Hormone Testing: Thyroid, Menopause, and Hormonal Imbalances Explained
Fatigue, weight changes, mood swings, and irregular cycles often trace back to hormonal imbalances. Dr. Sophia Rahman explains what hormone testing looks for and when she orders it in Plano, TX.
Hormones regulate almost everything — your metabolism, sleep, mood, reproductive cycle, stress response, and more. When they’re out of balance, the effects show up across your whole body, often in ways that are hard to connect to a single cause.
Patients in Plano, TX come to me with symptoms like unexplained fatigue, weight gain that won’t budge, brain fog, irregular periods, or feeling generally “off.” Hormone testing is frequently where we find the answer.
Thyroid Function
The thyroid is responsible for regulating your metabolic rate and energy levels. Thyroid dysfunction is one of the most commonly missed diagnoses in primary care because its symptoms overlap with so many other conditions.
I test for:
- TSH (thyroid-stimulating hormone): The primary screening marker. An elevated TSH suggests the thyroid is underperforming (hypothyroidism); a suppressed TSH suggests overactivity (hyperthyroidism).
- Free T4: The main hormone produced by the thyroid, converted to the active form T3 in peripheral tissues.
- Free T3: The biologically active thyroid hormone. Some patients feel best when T3 is in the upper portion of the normal range, even if TSH looks normal.
- Thyroid antibodies (TPO, anti-thyroglobulin): Elevated antibodies indicate Hashimoto’s thyroiditis, an autoimmune condition and the most common cause of hypothyroidism in the US.
Symptoms that prompt thyroid testing: fatigue, cold intolerance, dry skin, hair loss, weight gain, constipation, depression, or slowed heart rate on one end — and anxiety, heat intolerance, weight loss, palpitations, or diarrhea on the other.
Menopause-Related Hormones
The perimenopause and menopause transition involves a gradual decline in estrogen and progesterone, with corresponding changes in FSH (follicle-stimulating hormone) and LH (luteinizing hormone). Testing helps confirm whether symptoms are hormonally driven and where someone is in the transition.
Key markers I assess:
- Estradiol (E2): The primary estrogen. Declining levels drive hot flashes, vaginal dryness, sleep disruption, and mood changes.
- Progesterone: Works alongside estrogen in the menstrual cycle. Low levels can contribute to irregular bleeding and sleep issues.
- FSH and LH: As the ovaries produce less estrogen, the pituitary increases FSH and LH output. Elevated FSH is a reliable indicator of menopause transition.
Testing alone doesn’t determine treatment — symptoms do. But labs give us an objective picture that helps guide whether hormone therapy, lifestyle adjustments, or other interventions make sense.
Other Hormonal Imbalances
Testosterone
Both men and women produce testosterone, and deficiency affects both. In men, low testosterone causes fatigue, reduced libido, difficulty building muscle, and mood changes. In women, testosterone influences libido, energy, and bone health. I test free and total testosterone when the clinical picture points in that direction.
Cortisol
Cortisol is the body’s primary stress hormone, produced by the adrenal glands. Chronically elevated cortisol from ongoing stress, or pathologically elevated cortisol from a condition like Cushing’s syndrome, can cause weight gain, hypertension, blood sugar dysregulation, and immune suppression. Low cortisol (as seen in adrenal insufficiency) presents with profound fatigue, low blood pressure, and salt cravings.
DHEA-S
Often measured alongside cortisol, DHEA-S is an adrenal hormone that serves as a precursor to estrogen and testosterone. It declines with age and can influence energy and overall well-being.
When to Ask About Hormone Testing
You don’t need to present with a textbook symptom list. If something feels chronically off and your standard labs come back normal, hormones are often the next layer to investigate. Come in, tell me what you’re experiencing, and we’ll work through it together.
Book an appointment at sophiarahmanmd.setmore.com. We’re located at 1212 Coit Rd, Suite 105, Plano, TX 75075. Accepting new patients in Plano, Frisco, McKinney, Allen, Murphy, and surrounding Collin County.