• Estradiol
  Its presence may play a major role in the development of prostatic cancer. Therefore, it is essential to measure its level especially in men over 40 years of age. If there is too much of it in the blood it not only could contribute to the development of prostate cancer but it will also contribute to demasculanization and a diminished libido. This is the most abundant and active female hormone. It plays a most important role in being a female, the order of menstrual cycle, maintenance of bone density, prevention of cardiovascular disease, and feminine aggression. A postmenopausal level is not considered to be acceptable for most women's optimal health.

• Progesterone is the second most important female hormone with numerous metabolic functions. One of these is increasing cerebral sugar metabolism. This hormone is not only important for the female but also for men. Actually, its presence contributes to the prevention of prostate cancer by modulating estrogen's carcinogenic effects. In a sense it balances out possible estrogen over-production by the male.

• Use Traditionally, progesterone establishes the presence of a functioning corpus luteum or luteal cell function; confirm basal body temperature measurements for the occurrence of ovulation; obtain an indication of the day of ovulation; evaluate the functional state of the corpus luteum in infertility patients; assess placental function during pregnancy; ovarian function test.

• Progesterone and 17--hydroxyprogesterone are weak androgens. Increased in congenital adrenal hyperplasia due to 21-hydroxylase, 17-hydroxylase, and 11--hydroxylase deficiency. It is decreased in threatened abortion, primary or secondary hypogonadism, and short luteal phase syndrome.

• Free Testosterone - Testosterone exists in serum both free and bound to albumin and to sex hormone binding globulin (SHBG) (testosterone binding globulin). Unbound (free) testosterone is the active moiety. Free as well as total testosterone can be measured. Usual testosterone assays measure both bound and unbound levels. In certain settings, total testosterone can be normal but free testosterone increased, or the reverse; then the total testosterone result is misleading.

• IGF-1 is a more precise indicator of human growth hormone (GH). IGF-1, also called Somatomedin-C (Sm-C) measurements reflect availability of the number one human "youth and longevity hormone" the growth hormone. Clinical studies have shown that GH administration to the elderly has significant rejuvenating effects. Some of these are improved cognesence, muscle and bone strength, libido, generally longevity. IGF-1 also enhances athletic performance.

• Use Traditionally IGF-1 is used to diagnose acromegaly, in which Sm-C and GH are increased; evaluate hypopituitarism and hypothalamic lesions in children (diagnosis of dwarfism and response to therapy). Low levels occur in Laron dwarfism, an entity in which GH is increased.

• Malnutrition will cause low somatomedin-C levels in spite of normal amounts of circulating growth hormone. The Sm-C level does not distinguish pituitary dwarfism from constitutional delay of growth and development.

• IGF-1 (Somatomedin-C) is a polypeptide hormone produced by the liver and other tissues, with effect on growth promoting activity and glucose metabolism (insulin-like activity). Somatomedin-C is carried in blood bound to a carrier protein which prolongs its half-life. Its level is therefore more constant than that of growth hormone.

• Low values are described with the extremes of age (first 5-6 years and advanced age), hypopituitarism, malnutrition, diabetes mellitus, Laron dwarfism, hypothyroidism, maternal deprivation syndrome, pubertal delay, cirrhosis, hepatoma, and some cases of short stature and normal GH response to pharmacologic tests. Low values may be found with nonfunctioning pituitary tumors, with constitutional delay of growth and development and with anorexia nervosa.

• High values occur with adolescence, true precocious puberty, pregnancy, obesity, pituitary gigantism, acromegaly and diabetic retinopathy.

• Since Sm-C is decreased with malnutrition, its concentration provides an index with which to monitor therapy for food deprivation.

• DHEA-S is the adrenal anti-stress, immunity, and longevity hormone. The production level will decrease with stress and age, and it is required for proper immune function, especially as it is related to the thymus gland. The level is low or zero in most cancer patients, and declines with aging. The DHEA-S form of the hormone is a better analyte to test than DHEA itself because of its longer half-life (presence in the blood) and more abundance. However, the two are readily inter converted. DHEA (DHEA-S) is exerting its affect through the blood therefore other specimens, e.g. saliva may not give proper results.

• Prostate Specific Antigen (PSA) In general, serum PSA levels increase due to physical changes to prostate architecture caused by trauma, infection, inflammation, prostate manipulation, benign prostatic hypertrophy (BPH) or malignancy.3,4 The sensitivity of PSA levels to these changes serves as the basis for the clinical use of the test. The PSA concentration in the serum of healthy men is a millionfold lower than that in seminal fluid. PSA in seminal fluid is predominantly free or uncomplexed. In serum, the majority of PSA is bound to inhibitors including 1-antichymotrypsin (ACT) and -2-macroglobulin (A2M). Measured total PSA consists of free and ACT-bound since PSA complexed to A2M is not immunologically detectable.

• Catalona and coworkers found that one in four patients with normal DRE and PSA levels between 4.0 and 10.0 ng/mL have prostate cancer. They recommended using a cutoff of 25% free PSA for this group of men to identify individuals with an increased risk of prostate cancer. They found that 95% of the men with cancer (as determined by biopsy) with normal DRE and total PSA between 4 and 10 ng/mL had percent free PSA 25%. Their study further indicated that 20% of men with benign disease (as determined by biopsy) with normal DRE and a total PSA between 4 and 10 ng/mL had percent free PSA greater than the 25% cutoff.

• Alternatively, percent free PSA may be used to determine the relative risk of prostate cancer in individual men.

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