From the Guidelines
You should not check your hormone levels unless you are experiencing symptoms or have a high risk of thyroid dysfunction, as the potential harms of screening and treatment may outweigh the benefits. The US Preventive Services Task Force (USPSTF) found no direct evidence on the benefits and harms of screening for thyroid dysfunction in nonpregnant, asymptomatic adults 1. The USPSTF also noted that the harms of screening for and treating thyroid dysfunction have been poorly studied, but screening and treatment have real potential harms, such as false-positive results, labeling, and overdiagnosis and overtreatment 1.
Some common symptoms that may indicate a need for hormone testing include fatigue, mood changes, weight fluctuations, sleep disturbances, or reproductive issues. Consider hormone testing if you have irregular menstrual cycles, fertility concerns, menopausal symptoms, low energy, unexplained weight changes, or a family history of hormone-related conditions. Common hormone tests include thyroid panel (TSH, T3, T4), reproductive hormones (estrogen, progesterone, testosterone), cortisol, and insulin.
The process typically involves a blood test, sometimes requiring fasting beforehand. For menstruating women, certain hormone tests are best done at specific times in your cycle. Speak with your healthcare provider about your symptoms and concerns, as they can recommend appropriate tests based on your specific situation. Hormone imbalances can affect many bodily functions since hormones act as chemical messengers regulating metabolism, growth, mood, and reproduction. Early detection of imbalances allows for timely intervention, potentially preventing more serious health issues. However, the decision to screen for thyroid dysfunction should be made on a case-by-case basis, taking into account the individual's risk factors, symptoms, and medical history 1.
It's also important to note that the optimal screening interval for thyroid dysfunction is unknown, and the USPSTF found no direct evidence that treatment of thyroid dysfunction based on risk level alters final health outcomes 1. Therefore, it's essential to discuss the potential benefits and harms of hormone testing with your healthcare provider to determine the best course of action for your specific situation.
From the FDA Drug Label
For pregnant patients with pre-existing hypothyroidism, measure serum TSH and free-T4 as soon as pregnancy is confirmed and, at minimum, during each trimester of pregnancy. In adult patients with primary hypothyroidism, monitor serum TSH levels after an interval of 6 to 8 weeks after any change in dosage. In patients with hypothyroidism, assess the adequacy of replacement therapy by measuring both serum TSH and total or free-T4.
Yes, you should check your hormone levels, specifically TSH and free-T4, as part of monitoring your hypothyroidism treatment, as indicated in the levothyroxine drug label 2.
From the Research
Checking Hormone Levels
- There are various studies that suggest checking hormone levels can be beneficial in certain situations, such as adrenal insufficiency 3, 4, 5.
- Adrenal insufficiency can lead to multiple endocrine gland dysfunctions, including hyperthyrotropinemia, hyperthyroxinemia, and hyperprolactinemia 3.
- Retinoic acid therapy for cutaneous T-cell lymphoma has been associated with central hypothyroidism and adrenal insufficiency, highlighting the importance of monitoring hormone levels in patients undergoing this treatment 4.
- In some cases, subclinical hypothyroidism can be reversible with adrenal hormone replacement therapy, without the need for thyroid hormone replacement 5.
- However, it is also important to consider the limitations of hormone level measurements, as they can be affected by measurement error and may not always accurately reflect the underlying physiological state 6.
Considerations for Checking Hormone Levels
- Hormone ratios can be used to capture the joint effect of two hormones, but they can be sensitive to measurement error and may not always be robust 6.
- Log-ratios may be a more robust alternative to raw hormone ratios, as they are less affected by measurement error 6.
- The decision to check hormone levels should be made on a case-by-case basis, taking into account the individual's medical history, symptoms, and treatment plan 7.