Hello and welcome! Glad to see you here on Legacy Compounding’s Blog!

I’m super excited to give you some education today on Urine Hormone Testing. In our last post, we discussed the strengths and limitations of blood hormone testing, and in our next post, I’ll be covering saliva hormone testing. So, here we go, down the rabbit hole again.


Urine hormone testing is the least used hormone testing method, but it just happens to be my favorite type of hormone test, at least for baseline levels. Why? I’m so glad you asked!


The first thing I need to clarify is that I only use this test for baseline levels to determine if a patient is a good candidate for hormone replacement, to begin with, and to be able to fully customize a treatment plan. Urine hormone testing gives you a WEALTH of information that is not available with blood or saliva testing. The drawback to urine testing is, much like blood level testing, when you are taking topical hormones they don’t really raise the hormone levels in urine. So, once I have a patient started on hormone replacement I will follow up with saliva testing to help me adjust doses.

Urine testing is a relatively new method for testing hormones.


Rewind, that’s not true. Urine testing has been around for ages and in recent history, it has been the gold standard for cortisol testing (cortisol is your stress hormone, to give you an overly simplified definition). However, it hasn’t been widely used to test hormones because it has always been very impractical. Someone would have to collect their urine (all of it) for 24 hours, and even then, how sure could you be that they really got it all? And who wants to do that anyway? So, there were some pretty significant barriers to urine testing.


But leave it to scientists to keep pecking away at something until they figure out a better method. Enter: Dried Urine Collection methods. With this method, you take a special absorbent collection paper, urinate into a cup at specific time points, and dip the collection paper into the cup. Next, you lay the papers out to dry, pack them, and ship them to the lab. It can all be done from the comfort of your own home and, as I said before, the results give your provider a lot of information that they wouldn’t have access to with a blood test or a saliva test (of course, your provider has to know what to do with this information).


Let’s pause for a moment. You may have noticed that I use the term “provider” a lot in place of “doctor”. In case you were wondering, the reason I do this is because there are a growing number of healthcare specialties that are able to provide you with healthcare besides just doctors. There are physician assistants, nurse practitioners, pharmacists, chiropractors, naturopaths...and I’m sure I’m still leaving someone out! So, that’s that. Back to business.


I use a company called Precision Analytical for all of my urine hormone testing because I trust them implicitly, I love the patient/provider educational tools that they provide, and they put these great graphics into their lab reports that help the patient to really get a grasp of what is going on in their body. I’m including a sample report in this post, which I won’t go over in great detail right now, but you can get an idea of the length of the report and the amount of information it contains. Knowledge is power, right?


So, to determine if a patient is a good candidate for hormone replacement therapy we obviously want to look at hormone levels and verify that the levels are actually low. So, the urine test will tell you what those levels are and if any hormones need to be replaced. And here is where things get really interesting. A urine hormone test will also give you the levels of hormone metabolites in your body-- which allows us to see what your body is doing with the hormones that you have. It gives us insight into how you metabolize your estrogen, which gives us a glimpse of your breast cancer risk. It shows us if you tend to take your Testosterone and convert it to DHT-- which causes acne and alopecia. It tells us not just how much cortisol you have, but how many cortisol metabolites you have...the implications of which I can’t even tell you in one sentence, it has to be a completely separate post of its own.


This test give me the ability to tell someone, “hey, I know your estrogen is low but we really shouldn’t supplement estrogen in your case because it could increase your risk of developing breast cancer.” or “Based on your estrogen metabolism and family history, you can feel pretty safe with estrogen replacement.” Now, obviously I can’t see into the future and the full breast cancer risk model is still being developed, but working with the knowledge that is available to us right now, I am confidently able to help patients and providers decide if estrogen replacement is the right choice.


So, I’ve really just given you the tip of the iceberg on urine hormone testing but I know you can only absorb so much information in one sitting, so until next time I hope this information has enriched your knowledge base.​

Urine Hormone Testing​

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