Hormone deficiencies are investigated using a combination of blood, urine and saliva tests. In patients with chronic fatigue, this practice assesses hormones involved in energy regulation, including thyroid hormone (thyroxine), DHEA, cortisol, aldosterone, testosterone, oestrogens, progesterone and growth hormone.
Where a deficiency is identified, I prescribe physiological replacement doses: amounts intended to meet the body’s normal requirements. Treatment typically continues for six months to one year, or longer if necessary, until repeat testing shows sufficient hormone production. The aim of these low doses is to restore normal function.
In some cases, I prescribe a slightly higher dose of a hormone even when urine testing does not indicate a deficiency. Where fatigue persists despite hormone levels within the reference range, or clinical symptoms suggest a possible deficiency, I consider additional hormones, particularly DHEA, thyroid hormone and cortisol, with the aim of supporting recovery.