Four Point Hormone Panel

  Show Description In this episode of Foundations and Functions, Dr. C.J. Pabla and Dr. Jason Amich dive into the groundbreaking Four Point Hormone Panel—a tool they've developed to bring clarity and insight to women struggling with unexplained hormonal symptoms. Drawing from personal experiences and years of clinical practice, the doctors explain how traditional hormone testing often fails to account for the natural fluctuations in female physiology. By testing key hormones four times throughout the menstrual cycle, they're able to map a more accurate picture of what's really happening in the body—and finally validate what so many women have been told to ignore: "Everything's normal" doesn't always mean everything's okay. Dr. Amich and Dr. Pabla break down the science behind the panel and share how it's transforming the way they help patients address symptoms like anxiety, depression, infertility, and fatigue. From hormone behavior to root causes like thyroid dysfunction, PCOS, and even environmental toxins, this episode is packed with eye-opening insights into how functional medicine can restore balance and well-being. Whether you've been dismissed by traditional care or you're simply curious about a deeper approach to hormonal health, this episode will help you ask better questions—and understand your body like never before. Disclaimer: The information provided in this podcast is for educational and informational purposes only and is not intended as medical advice. The content is not a substitute for professional medical care, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider with any questions you may have regarding a medical condition. If you would like more detailed medical information, please contact Integrative Medicine through their website at https://integrativemla.com/     Show Transcription 3 0:00 Welcome to Foundations and Functions weekly podcast, where we return to when medicine actually made you better. Now here's Dr. Jason Amick and Dr. C.J. 6 0:14 Pabla. 2 0:16 This is Dr. C.J. Pabla with Dr. Jason Amick. Welcome to our Foundations and Functions podcast. Today we're going to be talking about the Four Point Hormone Panel and kind of like why we decided to do the Four Point Hormone Panel. So I'm going to pass it on to my partner, Dr. Amick. Why don't you tell us kind of how you came up with this concept and how it really has 2 0:40 helped our patients? 1 0:41 Dr. Amick Morse Yeah, thanks so much. So, you know, one of the things that I say pretty frequently is, you know, I'm a girl dad, and constantly in my life, you know, I've been faced with situations, you know, with my daughters and my wife, and I just think, wow, dudes don't put up with that. 1 0:58 You know, a dude would never go through that the way you guys do that. And so, you know, in seeing a lot of our patients, female patients who come in really frustrated, and they hear kind of the same thing, like, well, you know, I haven't felt well, I haven't felt well, and my doctor just tells me everything is normal. My labs are normal, my hormones are normal, but I don't feel well. And you know, I kind of thought about that for a while, and it occurred to me, biologically, dudes 1 1:30 are dumb. I mean, from a biological perspective, our hormones are really pretty basic. You're 10 years old, you're 12 years old, boom, you hit puberty, your testosterone spikes, kind of hangs out there. Yeah, maybe in your late 30s and 40s, your testosterone may waver a little bit, 1 1:47 but female physiology, their hormones change daily. Daily, and it's a cycle that they go through every single month. And so, one of the things that I thought of was, what does normal mean when you talk about an estrogen level? So we know the range of estrogen can be, depending on where you are in your cycle, 4 to 400, 1 2:14 generally speaking. And that's a huge range. And so I applied that and I thought, well, gosh, 71 is normal. But is it always 71? Is 71 the highest that you get? Is 71 the lowest that you get? 1 2:32 And so, yeah, I mean, it would be great to, as scientists and as nerds that we are, to get as many data points as possible. But it's really hard to get people to come in and get blood drawn every day for 28, 32 days. 5 2:46 Right. 1 2:47 So really we work with our lab. We've got a great relationship with our lab that keeps a lot of costs down for patients who pay out of pocket. And so we're able to actually put together this panel that includes an estrogen level, progesterone level, luteinizing hormone, follicle stimulating hormone, prolactin, and testosterone. 1 3:07 And we can actually sample that on a patient four different times during their menstrual cycle for really low cost. And what that does for us is it allows us to graph that. Now it took me some time. I had to go back and remember my Excel and logarithmic functions to put all that on a graph. But really, it was eye-opening. 