studies have validated its use and the list of physicians and coaches who now employ this method of monitoring both athletic fitness and health is ever growing. This simple hormone evaluation can even allow you to monitor if your over-the-counter hormone replacement program is having its desired effect. For example, if you're using Androsol, checking your T levels may be one more way to mark its effectiveness.

Saliva testing reflects the biologically active portion of hormones, while allowing the user to do multiple testings throughout the day (which allows for circadian evaluation.) The test will evaluate Testosterone, estradiol and cortisol. Many studies point to a direct relationship between Testosterone and cortisol as a marker of overtraining.

If you're not making progress in the gym or are suffering from fatigue, irritability, restless sleep or general malaise with respect to your exercise, then perhaps your cortisol levels are elevated and Testosterone decreased (known as the Testosterone to cortisol ratio or T/C.) This diminished T/C ratio is a way to let you know exactly what's hormonally wrong. Thus, your dilemma is determined and now you'd be able to chart a plan to beat the overtraining problem, i.e., cut back on the training so you can resume growing.

What to do

If you're interested in knowing your Testosterone, estradiol or cortisol level, contact one of the following:

Salivatest.com
Renewman.com
BodyBalance.com

You can also call Med Specialties Pharmacy at 714-572-2272 and order the test that you seek. The tests can vary from $59.00 to $120.00, but are well worth it. Some of the companies that offer the test also have a full medical staff that will work with you when Testosterone or growth hormone therapy is indicated.

Once you receive the kit, you must fill at least half of the vial with saliva (first thing in the morning) and mail it back. It's that simple! The saliva samples are stable for about two weeks and can be frozen if you're taking more than one sample. Typically, you'll have your results in less than two weeks time.

If you don't like to spit

If you don't want to fork out the dough for a saliva test or you aren't too excited about going and having blood drawn, then you may be wondering if there are any other tests that can be utilized to denote a low Testosterone level. The answer is yes.

The following checklist is a validated questionnaire used in determining low Testosterone:

1	Do you have a decrease in libido (sex drive)?	Yes	No
2	Do you have a lack of energy?	Yes	No
3	Do you have a decrease in strength or endurance?	Yes	No
4	Have you lost weight?	Yes	No
5	Have you noticed a decreased "enjoyment of life"?	Yes	No
6	Are you sad and/or grumpy?	Yes	No
7	Are your erections less strong?	Yes	No
8	Have you noticed a recent deterioration in your ability to play sports?	Yes	No
9	Are you falling asleep after dinner?	Yes	No
10	Has there been a recent drop in your work performance?	Yes	No
11	Do you find yourself taping The View so you can watch it with your girlfriends during your weekly knitting parties?	Yes	No

Okay, I made that last one up, but you get the picture. If you answer "yes" to questions 1 and 7 or "yes" to more than three total questions, you should have your Testosterone levels evaluated. It's well known that Testosterone affects sex drive, mood, muscle mass, ability to focus, and body composition. Therefore, this questionnaire was developed as a first step in evaluating T levels for men who are reluctant to ask their physician to give them a hormonal workup. Actually, believe it or not, this questionnaire is often used in deciding if the prescription Androgel (testosterone cream) is right for a patient.

What about Growth Hormone?

Growth hormone (GH), has been the rage of the anti-aging community, but is it really all that and a bag of Doritos? To many, GH represents the fountain of youth, to others it's nothing but a bloated belly (the look made famous by so many professional bodybuilders.) To me, it's a hormone that's sensitive and can effect many different systems in the body.

GH is secreted by the anterior pituitary and is both pulsatile and diurnal. This basically means that GH levels vary throughout the day. GH is regulated by hypothalamic growth hormone releasing hormone (GHRH) and somatotropin release inhibiting factor (SRIF), which respectively, stimulate or inhibit GH release. Physiologic factors known to stimulate GH release include exercise, amino acid ingestion, eating, stage IV sleep, and hypoglycemia (this may be the reason that people who train first thing in the morning get a response to training on an empty stomach.)

Clearly, we know that GH along with Testosterone levels are elevated after a bout of intense exercise, but what do you do if you're not shedding the fat that you desire or reaping the other rewards of training? As of late, more and more physicians have been giving GH therapy for "adult GH deficiency."

