Last week I talked about why you should get your hormones tested if you have acne. This time I promised you I’d tell you which ones to get tested and by which methods.
So first of all, let’s talk about the main hormones that are useful to know about if you have acne.
They are:
- Progesterone
- Estrogen (specifically estradiol)
- Testosterone
- DHEAS
- DHT
- Cortisol
- Luteinizing Hormone (LH)
- Prolactin
- Insulin
Why You Want to Test These Hormones If You Have Acne
Progesterone that is too low compared to estrogen (or progesterone that is normal with estrogen that is too high) is a very common issue that can lead to acne as it increases androgen activity in the skin. This ramps up acne production.
A low progesterone to estrogen ratio is a clue that an estrogen dominance type treatment & supplement plan will work better for you.
Testosterone, DHEAS, and DHT are androgens and these can directly lead to acne, so one or all of them being high is something to look out for.
High androgens are a clue that an androgen based treatment & supplement plan will work better for you.
Note: Androstenedione is also an androgen that frequently shows up as high for women with acne, although androstenedione seems to almost always be high when found alongside a low estrogen/progesterone ratio and is likely caused by this imbalance. That means this kind of acne responds better to an estrogen dominance type treatment than an androgen based treatment.
Cortisol (your stress hormone) levels are useful to know to determine if stress is a big root cause of your acne.
Luteinizing hormone (LH) and prolactin are useful for knowing whether or not you should take certain herbs as treatment. In particular, Vitex chasteberry should not be used if your LH is high but good if your prolactin is high.
Insulin resistance can be a root cause of androgen based acne, so particularly if you have high testosterone or are diagnosed with PCOS, getting your insulin tested can definitely be useful.
Testing Your Hormones with Blood Testing
The most common testing method for hormones is serum blood testing. This is what you can get done through your regular doctor.
Blood tests measure what’s called bound hormone — it’s attached in the blood to SHBG (sex hormone binding globulin). When a hormone is bound, it can’t be used at a tissue’s receptor site. But hormones acting on receptor sites in tissue are what actually create symptoms.
So in essence, it is not a very good reflection of what is actually causing you symptoms.
Time and time again, I hear from women who clearly have a gamut of hormonal symptoms and a blood test that says everything is completely normal. Which is obviously not true.
However, blood testing can be useful for some things. Testosterone tends to be better tested through blood. And blood testing is where you’re going to find out about your LH and LSH and prolactin.
So if you can get a blood test from your doctor, then great. Do it.
But I don’t think it gives the full picture. So I’d also recommend getting a saliva or urine test done.
Testing Your Hormones with Saliva Testing
Saliva testing tests more of the free, unbound hormone that is available to your tissue’s receptor sites. This means it more accurately reflects your symptoms.
Saliva tests generally test all the hormones I mentioned above, except for LH, prolactin, and insulin.
The bad news is that regular doctors don’t do it and it needs to be paid for privately through a lab or natural practitioner of some sort. They usually go for around $150.
The kits can be mailed to you wherever you live, as long as you can send them back via courier with two day shipping.
It’s also easy to do — just spit in some test tubes.
Testing Your Hormones with Urine Testing
Urine testing is like saliva testing, except it usually tests more hormones.
It may also be slightly more accurate especially if collected over a 24 hour period, and is more stable if it’s a dried urine test (which means better if you live internationally and need to mail it back in — you have more time).
But, it’s also more expensive. And you also need to do it through a natural practitioner who offers it.
An example of this is the DUTCH test. This is a great test. If you can afford it and can find someone who does it and knows how to interpret it for acne patterns, then I’d recommend this.
For the most part though, a basic saliva test that tests the hormones I listed will do a great job. I find myself recommending this the most.
Getting Your Insulin Tested
If you wanted to see if you were insulin resistant, you would get this done through your regular doctor with a test called “Fasting Glucose Level”.
However, doctors can often be living with tunnel vision, and they may be resistant to letting you do it unless you are overweight, have been diagnosed with PCOS, or have a history of diabetes in your family.
If you have good reason to believe your acne might be tied to blood sugar levels, then push to get the test done. If not, keeping your blood sugar levels stable is a great acne strategy regardless.
Other Things to Be Aware Of with Testing Hormones for Acne
Note that getting your hormones tested when you’re on hormonal birth control is pretty useless. The synthetic hormones in it completely suppress and override your natural hormones.
Since hormone testing tests your natural hormones, it will likely say everything is low across the board and not give you anything too useful.
Another thing to note with saliva or urine testing is that it is very important to have someone who understands acne and the testing to help you interpret them. It’s pretty useless to get back a test, have no idea what it means or what to do with the info, and have your money be wasted.
Ideally the natural practitioner who you run it through will know how acne works and give you some good advice.
There’s also me, of course. For years I have been helping my lovely Love Vitamins interpret their saliva tests in my Naturally Clear Skin Academy.
So if you’d like my help, consider joining us. I also have a special bonus for Academy members only – they get an exclusive 30% discount on a saliva test through a specific company (ie saliva tests for $99).
Do you now feel more confident about getting your hormones tested?
