Health Test Categories & Biomarkers

Cortisol is a hormone produced by the adrenal glands, and it plays a crucial role in various bodily functions. Often referred to as the 'stress hormone,' cortisol helps fight infections, maintain blood pressure, regulate blood sugar and metabolism (how your body processes food to create energy), and control the sleep-wake cycle.

Cortisol levels naturally fluctuate throughout the day, typically peaking in the early morning (around 6-8 AM), and gradually decreasing throughout the day, unless a person works late or has changing shifts. Other events or factors that can affect cortisol levels include exercise, hypothyroidism, infections, injury or disease, medications (such as hydrocortisone, prednisone, or birth control pills), obesity, pregnancy, and physical or emotional stress.

The AM cortisol test is usually conducted in the morning to capture the highest cortisol level, which helps assess the function of the adrenal glands and diagnose related disorders.

Abnormal AM Cortisol Levels

Low AM Cortisol - Causes

Primary adrenal insufficiency (Addison's disease): The adrenal glands are damaged and cannot produce enough cortisol, often due to autoimmune disorders, infections (like tuberculosis), or cancer.
Secondary adrenal insufficiency: The pituitary gland fails to produce enough adrenocorticotropic hormone, ACTH, leading to reduced cortisol production. This can be caused by pituitary tumors, head injuries, or long-term use of corticosteroids.
Congenital adrenal hyperplasia: A genetic disorder affecting cortisol production from birth.

Low AM Cortisol (Indicative of Adrenal Insufficiency) - Symptoms

Fatigue: Persistent tiredness and lack of energy.
Weight loss: Unexplained weight loss due to poor appetite and low metabolism.
Muscle weakness: Difficulty in physical activities due to weakened muscles.
Low blood pressure: Dizziness, fainting, and salt cravings.
Hyperpigmentation: Darkening of the skin, especially on scars, knuckles, and other pressure points.
Hypoglycemia: Low blood sugar levels, leading to shakiness, sweating, and irritability.

High AM Cortisol - Causes

Cushing’s syndrome: Often caused by a pituitary tumor (Cushing's disease) that produces too much ACTH, or an adrenal tumor that produces excess cortisol. Long-term use of corticosteroid medications can also lead to Cushing's syndrome.
Stress: Chronic stress can lead to elevated cortisol levels.
Ectopic ACTH syndrome: Some cancers, such as small cell lung cancer, can produce ACTH, leading to increased cortisol production.
Adrenal Hyperplasia or Tumors: Non-cancerous growths in the adrenal glands can cause overproduction of cortisol.

High AM Cortisol (Indicative of Cushing’s Syndrome) - Symptoms

Weight gain: Particularly around the abdomen, face (moon face), and upper back (buffalo hump).
High blood pressure: Increased risk of hypertension and related complications.
Muscle weakness: Particularly in the limbs due to muscle breakdown.
Mood changes: Depression, anxiety, and irritability.
Osteoporosis: Thinning of bones, leading to an increased risk of fractures.
Skin changes: Thinning skin, easy bruising, and stretch marks (purple striae) on the abdomen, thighs, and breasts.

The PM Cortisol Test measures the level of cortisol in the blood during the evening, typically around 4-6 PM. The PM cortisol test assesses this pattern and can be crucial in diagnosing conditions related to abnormal cortisol production and adrenal function.

Abnormal PM Cortisol Levels

Low PM Cortisol Levels - Causes

Primary adrenal insufficiency (Addison’s disease): The adrenal glands fail to produce enough cortisol, often due to autoimmune destruction.
Secondary adrenal insufficiency: Reduced production of ACTH from the pituitary gland leads to decreased cortisol production.
Chronic fatigue syndrome: A condition that may be associated with abnormally low cortisol levels, particularly in the evening.

Low PM Cortisol Levels - Symptoms

Fatigue: Extreme tiredness, particularly in the late afternoon or evening.
Low blood pressure: May lead to dizziness, fainting, or lightheadedness.
Weight loss: Unintentional weight loss due to reduced appetite and metabolism.
Weakness: Generalized muscle weakness and lack of energy.
Hypoglycemia: Low blood sugar levels, causing shakiness, sweating, and confusion.
Salt cravings: A strong desire for salty foods.

