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Frequently Asked Questions: About Hormones


FAQs

FAQs: Patients’ Concerns

Why do I need to provide a 24-hour urine sample? My friend just gave a saliva sample and it was so easy.

Hormones are a complex system that can’t be understood without looking at each part of the system and how it works over time. A 24-hour urine sample provides all the information needed to evaluate hormone levels throughout the day and night. A saliva sample provides only a momentary picture of hormone levels – a snapshot instead of the complex, detailed image provided via urine.

Saliva samples present other problems beyond simple inadequacy. Just collecting a saliva sample can change the hormone levels being measured. Cortisol, for example, typically increases under the pressure of producing sufficient saliva for a sample – so any measurement of cortisol in that moment is meaningless.

In addition, people often have small cuts or lesions in the mouth that they may not even be aware of. Blood contamination resulting from these undetectable breaches in the skin or on the tongue immediately makes a saliva sample useless.

Why can’t I just get a little pinprick and use a blood sample?

Again, as in the collection of saliva, producing a blood sample to measure hormones often is stressful and therefore can actually change hormone levels. Many people don’t like needles, and even a pinprick can be stressful enough to affect the sample. Blood samples also are frequently contaminated by undetected substances on the skin, which compromises any information that may have been available.

What about using dried spots of urine? I saw a website that said three spots of dried urine give all the same information as your 24-hour sample.

A website can claim just about anything. The truth is that dried urine spots are not useful in determining hormone levels because, like saliva and blood spot samples, any information they may offer reflects only the moment in which the sample was given.

Only a 24-hour urine sample provides the information needed to accurately assess hormones levels and function.

Can I order the hormone profile test directly from Rhein Consulting Labs?

All tests conducted by Rhein Consulting Labs must be ordered by a licensed healthcare practitioner.

 

Can I get a copy of my results as soon as they are completed?

Federal regulations require that we send all test results directly to the ordering healthcare provider. You may obtain a copy of your results from your healthcare provider.

 

When is the best time of my menstrual cycle to do the collection?

On a 28-day cycle, it’s best to collect on day 19, 20 or 21. If your cycle is of a different duration or is erratic, you should ask your healthcare practitioner about the timing of collection. Women who are no longer menstruating may collect at any time.

 

I missed a urine collection. What should I do now?

It is best to start over. Just rinse your container with water and begin again the next morning.

 

How long can I leave my urine in the refrigerator?

A urine sample is stable in the refrigerator for 1-2 days at most. Please freeze your sample as soon as possible.

How long can my urine remain frozen?

Your urine sample remains stable for several weeks when frozen.

 

Will the delivery service keep my sample frozen?

A sample typically thaws during transit. The ice pack provided will keep the urine cool, however, and therefore it remains stable during transport.

Do I have to pay for shipping?

No, a prepaid return label is included with the collection kit.

 

How long will it take for my sample to get to you?

The sample will arrive at the lab via overnight delivery.

 

How long will it take before my doctor has the results?

The results will be available to your doctor in 3-7 business days.

 

FAQs: Payment and Insurance

 

Will my insurance cover the hormone profile?

Most insurance companies reimburse fully for the Rhein Labs hormone profile. Of course, it’s wise to check with your insurer in advance.

 

Do I have to pre-pay for the test?

Payment is required, either to your healthcare provider or directly to the lab, at the time you send in your sample. If you are uncertain about payment, please check with your healthcare provider.

 

Will you bill my insurance directly?

Patients pay at the time of service for their hormone profiles and are reimbursed by their insurer. The Rhein Labs hormone profile is widely accepted for reimbursement by all major insurers. We provide patients with a claim form to submit to their insurer in order to obtain reimbursement. In cases where the insurer reimburses Rhein Labs directly, we immediately issue a refund to the patient.

 

Rhein Labs may be out of network for your insurer, but this is no bar to reimbursement. We are in network with the following insurers:

 

Medicare

Blue Cross/Blue Shield of Oregon

ODS/Moda

PacificSource

PacifiCare

 

How much does the Rhein Labs hormone profile cost?

Please contact your healthcare provider for pricing information. It’s important to know exactly what is being ordered and how your provider’s office wishes to handle payment.

 

FAQs: For Clinicians

 

Can I drop ship a test kit to a patient?

Yes! Please either fax or email us your request. Please include the patient’s name, address, phone number, the data you want to receive, and any applicable diagnostic codes.

 

How do I order kits?

You may call, fax or email your request. We will ship the kits to you on the same day that you order them.

 

Are the kits free of charge?

Yes, the kits are free of charge. Where a deposit is required, it is applied to the price of the test. Payment is required when the sample is mailed to Rhein Labs. Processing of samples is contingent on payment.

 

How long before my office has the results?

We will fax or email results to you within 3-7 business days. On a weekly basis, results are completed and faxed on Monday afternoons.

 

Can I discuss my patients’ results with someone at the lab? The lab we use now doesn’t have anyone who understands the data.

