The Ultimate Hormone Report is East x West Med's most comprehensive testing package. Dr. Robbins has developed an extensive evaluation to provide the most complete hormone assessment and care plan. This assessment is perfect for those who have a complex hormonal history or who want to have the most thorough understanding of your hormone functionality.

Testing is primarily completed through DUTCH, which is a group of dried urine and saliva tests that offer a complete evaluation of sex and adrenal hormones, including metabolites. These tests are easier to collect and offer a more in depth look compared to blood tests. Although DUTCH offers direct-to-consumer lab testing, it does not include a complete workup with personalized clinical implications and recommendations. The Ultimate Hormone Report, however, includes medical review of the results, interpretation, and proposed next steps with your goals in mind in addition to testing for even less than if you ordered the test yourself without a clinician's oversight. 

The foundational report looks at sex hormones and their metabolites. While traditional  testing looks at serum (blood) sex hormone levels, The Ultimate Hormone Report also looks at how the body breaks down these hormones, which can impact total hormone concentrations, symptoms of hormonal imbalances, and even risks for certain health diseases and cancers. 

This test includes:

• Estrogen and estrogen metabolites

• Androgen and androgen metabolites (Testosterone, DHEAs, DHT, and more)

• Progesterone and progesterone metabolites

The package includes a detailed report of lab results that includes visual representations of results to get the best understanding of your body. The report also includes a detailed analysis and interpretation done by Dr. Robbins that summarizes her findings as well as her thorough treatment proposal including prescriptive, non-prescriptive, and lifestyle medicine recommendations to achieve the goals outlined in the intake.

The Ultimate Hormone Report is something that may be recommended after your initial evaluation if Dr. Robbins feels that standard hormone testing wont be as sufficient (or if you request more comprehensive testing). Your results will be provided by typed report that is complete and more thorough than most face-to-face functional assessments. We also offer the opportunity to also meet with Dr. Robbins virtually to review pertinent findings, address any questions unanswered, and/or choose a treatment plan together (additional fees apply).

Additional Tests

Some additional tests may be worthwhile to include to provide further insights into hormone health. With the exception of cycle mapping, anyone can benefit from the additional insights below. Each test can be added individually from the list and/or with a testing bundle. 

Organic Acid Tests (OATs) Profile

This profile offers a broad look at organic acids as well as other hormonal and neurotransmitter metabolites. Organic acids are a group of byproducts of proteins, fats, and carbohydrates that play a significant role in longevity health, particularly cognitive function and brain health. 

Abnormal organic acid levels may indicate nutritional deficiencies, neurotransmitter deficiencies, inflammation, oxidative stress, circadian rhythm dysfunction, and/or poor digestion and gut microbiome. All of these findings play a role in the overall hormone picture. 

This test includes:

• Vitamin B12 (methylmalonate)

• Vitamin B6 (xanthurenate and kynurenate)

• Biotin (b-Hydroxyisovalerate)

• Glutathione/inflammation (pyroglutamate)

• Dopamine (homovanillate)

• Norepinephrine/epinephrine (vanilmandelate)

• Oxidative stress – 8-Hydroxy-2-deoxyguanosine (8-OHdG)

• Melatonin (6-OHMS)

• Gut dysbiosis (Indican)

Cortisol Testing

Daily free cortisol patterns can reveal answers to questions about the Hypothalamus-Pituitary-Adrenal axis (also known as the HPA axis), which is a communication system between the three areas of the body to help manage stress and maintain endocrine balance. The HPA axis can become dysfunctional and cause chronically low or high cortisol levels, which can in turn cause mood disorders, immune system disruption, metabolic diseases (think: diabetes and obesity), cardiovascular diseases and more. Gaining insights into the overall diurnal pattern of free cortisol and the total distribution of cortisol metabolites with this test can be an important step in treating root cause. 

This test includes: 

• Daily free cortisol pattern

• Daily free cortisone pattern

• Cortisol metabolites (a-THF, b-THF)

• Cortisone metabolites (b-THE)

• DHEAs

• Free OATs Profile

Cortisol Awakening Response (CAR)

When we open our eyes upon waking, cortisol levels naturally begin to rise quickly to propel us into a successful day. By 60 minutes after waking, cortisol levels have peaked and will slowly decline for the rest of the day and during sleep. Measuring this rise and fall of cortisol levels at waking can be used as a "mini stress-test." Research indicates that the CAR is a superior test as the increase in levels upon waking is a stronger indicator of HPA axis function than the levels of individual samples alone.  

This test includes:

• 5 measurements of cortisol and cortisone collected from waking to bedtime

• Analysis to provide the up-and-down pattern throughout the day as well as the cortisol awakening response (CAR) calculation

Cycle Mapping

For some women, testing sex hormones on a single day is sufficient. In many situations, however, "mapping" out the hormonal pattern throughout the menstrual cycle is critical to understand the entire picture. Different sex hormones fluctuate depending on the phase of the menstrual cycle and a disruption in a hormone's natural course can lead to infertility or hormonal imbalance. 

Examples of when cycle mapping is recommended include when there are concerns about fertility, irregular cycles or PCOS, hormonal symptoms that tend to fluctuate throughout the cycle, history of very long or short cycles, PMS, mid-cycle spotting, etc. This test is not helpful for women who are on combined (estrogen and progesterone) oral birth control, post menopausal or post total hysterectomy, on hormone replacement therapy, or do not have normal menstrual cycles. 

This test includes:

• 9 targeted estrogen measurements taken throughout the cycle to characterize the follicular, ovulatory and luteal phases of a menstrual cycle

• 9 targeted progesterone measurements taken throughout the cycle to characterize the follicular, ovulatory and luteal phases of a menstrual cycle

Thyroid Function Tests

Thyroid function testing is the only panel not offered through DUTCH as it can only be tested through blood but provides an added layer to the overall hormone picture. Thyroid levels impact sex hormone levels in a number of ways, including impacting how the body frees up testosterone and how the body detoxifies estrogen. There are also many symptoms of thyroid dysfunction that overlap with sex hormone imbalances, including low energy, dry skin, and brain fog. 

This test includes:

• Thyroid Stimulating Hormone (TSH)

• Thyroxine (Free T4)

• Triiodothyronine (Free T3)

• Reverse T3

• Thyroid antibody tests

To learn more about pricing and what to expect, or if you are ready to book, please click below.