High PM Cortisol Levels - Causes

Cushing’s syndrome: The most common cause of elevated PM cortisol levels, often due to a pituitary adenoma (Cushing’s disease), adrenal tumor, or ectopic ACTH production from a non-pituitary tumor.
Chronic stress: Prolonged stress can lead to persistently high cortisol levels, including in the evening.
Adrenal hyperplasia or tumors: Overactivity or tumors in the adrenal glands can cause cortisol levels to remain elevated throughout the day.

High PM Cortisol Level - Symptoms

Persistent high blood pressure: Hypertension that doesn’t respond well to treatment.
Central obesity: Weight gain, particularly around the abdomen, with thin arms and legs.
Mood disorders: Depression, anxiety, irritability, and cognitive difficulties.
Muscle weakness: Especially in the limbs.
Sleep disturbances: Difficulty falling asleep or staying asleep.
Glucose intolerance: Elevated blood sugar levels, potentially leading to diabetes.
Osteoporosis: Increased risk of fractures due to weakened bones.

Dehydroepiandrosterone (DHEA) is a hormone produced primarily by the adrenal glands, with smaller amounts also produced by the ovaries in women and the testes in men. DHEA serves as a precursor to other important hormones, including testosterone and estrogen, and plays a role in the development of secondary sexual characteristics during puberty. It also has functions in immune response, metabolism, and overall well-being.

Unconjugated DHEA refers to the form of DHEA that has not been modified by other added molecules. It is a weakly androgenic (related to the development or maintenance of male characteristics) steroid that is useful to measure when congenital adrenal hyperplasia is suspected. It is also useful in determining the source of androgens in hyperandrogenic conditions, such as polycystic ovarian syndrome and adrenal tumors.

Abnormal DHEA Levels

Low DHEA Levels - Causes

Adrenal insufficiency: A condition where the adrenal glands do not produce enough hormones, including DHEA.
Aging: DHEA levels naturally decline with age, starting as early as the mid-20s.
Chronic illness or stress: Prolonged physical or emotional stress can deplete DHEA levels.
Hypopituitarism: A condition where the pituitary gland does not produce adequate stimulating hormones, leading to low DHEA production.
Use of certain medications: Some drugs, including corticosteroids, can suppress DHEA production.

Low DHEA Levels - Symptoms

Fatigue and low energy: Persistent tiredness or lack of motivation.
Depression or mood swings: Feelings of sadness or irritability.
Reduced libido: Decreased interest in sexual activity.
Weight gain: Particularly around the abdomen.
Cognitive decline: Problems with memory or concentration.

High DHEA Levels - Causes & Associations

Polycystic ovary syndrome (PCOS): A condition that affects hormone levels in women, often leading to elevated DHEA.
Adrenal tumors or hyperplasia: Abnormal growth or activity in the adrenal glands can cause excessive DHEA production.
Cushing's syndrome: A disorder caused by high cortisol levels, often linked with increased DHEA.
Early puberty: High DHEA levels can trigger the early onset of puberty in children.
Use of certain medications: Steroids and hormonal treatments can elevate DHEA levels.

High DHEA Levels - Symptoms

Women
Excessive hair growth (hirsutism)
Acne
Irregular or absent menstrual periods
Deepening of the voice
Infertility

Men
Aggression or irritability
Increased muscle mass or reduced body fat
Acne

Children
Early onset of puberty, such as pubic hair growth or rapid growth in height

‍

Follicle-stimulating hormone (FSH), produced by the pituitary gland, plays a vital role in reproductive health, regulating egg development in women and sperm production in men. FSH levels are often measured to assess fertility, menstrual irregularities, and pituitary function.

Gonadotropin-releasing hormone (GnRH) from the hypothalamus stimulates FSH release, with feedback mechanisms involving estrogen and testosterone helping to regulate levels.

