Comprehensive Evaluation • Board-Certified Internal Medicine
Physician-directed hormone testing for women and men with symptoms that may be related to hormonal change. David Nazarian, M.D., selects and interprets testing in the context of symptoms, medical history, medications, timing, and other possible causes—not as a stand-alone panel or automatic pathway to hormone treatment.
Fatigue, sleep disruption, mood changes, weight changes, brain fog, hair changes, menstrual irregularity, hot flashes, sexual concerns, reduced strength, and changes in body composition may occur with hormonal disorders—but they can also result from anemia, thyroid disease, sleep apnea, medication effects, metabolic conditions, nutritional deficiencies, depression, anxiety, chronic illness, or other medical problems.
The purpose of testing is not to search indiscriminately for an “imbalance.” It is to evaluate specific clinical questions and determine whether a result meaningfully changes diagnosis or treatment.
Symptoms, timing, menstrual or sexual history, sleep, medications, supplements, prior hormone use, medical conditions, family history, fertility goals, and patient priorities.
Physical evaluation is selected according to the concern and may include blood pressure, weight and body composition, thyroid, skin, reproductive, or other relevant findings.
Tests are selected according to the clinical question, with attention to timing, preparation, biologic variation, medications, and whether repeat confirmation is needed.
Depending on the patient: estradiol, progesterone, total or free testosterone, luteinizing hormone, follicle-stimulating hormone, prolactin, or related studies.
Testing may include thyroid-stimulating hormone and, when indicated, free thyroid hormone measurements or other thyroid studies.
Blood count, metabolic testing, glucose-related testing, lipids, iron studies, vitamin measurements, or other studies may be relevant when symptoms overlap with nonhormonal conditions.
Baseline and follow-up testing depends on the treatment under consideration and may include blood counts, liver-related studies, pregnancy testing, or prostate-related evaluation.
This is not a universal panel. Ordering every available hormone test can create incidental abnormalities, unnecessary expense, and confusing results that do not improve care.
Some hormones vary during the day. Testosterone is commonly evaluated in the morning, while cortisol testing may require specific timing depending on the clinical question.
Estradiol, progesterone, and related reproductive hormones vary across the menstrual cycle. Cycle day and contraceptive use may change interpretation.
Recent illness, poor sleep, fasting status, supplements, prescriptions, pregnancy, and hormone use may alter results or determine when testing should occur.
Blood testing is commonly used for many clinically established hormone measurements, but the appropriate sample depends on the hormone and question being evaluated.
Saliva or urine testing can be useful in selected endocrine situations, but broad commercial panels may not be validated for diagnosing the concerns they claim to assess.
At-home tests may offer convenience, but specimen collection, laboratory method, timing, reference ranges, and clinical interpretation determine whether a result is useful. An abnormal result should not automatically lead to treatment without medical evaluation and, when appropriate, confirmation.
A value outside a laboratory reference range does not always establish disease, and a value inside the range does not automatically exclude a clinically important problem. Reference ranges differ by laboratory, method, age, sex, cycle status, pregnancy, and treatment.
Results should be interpreted alongside symptoms, examination, prior values, medications, health risks, and the reason the test was ordered. Some findings require repeat measurement or evaluation of related hormones before a conclusion is reached.
Hormone testing does not guarantee that hormone therapy will be recommended. The safest conclusion may be observation, repeat testing, treatment of another condition, a nonhormonal strategy, or referral to another specialist.
Testing may be considered for menstrual irregularity, possible early menopause, fertility-related questions, androgen symptoms, pituitary concerns, thyroid symptoms, or an atypical menopause presentation. Many women over 45 with typical menopause symptoms do not require a large hormone panel for diagnosis.
Evaluation of possible testosterone deficiency generally includes symptoms and appropriately timed testosterone measurements, with additional testing chosen to confirm the result and help distinguish testicular, pituitary, medication-related, sleep-related, metabolic, or other causes.
Board-Certified in Internal Medicine
Dr. Nazarian evaluates possible hormone-related symptoms within the broader context of general medical health. His approach considers thyroid disease, metabolic conditions, sleep, medications, nutrition, cardiovascular risk, mood, and other factors that may overlap with hormonal concerns.
The goal is to order testing that is clinically useful, explain what the results do and do not show, and develop a plan based on the patient as a whole.
Discuss symptoms, timing, medical history, medications, supplements, prior testing, and treatment goals.
Choose focused laboratory studies and preparation instructions based on the clinical question.
Review results in context, including biologic variation, related findings, and whether confirmation is needed.
Discuss treatment, observation, repeat testing, preventive care, or specialist referral when appropriate.
Written by: David Nazarian, M.D.
Medically reviewed by: David Nazarian, M.D.
Medical review date: September 17, 2026
David Nazarian, M.D., is Board-Certified in Internal Medicine and has extensive experience evaluating and treating women and men with hormonal concerns. His approach emphasizes comprehensive assessment, evidence-informed decision-making, patient education, individualized treatment, safety, and ongoing follow-up.
Meet with David Nazarian, M.D., to discuss your symptoms, determine which tests may be clinically useful, and review your results in the context of your overall health.
David Nazarian, M.D., is Board-Certified in Internal Medicine and provides physician-led hormone evaluation and individualized care for women and men. His approach emphasizes comprehensive assessment, patient education, individualized treatment, safety, and ongoing follow-up. Dr. Nazarian specializes in bio-identical hormone replacement therapy in men & women. He has extensive training and knowledge in treating andropause and testosterone replacement therapy in men and menopause and estrogen replacement therapy in women. Supported by his experienced medical team, Dr. Nazarian treats men and women with hormone deficiencies and imbalances and enjoys the one-on-one relationship between patient and doctor.
HRT LA provides physician-led hormone evaluation and individualized care in Beverly Hills and Los Angeles with David Nazarian, M.D.
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