10 Responses
Hi Tracy,
Thanks for this article. I have been thinking about getting a hormone test for a while now. However, I am still breastfeeding my son. Is there any point getting a hormone test or would the results be misleading as due to nursing my hormones are probably all over the place? I’d be interested to hear your thoughts.
Thanks,
Andrea
Hi Andrea — good question. You could get them tested, if you are planning to continue breastfeeding for some time and willing to work with what your hormones are doing whilst breastfeeding (although supplement options are also much less plentiful in this stage). All things considered, it’s probably better to wait if you are not planning to breastfeed for years to come. I would probably get them tested again about three months after weaning.
Thanks Tracy, I’ll do as suggested?
Hi Tracy,
I have used about 1,5 years progesterone (norethisteron) for irregular periods, 10 days every month before period. The doctor didn’t find anything unusual (that would explain this period problem), so I guess it was “just” stress.
Hard to say how this has affected my skin. My pms skin is always worse than skin normally, but at least this product hasn’t made it even worse. But my concern is how it affects my mood. Just until recently I realised my “chaotic” feeling is linked to pms and this progesterone. So somehow it has eased some pms symptoms and this period problem, but it has created some new pms problems on its own!
In pms I feel very anxious, over reactive, over sensitive, I want to avoid people, I’m very irritated, have strange thoughts, become obsessive, feel like becoming crazy, losing control…it’s scary, normally I’m not like that!
It’s interesting that this same product can also used to ease pms! (with a little bit different dosage)
I’d curious to know, what is the mechanism that causes this? Why hormones/synthetic hormones/pms affects so much brain and nervous system? Is there too much or lack of something? And most importantly, what I could do with this? I’d like to feel like myself the whole month! What lifestyle, nutrition etc. choices?
I’ve also been thinking, if I should quit this and try vitex instead. But can vitex cause some side effects or pms problems too, that are specific only to it?
I’d love to hear your thoughts about this.
Thanks! 🙂
Hi A — yep hormones are very tricky. My guess is that you’d be taking too much of it? If it’s a cream, sometimes it can build up in your system, because creams are hard to dose. Have you ever had a saliva test? You might really consider it to see where you’re progesterone and hormones are actually at, currently, to see what you might want to do from here. Vitex or bio-identical progesterone drops (drops are easier to dose) would be a possibility.
Hi,
They are pills.
I haven’t heard of saliva test. In local health care, they do only blood tests to some hormones (like thyroid) but the doctor said “it’s useless to test progesterone and estrogen, because they fluctuate, naturally, all the time anyways”.
Is saliva test something I could do myself, order from somewhere?
Sometimes I feel frustrated, humankind have been in the moon but there’s still no magic pill found to cure pms! How annoying 🙂 Or I know what the doctors would say, that the “magic pill” is the pills. But I don’t like to use pills, I don’t understand why the doctors always promote them? Shut down all the natural hormonal activity and replace it with artificial ones, to a forced rhytm. How that could be a good thing? 🙁
I found an article that said that actually vitamin B6 could help with all pms symptoms. If it’s true, that’s awesome! Vitamin supplements are easy to find and not expensive. But do you know, should I then take them all the time, or would it help if I’d take them for example only 10 days before the period? How fast vitamin supplements can “work”? I think vitamin supplements are quite strong and somehow “artificial” too, so I’m not sure if it’s good to use them every day many months?
Hi Tracy!
I got off birth control in my early twenties and broke out in severe acne. I got on the acne.org regimen for the past 8 years and it has cleared me up completely, but I have felt like my hormones have been out of whack for years, especially after two children. I have been struggling with my benzoyl peroxide treatment lately, it just causes so much dryness and irritation and in the long run I don’t think its very healthy. I am acne free at this point, but I know if I stop using the BP my face will freak out . I am highly interested in your program, but again I am so nervous to get off the treatment that has worked so well for me. Is it possible to do your program while weaning off of the BP?
I’ve suffered from hormonal acne for about 6 years now. Medication that dermatologist prescribes always works for awhile and then stops working. I’m trying curology now since I don’t really have a dermatologist anymore because I’m moving and having to change health insurance once the move is completed. So far no results. I’ve been on hormonal birth control for a couple years now after prescribed by my dermatologist and was using other topicals but then lost control of my skin again around 2 months ago. I’m nervous to go off the birth control because even though my skin is bad now, I’m afraid it will get even worse without the birth control even though I think when I was younger, it actually looked better (when I was on no medication for acne) than it does now (on the medication but stopped being as effective). I’m worried the medications and topicals are never actually going to solve a problem that doesn’t seem to be going away on its own (and may over the long run be making it worse). How long does it take to detox from hormonal birth control so I can take the saliva test with the most accurate results? Also, I would most likely be sending results to you because as I said I’m moving and not sure I’ll be able to find someone who can interpret the results.
Hi there! Thanks for yourblog. I am typically not an acne sufferer. However, during my last cycle I had terrible boob soreness and awful cramping. After my period was over, I got pimples all over my chin. I started taking Vitex around the same time. Do you have any insights?
Hi Catie, hard to say — Vitex isn’t for everyone. Did you stay on it? Sometimes it makes it worse at first but within several cycles you see the changes.