In fertility testing, elevated FSH may indicate diminished ovarian reserve, while low levels could suggest hypothalamic or pituitary issues. FSH testing is also important during perimenopause, as rising levels reflect declining ovarian function, leading to irregular cycles and eventual menopause.

Abnormal FSH Levels

Low FSH Levels - Causes

Hypothalamic or pituitary disorders: Conditions such as hypopituitarism can result in low production of FSH.
Hyperprolactinemia: Elevated prolactin levels can suppress FSH production.
Stress or extreme weight loss: Physical or emotional stress, eating disorders, or excessive exercise can disrupt hormone production.
Polycystic ovary syndrome (PCOS): In some cases, PCOS can cause low FSH levels due to hormonal imbalance.
Hormonal medications: Certain medications, such as contraceptives or hormone therapy, can lower FSH levels.

Low FSH Levels - Symptoms

Women: Irregular or absent menstrual periods, infertility, and signs of low estrogen such as hot flashes or vaginal dryness.
Men: Low sperm count, decreased libido, and signs of low testosterone such as fatigue and decreased muscle mass.

High FSH Levels - Causes

Menopause: High FSH levels are common in women who are transitioning into menopause.
Premature ovarian failure (POF): Early loss of ovarian function before the age of 40 can cause elevated FSH levels.
Polycystic ovary syndrome (PCOS): Sometimes results in elevated FSH, although it is typically associated with a different hormone imbalance.
Testicular failure: Conditions such as Klinefelter syndrome or damage from chemotherapy/radiation can cause high FSH in men.
Hypothalamic or pituitary disorders: Disorders affecting the hypothalamus or pituitary gland, such as tumors, trauma, or radiation therapy, can disrupt the regulation of FSH production and secretion.

High FSH Levels - Symptoms

Women: Irregular or absent menstrual periods, hot flashes, vaginal dryness, difficulty conceiving, and early menopause symptoms.
Men: Low sperm count, decreased libido, erectile dysfunction, and difficulty conceiving.
Age: FSH levels naturally fluctuate throughout life. In women, FSH levels typically rise as menopause approaches, reflecting declining ovarian function and decreased estrogen production. In men, FSH levels may increase with age as well, although the change is less dramatic compared to women.

Pregnenolone is a hormone produced primarily in your adrenal glands. Often referred to as the "master hormone, it is a precursor to all steroid hormones, such as DHEA, progesterone, testosterone, estrogen, and cortisol. It plays a crucial role in thinking, memory, and mood regulation. Further, it is part of many body functions, such as stress and immune responses and managing inflammation.

The Pregnenolone, LC/MS test measures the level of pregnenolone in your blood. LC/MS stands for Liquid Chromatography/Mass Spectrometry, a method used for accurate hormone measurement.

This test is often used to evaluate hormone balance and adrenal function. It can also help diagnose conditions related to abnormal steroid hormone production.

Abnormal Pregnenolone Levels

Low Pregnenolone Levels - Causes

Adrenal insufficiency: The adrenal glands do not produce enough hormones, which can lead to lower pregnenolone levels.
Chronic stress: Prolonged stress can deplete pregnenolone as the body prioritizes cortisol production.
Aging: Pregnenolone levels naturally decline with age, starting around age 30. The decline in pregnenolone is more pronounced in men compared to women [1].
Hypothyroidism: Low thyroid function can disrupt the production of pregnenolone.
Nutrient deficiencies: Deficiencies in cholesterol (a precursor to pregnenolone)or essential vitamins like B5 and B6 can affect its production.

