• Before starting BHRT, run comprehensive baseline labs — not just estrogen or testosterone.
• Core tests cover sex hormones, thyroid, cortisol/adrenal rhythm, metabolic markers, and key nutrients.
• DUTCH and Organic Acids Testing (OAT) show how your body processes hormones and energy.
• At Lakeside Holistic Health (Coeur d’Alene, Idaho), we test and monitor four times per year for safety and precision.
• Goal: midlife hormone balance that supports energy, metabolism, and longevity — not quick fixes.

Why Testing Matters Before BHRT

The Core Labs Every BHRT Provider Should Order

1) Serum (Blood) Hormone Panel

• Estradiol (E2) — bone, brain, skin, and vaginal health
• Progesterone — balances estrogen; supports calm, sleep, uterine lining
• Total & Free Testosterone — energy, libido, muscle tone
• DHEA-S — precursor for estrogen/testosterone pathways
• Thyroid Panel — TSH, Free T4, Free T3 (antibodies if indicated)
• Cortisol (AM/PM) — stress response and adrenal rhythm
• Metabolic Health — fasting glucose, insulin, and lipid panel

2) DUTCH Test (Dried Urine Test for Comprehensive Hormones)

• Sex-hormone metabolites (estrogen, progesterone, testosterone, DHEA)
• Estrogen detox pathways — how your body clears hormones
• Cortisol rhythm throughout the day
• Melatonin production (sleep regulation)

3) Organic Acids Test (OAT)

• Cellular energy (ATP) and mitochondrial function
• B-vitamin/antioxidant status
• Detox & methylation capacity (hormone and toxin clearance)
• Gut/microbiome indicators and neurotransmitter precursors

Additional Labs Your Provider May Recommend

• CBC & CMP — general screen (blood cells, liver, kidney)
• Vitamin D, B12, Ferritin — key nutrients for metabolism and mood
• Inflammation markers — hs-CRP, homocysteine (case-by-case)
• Insulin resistance panel — deeper look at blood sugar balance

What Happens After Testing

1. Review Results + Symptoms: We map labs to how you feel.
2. Explain Imbalances: Which hormones are low or out of range — and why.
3. Create a Personalized BHRT Plan: Estrogen, progesterone, and/or testosterone as appropriate.
4. First Follow-Up at 8–12 Weeks: Early response and tolerance check.
5. Quarterly Monitoring: Four times per year to keep levels balanced and safe.

Safety & Follow-Up Testing

• Breast tenderness or mild bloating
• Spotting (early in treatment)
• Mood or sleep changes
• Headaches or skin irritation (topicals)

Seek Medical Care Immediately If You Notice:

• Chest pain or shortness of breath
• Leg pain, redness, or swelling
• Severe headaches or vision changes
• Heavy or unusual vaginal bleeding

Our Testing Approach at Lakeside Holistic Health

1. Comprehensive Intake — history, goals, and symptoms
2. Baseline Testing — serum + DUTCH + OAT
3. Personalized BHRT Plan — tailored dosing for your body
4. Quarterly Monitoring — four checkpoints per year
5. Functional Support — nutrition, gut, and stress care for midlife balance

Sources & Citations

• Institute for Functional Medicine (IFM)
• BHRT Training Academy
• Evexias Health Solutions — Lakeside Holistic Health
• National Center for Biotechnology Information (NCBI)