Dr. Frank Nordt, founder and CEO of Rhein Labs, is personally involved in assessing and releasing every set of results. He is readily available to discuss this information with healthcare practitioners. Please contact Rhein Labs to schedule a telephone consult at your convenience.

FAQs: About Hormones

Exactly what are hormones?

Hormones are chemical “messengers,” produced within the body, that carry signals from one set of cells to another. The balanced, integrated production and functioning of hormones is collectively called the endocrine system.

The body makes many different hormones, including steroid hormones. Steroid hormones are involved in:

  • Regulation of sexual differentiation and reproductive function
  • Maintaining the balance of fluids and minerals within the body
  • Protecting the body from acute or chronic physical and/or psychological stress

What do hormones do?

Working together as a system, hormones help to regulate dozens of ways in which the body operates. When they’re not working well together, or when one or more hormones are produced in excessive or inadequate amounts, the body reacts with symptoms that should not be ignored.

A good example is cortisol, popularly called “the stress hormone.” When we’re under stress, the body produces extra cortisol that isn’t easily dispersed or disposed of after the stress lessens. Looking at the levels of all steroid hormones reveals whether and how the body is reacting to excess cortisol.

What is a hormone profile?

At first glance, a hormone profile is a collection of numbers that don’t make much sense. When interpreted, however, the numbers reveal a complex but organized picture of how an individual’s system of steroid hormones is working.

Understanding Rhein’s comprehensive hormone profile is a little like looking at a painting. When you look up close, at just a small area of the painting, all you see is brushstrokes – or, in our work, measurements of a single hormone. But when you step back and look at the entire painting, you see how the brushstrokes work together to create a picture – or a true, complete assay of the individual’s hormone levels and their interaction.

 

Why do I need a hormone profile? Can’t my healthcare practitioner measure only the hormones we’re concerned about?

Hormones operate together throughout the body, changing dramatically over a 24-hour period as well as longer timespans. Their operation is so complicated that it is not entirely understood. We do know, however, that some hormones can convert themselves into different hormones, and some can trigger the creation or conversion of other hormones.

In such a complex, delicately balanced system, measuring just one or two hormones is meaningless.

Who can benefit from hormone profiling?

Both men and women may experience a wide range of symptoms and conditions that indicate the need for a comprehensive hormone profile. Because many such symptoms and conditions are sex-specific, this list divides them by sex.

In women, these symptoms and conditions include but are not limited to:

  • Irregular or skipped menstrual periods in women of all ages
  • Stress (excess cortisol)
  • Hot flashes
  • Depression
  • Night sweats
  • Reduction or loss of libido
  • Hair loss
  • Mood swings and/or irritability
  • Extreme tiredness and/or difficulty sleeping
  • Weight gain, especially in the waist area
  • Osteoporosis
  • Itchy or irritated skin
  • Inability to conceive
  • Hirsutism (excessive hair growth, often in unusual locations on the body)
  • Polycystic ovary disease
  • Premenstrual syndrome (PMS)
  • Headaches
  • Bloating
  • Any condition for which hormone replacement therapy (HRT or BHRT) is prescribed (to gauge and monitor effectiveness of treatment)
  • Supplementation with over-the-counter preparations, such as DHEA

In men, these symptoms and conditions include but are not limited to:

  • Erectile dysfunction (ED)
  • Reduction or loss of libido
  • Infertility
  • Depression
  • Stress (excess cortisol)
  • Excessive hair growth, hair loss, changes in body hair growth
  • Changes in muscle or skin tone
  • Weight gain, especially in the truncal (abdominal) area, and especially in middle age
  • Supplementation with over-the-counter hormone preparations, such as DHEA, androstenedione, pregnenolone, saw palmetto, etc.
  • Any condition for which hormone therapy, including testosterone replacement, is indicated (to gauge and monitor effectiveness of treatment)

Again, the symptoms and conditions indicating a need for hormone profiling are more varied and numerous than those listed here, which are only the most common. Ask your healthcare practitioner if your symptoms or conditions might indicate a need for hormone information.

Can hormones help stop aging?

Slowing or even stopping the aging process is a popular reason for many people to seek hormone therapy. Restoring hormone levels to those of a younger age may result in a more youthful appearance and function, whether the hormones used are synthetic or bio-identical.

Whether it’s advisable for an individual patient to use such supplementation is a question best addressed with qualified medical help. Hormone supplementation should never be undertaken without medical supervision.

Why do I need a healthcare practitioner to make my hormone therapy decisions? You see people in the media constantly who say they make their own choices about hormone therapy.

Smart, sensible people know that they can’t make medical decisions without expert input. Celebrities may say they’re in charge of their own hormone therapy, but if you look closer, you’ll usually learn that they’re under the care of a physician or other healthcare practitioner.

It’s a self-evident fact that an expert who works with hormones professionally, every day, is more competent than an untrained person when it comes to evaluating hormone levels and addressing any imbalance.

 



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  • Rhein Consulting Laboratories

    4475 SW Scholls Ferry Road
    Suite 101
    Portland, Oregon 97225

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    Frank J. Nordt, Ph.D.
    franknordt@rheinlabs.com

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