Low Pregnenolone - Symptoms

Fatigue and lack of energy
Memory problems or brain fog
Mood disturbances such as depression or anxiety
Decreased libido
Joint pain or muscle weakness
Sleep disturbances

High Pregnenolone Levels - Causes

Clinically, it is uncommon to find elevated pregnenolone levels outside of excessive pregnenolone supplementation. Causes of elevated pregnenolone may include:

Hormonal therapy or supplementation: Excessive pregnenolone supplementation can lead to elevated levels.
Short-term high stress: Pregenolone levels may increase short-term in response to high stress. However, long-term stress typically causes decreased levels [2].
Adrenal hyperplasia and adrenal tumors: Some adrenal tumors become very efficient at producing pregnenolone from cholesterol [3].
Pregnancy: Pregnenolone levels rise in pregnancy [4].
Polycystic Ovary Syndrome (PCOS): Hormonal imbalances associated with PCOS can cause higher levels of pregnenolone.

High Pregnenolone Levels - Symptoms

Mood swings or irritability
Aggressiveness or agitation
Acne or oily skin
Insomnia
Increased body hair
Menstrual irregularities in women

Prostate-Specific Antigen (PSA) is a protein produced by the prostate gland, a small gland in men that creates fluid for sperm.

This test measures the total amount of prostate-specific antigen (PSA) in your blood. PSA is a protein produced by cells in the prostate gland. The test is often used to screen for prostate issues, including prostate cancer, but keep in mind, that higher PSA levels can also be due to less serious conditions like an enlarged prostate, an infection, as well as inflammation or trauma to the prostate, such as following a biopsy or colonoscopy.

Factors Lowering PSA Levels

For men who are thinking about being screened for prostate cancer, it’s important to talk to your doctor about anything you’re taking that might affect your PSA level, as it might affect the accuracy of your test result. Some things that might lower PSA levels (even if a man has prostate cancer) include the following:

5-alpha reductase inhibitors: Certain drugs used to treat BPH or urinary symptoms, such as finasteride (Proscar or Propecia) or dutasteride (Avodart), can lower PSA levels. These drugs can also affect prostate cancer risk. So, tell your doctor if you are taking one of these medicines as they can lower PSA levels. The doctor might need to adjust for this.
Herbal mixtures: Some mixtures sold as dietary supplements might mask a high PSA level. So it’s important to let your doctor know if you are taking any dietary supplements, even ones that are not necessarily meant for prostate health. Saw palmetto (an herb used by some men to treat BPH) does not seem to affect PSA.
Certain medicines: Some research has suggested that long-term use of certain medicines, such as aspirin, statins (cholesterol-lowering drugs), and thiazide diuretics (such as hydrochlorothiazide) might lower PSA levels. More research is needed to confirm these findings.

Elevated PSA Levels

Elevated levels of PSA have been associated with benign and malignant prostatic disorders. Studies indicate that in men 50 years or older measurement of PSA is a useful addition to the digital rectal exam in the early detection of prostate cancer. In addition, PSA decreases to undetectable levels following complete resection of the tumor and may rise again with recurrent disease or persist with residual disease.

Elevated PSA Levels - Causes

Benign prostatic hyperplasia (BPH): Non-cancerous enlargement of the prostate.
Prostatitis: Inflammation or infection of the prostate.
Prostate cancer: Elevated PSA can be a sign of prostate cancer, although it is not definitive.
Urinary tract infections (UTIs): Can temporarily increase PSA levels.
Recent ejaculation or prostate stimulation: Sexual activity or certain medical procedures can elevate PSA levels temporarily. This is why some doctors suggest that men abstain from ejaculation for a day or two before testing.
Age: PSA levels can naturally increase with age.
Riding a bicycle: Some studies have suggested that cycling may raise PSA levels for a short time (possibly because the seat puts pressure on the prostate), although not all studies have found this.
Certain urologic procedures: Some in-patient procedures, such as a bladder exam, prostate biopsy, or cystoscopy, can affect the prostate and raise PSA levels for a short time. Some studies have suggested that a digital rectal exam (DRE) might raise PSA levels slightly, although other studies have not found this. As such, if both a PSA test and a DRE are being done during a doctor visit, some doctors advise having the blood drawn for the PSA before having the DRE, just in case.
Certain medicines: Taking male hormones like testosterone (or other medicines that raise testosterone levels) may cause a rise in PSA.
Warmer climates

