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However, many of these symptoms overlap with other conditions, which is why comprehensive lab testing is the most reliable way to confirm a hormonal imbalance. Thyroid dysfunction is the most prevalent hormonal imbalance overall, affecting an estimated 20 million Americans according to the American Thyroid Association. This iterative, data-driven approach is what separates meaningful results from guesswork. We schedule regular follow-up labs to monitor your response, refine dosages, and adapt your protocol as your body changes. They coordinate your care, track your progress, adjust protocols based on follow-up labs, and ensure you stay on track toward your health goals. Unlike traditional healthcare, 1st Optimal pairs every member with a dedicated Membership Manager who serves as your personal health advocate. Our process begins with advanced at-home lab testing, including comprehensive blood panels, DUTCH hormone metabolite testing, and cortisol mapping.
By using bioidentical hormones, it's possible to regulate thyroid hormone levels and help restore normal function. In the case of hypothyroidism, BHRT can help restore hormonal balance by replacing the hormones your body is missing. If you want to support healthy testosterone production, you also need to focus on your thyroid hormones.
However, your free testosterone levels might still be in the normal range, says Fishman. Excess SHBG can also increase the conversion of testosterone into estrogen.11 This shift in the delicate balance of testosterone and estrogen can lead to irregular periods in women. "There’s a lot of interplay between the hormones," says Fishman. If you have both a thyroid imbalance and low testosterone, your doctor might start by treating the thyroid problem. Thyroid hormones usually stay within normal limits for clinically prescribed TRT. "Thyroid hormone affects your metabolic rate, so not only how quickly you process calories, but also how your body stores and uses energy," says endocrinologist Sarah Fishman, M.D.
"If you don’t address the hyperthyroidism, then you can have higher SHBG, which hijacks and grabs the testosterone," says Londono. If your thyroid is out of balance, your testosterone levels can be, too—particularly in men. Produced in the testes in men and the ovaries and adrenal glands in women, the hormone has widespread effects throughout the body.1
The thyroid is a small butterfly-shaped gland located in the neck, just below the Adam's apple. Testosterone also helps maintain bone density, muscle mass, and sex drive in adult men. Testosterone plays a crucial role in male development and reproductive function.
By getting tested, you and your healthcare provider can better understand the cause of your symptoms and identify next steps. Hormone imbalances can only be diagnosed by a healthcare provider based on your symptoms and history. Because hormone levels change over time—due to aging, lifestyle, medications, and stress—periodic testing can help you monitor patterns and shifts. This expanded women’s hormone panel measures key reproductive and metabolic hormones that play a role in ovulation, fertility, menstrual cycle regulation, and overall hormone balance. Always consult a qualified healthcare provider before starting any hormone therapy or treatment program.
Women experience the most dramatic shift during perimenopause and menopause, when estrogen and progesterone levels drop significantly. They typically result from a combination of factors that compound over time. 1st Optimal’s men’s hormone care program uses advanced diagnostics to identify the root cause and build a personalized treatment protocol. Beyond physical symptoms, hormonal imbalance in men frequently manifests as a loss of ambition and competitive drive. Men with suboptimal testosterone often describe difficulty concentrating, poor memory, and reduced mental clarity.
Because your body doesn’t operate in silos—and neither should your care. In the meanwhile, testosterone affects mood, libido, muscular mass, and general vitality. The reality is that they are always communicating to each other, and ignoring one can totally ruin the other. They can help test a person’s levels and rule out potential causes, which may help identify the most effective treatment. People who suspect they could have low testosterone need to speak with a doctor. In females, low testosterone can occur due to conditions affecting the ovaries, pituitary gland, or adrenal glands.
We considered pTwo-sample MR analyses with summary data were performed by the freely available mrrobust Stata package (17). We extracted summary statistics for sex-stratified and sex-combined, as well as for crude and standardized (rank-based inverse normal transformed "irn") continuous outcomes when available. Additionally, we verified our findings using a genetic risk score (GRS) approach on individual level data in the UK Biobank. Finally, an indirect effect on the gonads via an interaction between the hypothalamic-pituitary-thyroid axis and the hypothalamic-pituitary gonadal axis through prolactin has also been suggested (7). We performed two-sample Mendelian randomization (MR) analyses on summary level, and unweighted genetic risk score (GRS) analysis on individual level data. To learn more about our collection, use, and sharing of data, please see our Privacy Policy. If you click 'I Agree', we may also share certain categories of data with select third parties for analytics and advertising, and to improve our services.

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