1 3:28 I remember when you and I first looked through that graph and went, wow, this is kind of out of a textbook. We know how the hormones are supposed to fluctuate throughout the different – the luteal phase, for example. We know kind of where estrogen should be in relation to progesterone. And so we've been able to take that graph and really give patients a lot of data and 1 3:53 help them make it make sense. And so there are patients that we've definitely sat across from and said, you know what, right, all of your lab values are within the normal range. But the behavior of these hormones are not normal. And so, validating that, I think, means a lot to a lot of patients that say, you know what, you're right, you don't feel well. 1 4:14 You're not crazy. There's nothing wrong with you. You're not broken. You just have some physiology that's off and that manifests in emotions, anxiety, depression, sometimes infertility even. And so using that data set and what we know about physiology helps us really paint the picture for our patients and put them on the right track, know what questions to 1 4:39 ask. And then sometimes that means going back to their OBGYN or going back to their primary care doctor and saying, hey, here's this graph. And I know in my experience, most of those providers have never seen a graph like that. 4 4:52 Yeah. 1 4:53 The current insurance model just would never allow a primary care doctor using insurance to order the same five or six labs four times in a month. Right. You know, and cover those costs. to order the same five or six labs four times in a month, you know, and cover those costs. So we're able to do that, and because of that, we can provide a lot of insight into, you know, what's happening with someone's hormones. 1 5:17 And so from there, you know, some of those patients may choose to see us from a functional medicine perspective, right, where, you know, they see you, and we start kind of digging down that root cause path of why is that? choose to see us from a functional medicine perspective, right, where they see you and we start kind of digging down that root cause path of why is that? Why is your progesterone flat? 1 5:31 So that may indicate you're not ovulating. Well, why would that be? So then we can kind of talk about some of the reasons that someone may have hormone 2 5:43 dysfunction. Dr. Darrell Bock Yeah, polycystic ovarian syndrome. You could have thyroid dysfunction. So those can affect high androgens. Elevated prolactin can suppress ovulation. So there's several root causes that we can look up and kind of try to determine, like, why are you not ovulating? 2 6:04 And you know, how many times have you had people come in and said, well, I have my hormones checked and I'm like, okay, where were you in your cycle? Like, I don't know. And I said, well, then this data makes no sense because your hormones change so much throughout your cycle. And so I think just helping women know that there's not a linear response to your hormones throughout all 28 days. They change. 2 6:25 And I think that's kind of like their aha moment. They're like, oh, okay, now that makes sense to me. And then that's why we're looking at four data points so we can follow this curve. So yeah, I think the four-point panel has really helped a lot of our women kind of understand what's going on throughout their cycle and their responses to their hormones. 1 6:45 Darrell Bock And then we take that lens and we broaden that lens because, again, we go back to where do some of these hormones come from? What are the foundations of these hormones? And so, again, we go in and we look at gut health. We look at toxin load. We look at chronic viral infections. 1 7:01 And we really kind of figure out, oh, it may not be PCOS, it may not be a thyroid, it may be something going on with your environment. It could be a heavy metal toxicity, it could, mold exposure, we talk about that a lot. A lot of these things can affect your physiology in lots of different ways. 1 7:19 So that's kind of where we started down the path with these four-point hormone panels. And man, it's one of my favorite things to do with patients and helping them really gather good quality data that really helps explain their physiology. So if you are someone who thinks, gosh, I just don't feel well, I want to get my hormones checked, the questions to ask are are what hormones are you getting checked? 1 7:46 When are you getting them checked? Maybe a good option would be to come to our office and let's do a four-point hormone panel and just take a look at how your hormones are behaving, not necessarily what their level is because one of the things I explain to people too, it seems like no one really kind of knows what a normal estrogen level should be. That's going to be different person to person. 1 8:08 So it's about the behavior though. So hopefully that helped make it make sense. And thanks for listening today to our Foundations and Functions podcast with Dr. Pabla and Dr. 3 8:21 Amy. The information provided in this podcast is for educational and information purposes only and is not intended as medical advice. The content is not a substitute for professional medical care, diagnosis, or treatment. Always seek the advice of a qualified healthcare provider 3 8:38 with any questions you may have regarding a medical condition. If you would like more detailed information, please contact Dr. Amick or Dr. Pabla at Integrative Medicine through their website at please contact Dr. Amick or Dr. Pabla at Integrative Medicine through their website at integrativemla.com