nnComprehensive 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.
The practice is equipped to perform broad laboratory evaluation in the office when clinically appropriate. Depending on the patient, testing may include FSH, LH, total and free testosterone, estradiol, thyroid testing, vitamin and nutritional deficiencies, iron studies, DHEA, cortisol and adrenal-related evaluation, glucose and metabolic markers, inflammatory markers and additional studies selected according to symptoms and medical history.
The goal is not to order the largest possible panel. It is to use a sufficiently comprehensive, evidence-based evaluation to identify hormone deficiency when present and to look for other conditions that can produce similar symptoms.
Hormone care can intersect with bone, cardiovascular, metabolic and functional health. When clinically indicated, evaluation may include:
Testing is selected according to symptoms, medical history and the clinical question. More testing is not automatically better; the goal is to obtain the information needed to make a sound medical decision.
These capabilities allow laboratory results to be interpreted alongside broader health information rather than in isolation, under the oversight of David Nazarian, M.D., Board Certified in Internal Medicine.
Which hormones should I test? There is no universal hormone panel for everyone. Testing should be selected based on symptoms, age, sex, menstrual or fertility history, medications and the specific condition being evaluated.
Can I diagnose perimenopause with a hormone test? Usually not in women over 45 with a typical menopause-transition history. Hormone levels can fluctuate substantially, so symptoms and cycle changes are often more informative than a single test.
Does one low testosterone test diagnose low T? Usually no. Men with suspected hypogonadism generally need compatible symptoms plus consistently low testosterone levels confirmed with repeat morning testing.
Are at-home hormone tests enough? At-home tests may provide limited information, but results still require clinical interpretation and may not answer the underlying diagnostic question.
When is broader testing useful? Targeted thyroid, pituitary, adrenal, reproductive or metabolic testing may be appropriate when symptoms or initial results point toward a specific disorder.
Common questions we evaluate are covered in our guides to signs that warrant a hormone evaluation, sudden loss of libido, PCOS-related hair loss, and fatigue and adrenal concerns.
Use our hormone deficiency symptoms guide to see which symptoms may justify targeted testing and which may need a different medical evaluation. Related symptom pages include bone loss, vaginal dryness, and hair loss and TRT.
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.
Learn more about hormone replacement therapy, hormone testing and evaluation, testosterone therapy, and women’s hormone and menopause care. Treatment recommendations depend on the individual clinical evaluation and are not based on symptoms or laboratory values alone.
Our Beverly Hills office serves patients throughout greater Los Angeles seeking physician-led hormone evaluation and individualized care.
Commonly served areas include: Beverly Hills, West Hollywood, Century City, Brentwood, Santa Monica, West Los Angeles, Bel Air, Culver City, Hollywood, and Pacific Palisades.
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 by the American Board of Internal Medicine and has completed advanced bioidentical hormone replacement therapy training through WorldLink Medical. He provides physician-led hormone evaluation and individualized care for women and men, with an emphasis on comprehensive assessment, patient education, safety, and ongoing follow-up.
Hormone Replacement Therapy LA provides physician-led hormone evaluation and individualized care in Beverly Hills and Los Angeles with David Nazarian, M.D.
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