Dr. Alexander Landfield
Board-Certified Neurologist & Medical Director
Hormone testing through blood work is the foundation of effective hormone therapy, but not all hormone panels are created equal. At Rani Beauty Clinic in Renton, WA, Dr. Alexander Landfield orders comprehensive panels that evaluate the full hormonal picture rather than relying on the abbreviated testing that most primary care settings provide.
A thorough hormone panel for men should include total and free testosterone, estradiol, sex hormone-binding globulin (SHBG), DHEA-S, thyroid panel (TSH, free T3, free T4), cortisol, fasting insulin, and a complete metabolic panel. For women, the panel should additionally include estradiol, progesterone, follicle-stimulating hormone (FSH), and luteinizing hormone (LH), with testing timed appropriately to the menstrual cycle when applicable. These markers together reveal not just individual hormone levels but how they interact and whether conversion pathways are functioning properly.
Understanding optimal versus normal ranges is critical. Laboratory reference ranges represent the statistical range for the testing population, which includes healthy individuals and those with undiagnosed conditions. A testosterone level of 350 may be within the normal reference range but is far from optimal for a man experiencing symptoms of low testosterone. Dr. Landfield uses functional optimal ranges — narrower windows where patients tend to feel and function their best — to guide treatment decisions.
Timing and preparation for hormone testing matter. Blood should be drawn in the morning, ideally between 7 and 10 AM, when cortisol and testosterone are at their daily peak. Fasting for at least eight hours ensures accurate insulin and metabolic markers. For women who are still menstruating, certain hormones should be tested on specific days of the cycle. At Rani Beauty Clinic, patients receive clear instructions on how to prepare for their blood draw to ensure the most accurate results. Dr. Landfield reviews results in person, explains what each marker means in the context of your symptoms and health history, and outlines treatment options if optimization is warranted.
