Comprehensive Hormone Testing & BHRT Monitoring

Detailed hormone panel testing covering sex hormones (oestrogen, progesterone, testosterone, DHEA), thyroid hormones (TSH, free T4, free T3, reverse T3), adrenal function (cortisol, DHEA-S), and insulin/metabolic markers. SFPMG has been administering and monitoring bioidentical hormone replacement therapy since 1985 — one of the longest-running BHRT programmes in San Francisco. Testing is used to guide personalised BHRT protocols and monitor treatment progress.

SFPMG's hormone testing and BHRT monitoring programme is built on four decades of clinical experience — the clinic has been offering bioidentical hormone replacement therapy since 1985, making it one of the most established BHRT practices on the US West Coast. The hormone testing framework covers the full endocrine axis: sex hormones including oestradiol (E2), oestrone (E1), oestriol (E3), progesterone, total and free testosterone, DHEA and DHEA-S, and sex hormone binding globulin (SHBG), which determines the fraction of hormones available to target tissues. Thyroid assessment is thorough, covering TSH, free T4, free T3, total T3, reverse T3, and thyroid antibodies (anti-TPO and anti-thyroglobulin) — the reverse T3 measurement is particularly important for patients with hypothyroid symptoms but normal standard thyroid panels, as elevated reverse T3 can block cellular thyroid receptor activity even when serum T4 appears adequate. Adrenal hormone assessment includes morning and diurnal cortisol, DHEA-S, and in selected patients, salivary or urinary cortisol rhythm testing to assess adrenal fatigue or HPA axis dysregulation. Insulin and metabolic hormones — fasting insulin, C-peptide, and IGF-1 — are assessed as part of the anti-aging and metabolic health evaluation. Pregnenolone as the upstream neurosteroid and melatonin where sleep disruption is a concern may also be tested. Where indicated, advanced testing through DUTCH (Dried Urine Test for Comprehensive Hormones) provides metabolite-level assessment of hormone processing, catechol oestrogen pathways, and cortisol metabolites beyond what serum testing reveals. Testing results are interpreted in consultation with Dr. Paul Lynn, MD, whose anti-aging and integrative cardiovascular expertise guides the development of individualised BHRT protocols using bioidentical hormones compounded to match each patient's physiological needs. The goal of BHRT at SFPMG is to maintain hormonal balance associated with improved energy, cognitive function, body composition, bone density, and cardiovascular parameters. Follow-up testing at three to six month intervals monitors treatment response and allows dose titration.