What are the Different Types of Endometriosis Lab Tests?

It’s difficult to come to terms with why your body is seemingly working against you after an endo diagnosis. But despite the pain and confusion, you can have control over your health. Understanding more about endometriosis lab tests can make navigating endo a lot less complicated. 

You don’t have to become a medical expert on every endometriosis lab test, but it helps to know what to ask for and look for when visiting your medical professionals. As a fellow endowarrior and expert endometriosis dietitian, I’ve done the research for you! Today, I’m sharing the most important endometriosis lab tests to take control of your endo NOW.

The Most Common Labs for Endometriosis Explained

When it comes time for your annual check-up (or doctor visits in between), there are specific endometriosis labs that are helpful to request. Instead of getting the usual rundown of tests, these endometriosis lab tests show you the bigger picture of your health. I always advise my clients to understand each endo lab test before building a proper management plan.

Add these important endometriosis labs to your healthcare checklist:

DUTCH Test

The DUTCH Cycle Mapping Test tracks the progesterone and estrogen pattern throughout your menstrual cycle. This allows you to map out your hormone fluctuations during your cycle instead of just testing on one day only. The test is done by collecting a urine sample almost every day from CD7 through the start of your period.

When you get your results back, you’ll have information about your preovulatory estrogen, how quickly your progesterone and estrogen increase after ovulation, and whether or not they stay elevated. Look for these endo-specific patterns with your DUTCH test results.

Caution: you cannot have a DUTCH test completely accurately while taking hormonal birth control or hormone suppressants like Orilissa or Lupron. 

Can’t access a DUTCH test? A reasonable alternative is a peak (ovulation) + 7 day estradiol and progesterone blood draw. Estradiol should fall between 150-300pg/mL and progesterone should fall between 18.5-31.5ng/mL. 

Iron Panel

An iron panel is another vital endo lab test with valuable information about your health. Your body needs iron to make hemoglobin, which helps to distribute oxygen. If you have low levels of iron, your body won’t have enough oxygen dispersed to your organs. This leads to your organs not functioning as optimally as they should. Especially for the ovaries and uterus in terms of endo, this can trigger pain and higher amounts of oxidative damage. Low iron also can cause symptoms such as fatigue, poor thyroid function, suboptimal digestion, weak muscles, subfertility, and more.

Many doctors will only check a partial iron panel or diagnose deficiencies based on hemoglobin or RBC markers. However, there’s a lot more to it! Deciphering your results can be confusing, but it’s important to understand each part of your iron panel (use this quick guide for reference!).

Homocysteine

Looking at your homocysteine levels as part of your endometriosis labs gives you an indication of your total body inflammatory load. Methylation is a vital process in human life, and homocysteine helps to measure your methylation status. Our bodies rely on healthy methylation to eliminate estrogen from the body—especially relevant to endo warriors! If you have high levels of homocysteine, this could mean you have B vitamin deficiencies. When the levels are low, this may indicate poor glutathione status, which is your body’s natural inflammation fighter. Homocysteine levels should fall between 7-9.

Thyroid Panel

Keeping track of your thyroid health is an essential endometriosis lab test as it directly affects the disease. When your thyroid isn’t functioning as it should, this can worsen the severity of endo and contribute to infertility, AND it’s associated with more advanced stages of the disease. Your thyroid can be affected by things like high estrogen, nutrient deficiencies, or liver dysfunction, which are common in endo sufferers. A full thyroid panel includes TSH, FT3, FT4, TPO and Tg antibodies (and sometimes RT3). 

Liver Enzymes

If you’re taking hormone therapy for endo, regularly use prescription medications, experience pain on the right side of your ribcage, or suspect/have gallbladder concerns, include this endo lab test. Your liver works to eliminate pharmaceuticals and hormones from your body. It’s a key part of thyroid hormone conversion and storing minerals and vitamins. When there’s a dysfunction in the liver or liver cells, your AST and ALT will elevate in the blood.  

Cholesterol Panel

If your HDL is abnormally high, triglycerides abnormally low, and total cholesterol normal, this pattern points towards an autoimmune process. Most doctors won’t run autoimmune panels without signs or symptoms, so this is a useful endo lab test to bring up. The best time to address possible autoimmune development is before antibodies appear in blood labs. Unfortunately your risk of developing an autoimmune condition as someone with endometriosis is higher, so it’s important to be proactive. 

Some other endometriosis lab tests to consider include:

• Testosterone: Testosterone is vital for folliculogenesis and estrogen production—both essential for conception. However, high levels can cause inflammation, which can hinder conception, by skyrocketing inflammation.

• DHEA-s: your DHEA-s affects your egg quality—high levels may hinder conception due to inflammation. Women in their 30s can take DHEA supplementation to improve fertility outcomes (if needed).

• Peak +7 Progesterone: progesterone resistance is common with endo, with progesterone and hypothyroidism as the two leading causes of early losses. It’s best to address this sooner than later!

• CD3 LH, FSH + Estradiol: if your CD3 estradiol is elevated/high normal, it can suppress LH + FSH, making these values seem better than they are. Elevated levels of FSH can point to ovarian failure, early menopause, or declining fertility.

Improve Your Quality of Life with Thorough Endo Lab Results

Taking charge of your own health means learning everything there is to know about your body and its responses. This includes seeking out the right endometriosis lab tests that will help you with managing your endo symptoms. Data is power, and understanding your results allows you to become more in tune with your body and how it functions.

If you’re feeling overwhelmed, I understand where you’re coming from (I’ve been there, with my own endo diagnosis). I can help support you in understanding and accessing any of these labs for endometriosis inside my coaching programs. Since endometriosis is such a complicated condition, understanding the biomarkers in your body helps you address your symptoms more effectively.

Learn more about my 1:1 coaching program, and let’s take a total body approach to your endo together!