“I don’t get it” said one of my fertility clients to me…”every time I get a new blood test my levels are all normal…they can’t find anything wrong, yet they still give me drugs to try and fix my levels!!”
Yes indeed it’s complicated, many factors can be conspiring together to keep your fertility system under par….but one issue that really hits me is the routine over reliance on ‘average’ levels of hormones from blood tests.
The reference ranges for various hormones like estrogen, FSH, LH and progesterone are worked out using a hodge podge of averages across the population…but everybody in the lab testing world knows there is no such thing as an average person. Yet despite this we still try to aim for average norms.
The problem with this is twofold;
- Your ideal level of any given hormone may be different from the average (and hint…it always is!)
- The way hormone levels are detected in blood tests doesn’t really give you any functionally useful reading…it doesn’t really tell you what the heck is going on inside your body.
I’m not saying that average values from blood tests are pointless, I’m saying they’re useless! They are a holdover from the old way of doing things…and we all know how long it takes to stop doing old things and start doing new things. All of us…right! We all find it hard to change old habits…so I guess we can’t exactly get off complaining about the medical system and how it’s stuck in the mud, when we can’t do it ourselves!
Anyway…here’s the science bit if you want it…
Hormones travel around the blood either bound to proteins or not…either in taxi’s or walking!
When you measure estrogen from a blood test for example, what you are seeing is the total amount of estrogen…both the stuff in the taxi’s and the stuff walking around ‘free’. We call this bound and unbound.
Typically over 90% of the stuff is bound…in taxis, and the rest is unbound…or walking around freely.
Now here’s the clincher…only the free stuff can do anything to you…only the free estrogen can go into your cells and make them do something that estrogen makes them do.
Estrogen for example makes your womb lining grow in preparation for having a baby…but only free estrogen can do this…not estrogen bound to a carrier protein (aka a taxi).
So what’s the point of measuring all the estrogen when it’s only the free stuff that actually changes anything in your body?
It’s like….you’re on holidays in Lanzarote with your family…on paper you’re a millionaire coz you own 5 properties, but you can only buy beer and pizzas with whatever money you have in your pocket. (Credit cards don’t exist in this world…just go with it!)
If you only have €1.50 in your pocket, well you’re not exactly going to get pissed are you. But imagine an onlooker commenting about you that you’re as tight as tuppence because you won’t buy your kids pizzas!! It wouldn’t be very accurate would it? Yet that’s what doctors do…they comment on your overall wealth without knowing your immediate liquidity status, without knowing how much of your estrogen you can actually spend at any given moment. And whats worse…they often proscribe drugs to you based on this reading.
Is there a way to tell how much free estrogen (or progesterone…or LH or FSH for that matter) you have floating around your blood? The answer is yes….you can get this information in saliva tests, because the only hormone in saliva is the free stuff…and reference ranges have been worked out…and to boot (at least for the labs I use) the reference ranges are not generic averages…they are ranges based on what healthy people have, therefore they offer decent targets to aim at.
Why don’t doctors use these? Old ways are slow to change.
If you’re interested in finding out how you can get these tests send me an email and I’ll let you know.