Elevated PSA Levels - Symptoms

Often asymptomatic, especially in early stages.
Possible urinary symptoms, such as:
Frequent urination, especially at night
Difficulty starting or stopping urine flow
Weak or interrupted urine stream
Pain or burning during urination
Pain or discomfort in the pelvic area
Blood in the urine or semen (in advanced cases)

Sex Hormone Binding Globulin (SHBG) is a glycoprotein produced mainly in the liver that binds to sex hormones, specifically testosterone and estrogen, in the bloodstream. SHBG controls the amount of testosterone and estrogen that is available for the body's tissues to use. When hormones are bound to SHBG, they are inactive and cannot be used by cells. The levels of SHBG can influence the balance of available sex hormones, affecting many bodily processes.

The Sex Hormone Binding Globulin (SHBG) test measures the level of SHBG in your blood. This test is often used to help diagnose conditions related to abnormal levels of sex hormones, such as testosterone and estrogen. It is particularly useful when total hormone levels are normal, but symptoms of hormone imbalance are present.

Low SHGB Levels

Low SHBG levels have been associated with an increased risk of developing type 2 diabetes, cardiovascular disease, and metabolic disorders including metabolic syndrome, as well as some cancers and arthritis in both genders.

Low SHBG - Causes

Obesity
Type 2 diabetes
Hypothyroidism
Cushing’s syndrome
Use of anabolic steroids or androgenic medications
Excessive androgen production (polycystic ovary syndrome (PCOS), hirsutism, hair loss, and infertility in women).
Non-alcoholic fatty liver disease (NAFLD)

Low SHBG - Symptoms

Acne
Excessive body or facial hair (hirsutism)
Oily skin
Irregular menstrual cycles (in women)
Polycystic ovary syndrome (PCOS) symptoms
Aggression or mood changes (in men)
Potential symptoms related to excess free estrogen (in women):
Weight gain
Breast tenderness
Menstrual irregularities

High SHGB Levels

Often, higher levels of SHBG are associated with positive health outcomes. For example, elevated SHBG levels have been linked to a lower risk of type 2 diabetes and prostate cancer. However, they are also linked to a higher risk of bone loss and fractures, hypogonadism in males, and hepatic cirrhosis. In some cases, it may be caused by hyperthyroidism, as thyroid hormone stimulates the production and release of SHBG.

High SHBG - Causes

Hyperthyroidism
Hypogonadism
Liver disease (Hepatic cirrhosis)
Hormones: Estrogen (including estrogen therapy or oral contraceptives), thyroid or growth hormones or other growth factors
Pregnancy
Anorexia nervosa
Aging (SHBG levels naturally increase with age)
Certain genetic conditions
Nutritional status

High SHBG - Symptoms

Decreased libido
Erectile dysfunction (in men)
Fatigue
Loss of muscle mass
Osteoporosis or decreased bone density
Mood swings or depression

Progesterone is a hormone primarily produced by the ovaries in women and smaller amounts by the adrenal glands in both men and women. It plays a key role in regulating the menstrual cycle, supporting pregnancy, and maintaining overall hormone balance. In women, progesterone prepares the uterus for a fertilized egg and helps maintain early pregnancy.

The levels of progesterone fluctuate during a woman's menstrual cycle. If a woman becomes pregnant, progesterone levels will continually increase as the body prepares to support a developing baby. If the egg is not fertilized, progesterone levels will decrease, and the menstrual period will begin. If pregnancy occurs, progesterone blood levels could be ten times higher than in a non-pregnant woman. Men also produce progesterone but in much smaller amounts.