It's possible that if you're eating clean, training right and getting adequate deep sleep, yet still aren't seeing any results from your workouts, you may have GH deficiency. Of course, this can be tricky as almost everyone you ask thinks he's eating right, training hard, etc? A person would also have to be exquisitely in tune with his or her body before using that statement as an evaluation tool. Still, it's something to keep in mind.

Low GH?

Of course, you can go to your physician and have your GH levels evaluated either through the blood or urine (both are accurate.) There are seven tests that your physician can use to test for GH deficiency:

• intravenous (IV) arginine stimulation test
• clonidine stimulation test
• glucose suppression test
• growth hormone releasing hormone
  (GHRH) stimulation test
• insulin hypoglycemia test
• L-dopa stimulation test
• L-dopa + propranol stimulation test

Unfortunately, there aren't any nifty home methods with which to measure GH. And maybe you don't want to go through the hassle of and expense of getting it checked? What if you'd just prefer to assume that your body needs a boost of GH and you want to handle it on your own, without drugs?

Now, it's know that hypoglycemia can stimulate growth hormone. Likewise, arginine, an essential amino acid, can do the same. Another home brew will take advantage of these facts and let us know precisely how much arginine you'd need to elicit a GH response.

How to do your own home arginine test

This test is theoretical and not commonly used by mainstream physicians. It will involve you obtaining a glucometer, which is a blood glucose testing machine often used by diabetics. Glucometers are sold over-the-counter at almost every pharmacy and drug store. You'll also need a lancet (usually sold with the glucometer), alcohol pads and cotton balls.

After an overnight fast, take 12 ounces of cola syrup (if cola syrup is unavailable to you, get a Kool-Aid type drink equal to 75 grams of sugar) and mix in arginine. Exactly how much arginine you'll need to mix in is dependent upon your body weight. As a rule of thumb, use the range of 0.077 to 0.103 grams of arginine per pound of bodyweight. Arginine ingestion at this dose (~12 to 16 total grams) is known to stimulate growth hormone.

After the arginine is mixed into your drink, take your blood sugar with your glucometer and record it. Now drink the arginine mixture. Arginine is known to stimulate both GH and insulin. The stimulation of insulin via the ingestion of arginine should blunt the rise in blood sugar from occurring at any significant level. At the following times, note your blood sugar level:

Baseline (before drinking the arginine mixture)

15 minutes
30 minutes
60 minutes
90 minutes
120 minutes

In order to know whether you stimulated GH or not, the blood sugar value that you note at the 30 minute mark shouldn't vary over the next one and a half hours. In other words, the blood sugar value should stay relatively the same after the 30-minute mark. Or, to be more precise, your blood sugar should go down and not up. If this occurs, then the dose of arginine that you ingested is sufficient to bolster your GH output. However, if your blood sugar continues to rise at the 60 and 90 minute mark, the dose of arginine was not great enough to illicit a GH response.

Of course, using large doses of arginine day-in and day-out to boost GH production might get to be a pain. Additionally, it's a rather imprecise method. Pharmaceutical intervention might be the way to go, if your pocketbook can afford it.

Summary

In summary, having the ability to home test hormones offers many advantages over blood testing. Simply stated, it avoids having a needle put into your arm, saves you money from paying the physician, is easy to complete and offers results in an almost immediate fashion. Working with the clients that I have, I've found this type of testing to be a good marker of effectiveness of the an athlete's supplementation routine and training program. We all know that if you want to get something done right, do it yourself. Well, here's one more method to do just that.

About the author: Douglas S. Kalman MS, RD is a Director for Miami Research Associates, MiamiResearch.com, is a leading pharmaceutical and nutrition research organization in Miami, Florida. Doug is also a national spokesperson for the American College of Sports Medicine and according to his latest test has high T levels, so watch out ladies! Doug can be reached at dknole@hotmail.com.

References

1) Fisher DA. Endocrinology: test selection and interpretation. Second edition. 1998 Quest Diagnostics Inc.

2) Morley J. Androgen deficiency in aging men questionnaire. Saint Louis University School of Medicine, June 1997; Androgel.com.

3) Information from gsdl.com

4) Information from Medspecilatiesrx.com

5) Information from Science.McMaster.ca/biology/4s03/cortisol

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