My 2025 Functional Blood Work: High-Performer’s Guide to Sex Hormones & Adrenals – Part 5
In Part 1, I unpacked the signs of an overactive immune system.
In Part 2, I explored my kidney markers and why “dysfunction” might be misleading.
In Part 3, I looked at my GI function (gut health) and my sub-optimal total protein.
In Part 4, I took a close look at liver and gallbladder function, and followed up with a post on how my liver might be messing with my sleep.
This week, I’m diving into sex hormones and adrenal function. Interestingly, this category didn’t come back with a scary dysfunction score, it was flagged at around 45% probability. But there were still patterns worth paying attention to. Patterns that a conventional doctor might completely ignore, but functional medicine digs deeper to connect the dots.
Why Sex Hormone Markers Matter
In functional medicine, the question isn’t just:
“Are your sex hormones low?” It’s also: "Why are they low — if they are?”
Stress?
Poor sleep?
Liver congestion affecting SHBG?
Nutrient gaps?
Gut dysfunction impacting estrogen clearance?
Blood work should help answer these root causes — so we can rebuild a resilient, healthy system, not just chase lab numbers.
My Results at a Glance
My Marker-by-Marker Story
Total Testosterone (28.9 nmol/L) Pretty solid. Functionally optimal, high normal.
Free Testosterone (497 pmol/L) A bit low, given my total T. Functional sweet spot is usually 600–800 pmol/L. → Likely reason? My SHBG is too high, binding up my testosterone.
SHBG (52 nmol/L) Slightly high. SHBG (Sex Hormone Binding Globulin) grabs hold of testosterone, making less free for my cells to actually use. This can happen because of:
High protein intake
Low carb or caloric deficit
Liver strain
High thyroid
Lean, athletic build
In my case? Training hard, eating high protein, lean, plus mild liver load. Makes sense.
DHEA-S (2.4 umol/L) Lower than optimal (functional sweet spot is 3–7). DHEA is an adrenal reserve marker, fuels mood, resilience, and even testosterone pathways. → Could be reflecting chronic stress and high output.
LH (8 IU/L) & FSH (12 IU/L) These pituitary signals are in a healthy range. My brain is telling my testes to produce testosterone, which they’re doing. That’s good news.
Estradiol (142 pmol/L) Upper functional edge.
Higher estradiol usually comes from converting (aromatizing) testosterone
Liver detox and inflammation can make this worse
Estradiol supports mood and bones, so it’s not “bad,” but worth tracking
Prolactin (115 mIU/L) No worries — comfortably in range.
Cortisol (AM: 294 nmol/L) A bit low for a morning sample (functional optimal 350–500). → Possibly reflects under-recovery, stress, or inconsistent sleep (makes sense given my 3am wakeups lately).
IGF-1 (10.4 nmol/L) Lower than optimal. IGF-1 shows growth hormone activity, supports repair, muscle, libido, and deep sleep recovery. → Could be impacted by stress, heavy training, under-sleeping.
Pregnenolone (1.3 nmol/L) Pregnenolone is a “mother hormone,” upstream to DHEA and cortisol. Low pregnenolone = your body is drawing down reserves, not rebuilding them. → Tells me adrenal resources are running thin.
My Functional Roadmap
So what do I do with all of this?
✅ Liver support to help with SHBG, estrogen balance
✅ Adrenal recovery to build pregnenolone and DHEA
✅ Adequate carbs to keep SHBG down and support cortisol
✅ Nutrient repletion — zinc, magnesium, choline, B-complex
✅ Training deloads and rhythm to protect my reserves
✅ Better sleep hygiene and breathwork to lower night-time stress
My Supplement Stack Right Now
→ For Free Testosterone & SHBG
Boron (3–6 mg/day)
Zinc (15–30 mg/day)
Vitamin D (3000–5000 IU/day, targeting 100–130 nmol/L)
Tongkat Ali (200–400 mg)
→ For Adrenal / Pregnenolone Support
Vitamin C (500–1000 mg/day)
Pantothenic Acid (b5) (200–400 mg/day)
Adaptogens (Ashwagandha, Rhodiola)
→ For IGF-1 & Recovery
Glycine (3–5g before bed)
Collagen (10–20g per day)
Consistent deep sleep
→ For Cortisol Rhythm
Magnesium glycinate (300–400 mg before bed)
L-theanine (100–200 mg before bed)
→ For Liver & Estrogen Balance
NAC (600–1200 mg/day)
Calcium D-Glucarate (200–400 mg/day)
Milk Thistle (200–400 mg/day)
Choline (300–600 mg from food)
→ Overall Resilience
Methylated B-complex
Electrolytes
Creatine (5g/day)
Final Thoughts
These results don’t mean I’m going to die. They mean I’m in a high-output season, and my body is sending me signals:
Support the liver
Protect the adrenals
Prioritise recovery
Respect the rhythm
Because as men in midlife, the mission isn’t just to have big testosterone numbers, it’s to have a system that’s adaptable, resilient, and built to last.