The progesterone test is usually requested by physicians to:

Find out the cause of a woman's infertility
Determine when ovulation occurs
Evaluate miscarriage risk
Monitor high-risk pregnancies
Evaluate menstrual irregularities
Detect hormone imbalances
Diagnose ectopic pregnancies (a pregnancy that grows outside the uterus)

Abnormal Progesterone Levels

Low Progesterone - Indications and Causes

Anovulation: A cycle without egg release can lead to insufficient progesterone production.
Luteal phase defect: In some women, the corpus luteum (which produces progesterone after ovulation) may not produce enough progesterone.
Perimenopause: Hormonal fluctuations during this time can lead to lower progesterone levels.
Chronic stress: High cortisol levels (the stress hormone) can inhibit progesterone production.
Polycystic ovary syndrome (PCOS): This condition can disrupt ovulation and lower progesterone levels.
Hormonal imbalance: Conditions such as polycystic ovary syndrome (PCOS) or thyroid disorders (hypothyroidism) can disrupt progesterone levels.
Miscarriage risk: Low progesterone levels during early pregnancy may increase the risk of miscarriage.
Poor diet: Nutrient deficiencies, especially zinc, vitamin C, vitamin B6, and magnesium, can affect progesterone production.
Aging: Progesterone levels naturally decline with age, particularly during perimenopause and menopause.
High blood sugar: Elevated blood sugar levels affect many hormones and often play a role in hormone imbalance.
Excessive exercise: Intense or excessive physical activity can affect hormone balance and lower progesterone levels.
Medications: Certain medications, including hormonal contraceptives and corticosteroids, may suppress progesterone production.
Environmental factors: Exposure to endocrine-disrupting chemicals in plastics, pesticides, and personal care products can interfere with hormone function, causing increased hormonal symptoms, earlier menopausal transition, and increased risk of certain cancers.

Low Progesterone - Symptoms

Irregular or absent periods
Infertility or difficulty maintaining pregnancy
Short luteal phase (second half of the menstrual cycle)
Mood changes, including anxiety or depression
Fatigue
Spotting or bleeding between periods
Low libido

High Progesterone - Indications and Causes

Pregnancy: Progesterone levels naturally rise during pregnancy to support fetal development.
Luteal phase: Levels peak after ovulation during the second half of the menstrual cycle.
Hormone therapy: Progesterone supplementation or hormone replacement therapy (HRT) can cause high levels.
Ovarian cysts or tumors: In rare cases, ovarian cysts or certain tumors can cause elevated progesterone.
Adrenal disorders: Overproduction of progesterone can occur due to adrenal gland dysfunction.

High Progesterone - Symptoms

Fatigue or drowsiness
Mood swings, irritability, or depression
Bloating
Breast tenderness
Headaches
Weight gain
Acne or oily skin

The T4 test measures the levels of thyroxine in your blood. Thyroxine is a hormone produced by the thyroid gland and is crucial for regulating metabolism, heart and digestive function, muscle control, brain development, and bone maintenance.

There are two types of T4 tests: total T4 and free T4.

Total T4 measures both bound and free thyroxine
Free T4 measures only the unbound, active form of the hormone

Abnormal T4 Levels

If your T4 levels are abnormal, it’s important to follow up with your healthcare provider to determine the underlying cause. Your provider may recommend further testing, including thyroid-stimulating hormone (TSH) tests, to get a complete picture of your thyroid function.

Low T4 Levels (Hypothyroidism) - Causes

Hashimoto's thyroiditis: An autoimmune condition where the immune system attacks the thyroid, reducing hormone production.
Iodine deficiency: Rare in developed countries.
Pituitary dysfunction: Reduced TSH production due to pituitary gland problems, leading to low T4 production.
Thyroid surgery or radiation
Medications: Certain drugs, like lithium or amiodarone, can reduce T4 levels.

Low T4 Levels - Symptoms

Fatigue: Persistent tiredness or lack of energy.
Weight issues: Unexplained weight gain or difficulty losing weight.
Cold intolerance: Feeling unusually cold, even in warm environments.
Depression: Low mood, feelings of sadness, or depression.
Constipation: Infrequent or difficult bowel movements.
Dry skin and hair: Dry, rough skin and brittle hair or hair loss.
Bradycardia: Slower than normal heart rate.
Memory problems: Difficulty concentrating or memory lapses.
Menstrual changes: Heavy or irregular menstrual periods in women.

