What Your Hormone Labs Really Mean (and What to Do About It)

By Dr. Nate Fulton, NMD

You had your labs drawn. Your doctor said they were “normal.”

But you still feel like garbage—tired, moody, gaining fat, low libido, no motivation.

Here’s the truth:

“Normal” isn’t the same as “optimal.”

And most standard lab ranges are based on averages, not what actually makes you feel and function like a human being.

Let’s break down the key hormone labs I look at in my practice and what they really mean.

1. Testosterone (Total & Free)

Whether you’re a man or a woman, you need testosterone for energy, muscle, libido, confidence, and fat-burning.

What most labs miss:

• Total testosterone is often measured, but free testosterone is what matters. That’s what’s actually active in your body.

• SHBG (sex hormone-binding globulin) can trap your testosterone and make it useless, even if your total T looks fine.

Optimal ranges (not just “normal”):

• Men:

  • Total T: 800–1100 ng/dL

  • Free T: 20–30+ ng/dL

• Women:

  • Total T: 40–70 ng/dL

  • Free T: 1.5–3 ng/dL

What to do if it’s low:

• Look at sleep, stress, insulin resistance, nutrient deficiencies, and environmental toxins first.

• If lifestyle doesn’t fix it? Hormone therapy might be the right move, with the right provider.

2. Estradiol (E2)

Estrogen isn’t just about periods or menopause—it impacts mood, memory, metabolism, and even joint health.

Key points:

• Too low = anxiety, brain fog, hot flashes, vaginal dryness, slow recovery.

• Too high = heavy periods, bloating, breast tenderness, mood swings.

Optimal levels:

• Women (premenopausal, mid-cycle): 150–300 pg/mL

• Women (postmenopausal): 50–100 pg/mL (if on HRT)

• Men: < 35 pg/mL

Pro tip:

Always test estrogen with progesterone to get the full picture.

3. Progesterone

This one’s mostly for women, but low progesterone is one of the most common hormone issues I see.

Symptoms of low progesterone:

• Trouble sleeping

• Anxiety or racing thoughts at night

• Spotting before your period

• Short cycles or irregular periods

Optimal luteal-phase level:

10 ng/mL (about 5–7 days after ovulation)

Fixes:

• Support your adrenals, cut alcohol, fix blood sugar, and consider bioidentical progesterone (especially in perimenopause or postpartum).

4. DHEA-S

DHEA is your “anti-aging” hormone. It’s made in your adrenal glands and helps balance other sex hormones.

Low DHEA looks like:

• Fatigue

• Low libido

• Poor stress resilience

• Loss of muscle tone

Optimal range:

• Men: 300–500 mcg/dL

• Women: 200–350 mcg/dL

Low?

• Think: chronic stress, poor sleep, or adrenal burnout.

• Sometimes supplementing with DHEA helps, but don’t guess. Test.

5. Cortisol (AM & PM)

Cortisol controls your energy, sleep, mood, belly fat, and inflammation.

Most docs only test it in the morning. That’s not enough.

You need to see how it behaves throughout the day—especially if you’re feeling “wired and tired,” crashing mid-afternoon, or waking up at 2–3 AM.

Functional testing (like DUTCH or salivary panels) gives a better view than a single blood draw.

Here’s the Bottom Line:

If your labs came back “normal” but you still feel off…

You’re not crazy. You’re just not being heard.

I don’t just glance at your numbers, I actually interpret them through the lens of how you feel, what your goals are, and what your body needs to function at its best.

Need Help Making Sense of Your Labs?

If you’re in Arizona, I can establish a doctor-patient relationship and work with you directly on testing, prescriptions, and treatment plans.

If you’re outside of Arizona, I offer 1:1 virtual hormone consults to guide you through your labs, symptoms, and next steps—without the fluff or runaround.

No gaslighting. No “your labs are normal.” Just real answers and a plan that actually works for you.