Components of a Full Hormone Panel
A full hormone panel typically includes tests for thyroid function, reproductive hormones, adrenal hormones, and metabolic hormones to provide a comprehensive assessment of endocrine health.
Thyroid Function Tests
- Thyroid-stimulating hormone (TSH)
- Free thyroxine (Free T4)
- Free triiodothyronine (Free T3)
- Total triiodothyronine (TT3)
- Thyroid peroxidase antibodies (TPO-Ab)
- Thyroglobulin antibodies (Tg-Ab)
- TSH receptor antibodies (TRAb) when Graves' disease is suspected 1
Reproductive Hormones
- For females:
- Estradiol
- Progesterone
- Luteinizing hormone (LH)
- Follicle-stimulating hormone (FSH)
- Prolactin
- Total and free testosterone
- Sex hormone binding globulin (SHBG)
- For males:
- Total and free testosterone
- Luteinizing hormone (LH)
- Follicle-stimulating hormone (FSH)
- Estradiol
- Sex hormone binding globulin (SHBG) 2
Adrenal Hormones
- Cortisol (morning)
- Adrenocorticotropic hormone (ACTH)
- Dehydroepiandrosterone sulfate (DHEA-S)
- Androstenedione
- 17-hydroxyprogesterone (for suspected congenital adrenal hyperplasia) 2
Metabolic Hormones
- Insulin
- Glucose
- Hemoglobin A1c (HbA1c)
- Insulin-like growth factor 1 (IGF-1) 3
Additional Tests Based on Clinical Context
For suspected PCOS:
- LH/FSH ratio (>2 suggests PCOS)
- Androgen panel (testosterone, DHEA-S, androstenedione) 2
For suspected growth hormone disorders:
- Growth hormone (GH)
- IGF-1 4
For suspected adrenal disorders:
- Aldosterone
- Renin
- Metanephrines (if pheochromocytoma suspected) 2
Clinical Considerations
- Hormone testing should be performed under standardized conditions, as factors such as time of day, fasting status, menstrual cycle phase (in women), and medications can affect results 4
- Morning samples (8 AM) are preferred for cortisol and ACTH assessment 3
- Interpretation of hormone levels should consider age-specific and sex-specific reference ranges 2
- For thyroid function tests, pregnancy and critical illness can affect results without actual thyroid dysfunction 1
Common Pitfalls
- Using single hormone measurements rather than comprehensive panels may miss important interactions between different hormonal systems
- Failing to consider diurnal variations, especially for cortisol and growth hormone 4
- Not accounting for the effects of medications on hormone levels
- Interpreting results outside of clinical context
- Using outdated or overly broad reference ranges that may hide incipient pathological processes 4
For optimal clinical utility, hormone panel results should be interpreted in the context of the patient's symptoms, medical history, and other laboratory findings to guide appropriate treatment decisions.