High T4 Levels (Hyperthyroidism) - Causes

Graves' disease: An autoimmune disorder that leads to an overactive thyroid.
Thyroiditis: Thyroid inflammation can temporarily increase T4.
Thyroid nodules: Benign or malignant growths that can produce excess thyroid hormone.
Excess iodine intake: Too much iodine through diet or medications.
Medications: Certain drugs, such as amiodarone or levothyroxine, can elevate T4 levels.

High T4 Levels - Symptoms

Rapid heart rate (tachycardia): Increased heart rate or palpitations.
Weight loss: Unexplained weight loss despite normal or increased appetite.
Heat intolerance: Feeling warmer or sweating more than usual.
Anxiety and nervousness: Feeling jittery, anxious, or irritable.
Tremors: Shaking, particularly in the hands.
Insomnia: Difficulty sleeping or staying asleep.
Increased bowel movements: Diarrhea or frequent bowel movements.
Menstrual changes: Irregular or light menstrual periods in women.

The The Testosterone/Cortisol (T/C) ratio is a measure that compares levels of testosterone, an anabolic hormone, to cortisol, a catabolic hormone, in the body. Testosterone promotes muscle growth, recovery, and tissue repair, while cortisol is involved in stress response and can break down tissues if chronically elevated. The balance between these hormones provides insight into an individual's anabolic (building) versus catabolic (breaking down) state. This makes the T/C ratio an important indicator of overall physiological stress and recovery capacity.

Clinical Uses for the Test

Athletic performance monitoring: The T/C ratio is commonly used in sports science to assess the recovery status of athletes. A low ratio suggests that the body is under significant stress, with insufficient testosterone to balance cortisol's catabolic effects, potentially leading to overtraining.
Hormonal imbalance assessment: This test can help to evaluate hormonal imbalances in both men and women. Chronic stress, overexertion, or adrenal dysfunction may lead to an abnormal T/C ratio.
Stress and adrenal health: It is useful in examining chronic stress or conditions such as adrenal fatigue or hypogonadism (low testosterone).
Mental health and well-being: Since both testosterone and cortisol affect mood, energy levels, and cognitive function, this ratio is sometimes evaluated in cases of depression, anxiety, or chronic fatigue.

Abnormal Testosterone/Cortisol Ratio

Low Testosterone/Cortisol Ratio - Causes

Chronic stress: Prolonged physical or emotional stress leads to elevated cortisol levels, which lowers the T/C ratio.
Overtraining: Athletes who don't allow sufficient recovery after intense exercise can experience low testosterone and high cortisol.
Sleep deprivation: Lack of sleep can elevate cortisol and decrease testosterone, affecting the T/C balance.
Hypogonadism: In men, a condition where the body doesn't produce enough testosterone, leading to a low ratio.
Adrenal disorders: Overactive adrenal glands may produce too much cortisol.
Chronic illness: Long-term health conditions can affect both hormone levels, reducing testosterone while increasing cortisol.

Low Testosterone/Cortisol Ratio - Symptoms

Fatigue or lack of energy
Reduced muscle mass or strength
Decreased recovery after exercise
Low libido or sexual dysfunction
Poor mood or depression
Increased body fat, particularly around the abdomen
Difficulty sleeping or insomnia

High Testosterone/Cortisol Ratio - Causes

Suppressed cortisol: Some medical conditions or medications (e.g., glucocorticoid therapy) can suppress cortisol levels, leading to a higher T/C ratio.
Anabolic steroid use: The use of synthetic anabolic steroids can dramatically increase testosterone, leading to an elevated T/C ratio.
Testosterone therapy: Individuals undergoing testosterone replacement therapy may experience higher levels of testosterone relative to cortisol.
Adrenal insufficiency: Conditions like Addison’s disease can lead to abnormally low cortisol levels.

High Testosterone/Cortisol Ratio - Symptoms

Increased aggression or irritability
Rapid muscle growth (in the case of steroid use)
Potential long-term suppression of natural cortisol production
Possible adverse effects on immune function and inflammation control due to low cortisol
Disrupted metabolism or blood sugar regulation

/Cortisol (T/C) ratio is a measure that compares levels of testosterone, an anabolic hormone, to cortisol, a catabolic hormone, in the body. Testosterone promotes muscle growth, recovery, and tissue repair, while cortisol is involved in stress response and can break down tissues if chronically elevated. The balance between these hormones provides insight into an individual's anabolic (building) versus catabolic (breaking down) state. This makes the T/C ratio an important indicator of overall physiological stress and recovery capacity.

Abnormal Testosterone/Cortisol Ratio

-

-

-

- *

- Fatigue or lack of energy

- Reduced muscle mass or strength

- Decreased recovery after exercise

- Low libido or sexual dysfunction

- Poor mood or depression

- Increased body fat, particularly around the abdomen

- Difficulty sleeping or insomnia

-

- **Adrenal insufficiency: **Conditions like Addison’s disease can lead to abnormally low cortisol levels.

- Increased aggression or irritability

- Rapid muscle growth (in the case of steroid use)

- Potential long-term suppression of natural cortisol production

- Possible adverse effects on immune function and inflammation control due to low cortisol

- Disrupted metabolism or blood sugar regulation

Testosterone is a hormone that helps with things like muscle growth, bone strength, and even mood. If your testosterone levels are too low, you might feel tired, weak, or have a low sex drive.

Bioavailable testosterone refers to the fraction of testosterone that is freely available for bodily use. It includes free testosterone (unbound) and testosterone that is loosely bound to albumin, a protein in the blood. This form of testosterone is important because it is readily available to tissues and organs, influencing various bodily functions like muscle growth, fat distribution, bone density, libido, and mood regulation.

Bioavailable testosterone is different from total testosterone, which measures all testosterone in the blood, including the majority that is tightly bound to sex hormone-binding globulin (SHBG) and is unavailable for direct use by the body.

The Bioavailable Testosterone blood test measures the amount of testosterone available to your body's cells, free testosterone and testosterone loosely attached to a blood protein called albumin.

Abnormal Bioavailable Testosterone Levels

Low Bioavailable Testosterone - Causes

Aging: Testosterone levels naturally decline with age, which can reduce bioavailable testosterone.
Hypogonadism: A condition where the testes or ovaries produce insufficient amounts of testosterone or other sex hormones.
Obesity: Increased body fat can lead to higher estrogen levels and lower testosterone production.
Chronic illness: Conditions, such as liver or kidney disease, diabetes, and metabolic syndrome can affect hormone levels.
Elevated SHBG: High levels of sex hormone-binding globulin reduce the amount of testosterone available for use by the body.
Medications: Certain drugs, like opioids, glucocorticoids, and antidepressants, can lower testosterone levels.

Low Bioavailable Testosterone - Symptoms

Fatigue or low-energy
Reduced libido or sexual dysfunction
Depression or mood changes
Loss of muscle mass or strength
Increased body fat, particularly around the abdomen
Decreased bone density or osteoporosis
Difficulty concentrating or memory problems

High Bioavailable Testosterone - Causes

Anabolic steroid use: Some individuals use anabolic steroids to enhance muscle mass and athletic performance, leading to unnaturally high testosterone levels.
Polycystic ovary syndrome (PCOS): In women, PCOS can cause elevated levels of bioavailable testosterone, leading to symptoms like irregular menstruation and increased hair growth.
Adrenal disorders: Overproduction of testosterone due to adrenal gland dysfunction can cause elevated levels.
Androgen-secreting tumors: Rare tumors of the testes, ovaries, or adrenal glands can increase testosterone production.

High Bioavailable Testosterone - Symptoms in Males

Aggressiveness or irritability
Acne or oily skin
Sleep apnea
Excessive muscle mass
Balding or hair thinning

High Bioavailable Testosterone - Symptoms in Females

Irregular menstrual cycles
Excessive facial or body hair (hirsutism)
Deepening of the voice
Acne
Male-pattern baldness

Boost your efficiency

Men's Health

Ready to Take Control of Your Health?

Ready to invest in art?

Need help choosing?