A hormone result can fall inside a laboratory reference interval and still require thoughtful interpretation. These ranges are based on defined populations, while hormone measurements can vary with age, sex, time of day, assay method, medications, binding proteins, and physiologic state. Research on endocrine testing has shown that differences among assays and reference intervals can affect diagnosis and management.¹
At Pellecome®, our provider resources are shaped by founder and medical director Enrique G. Jacome, MD, FACOG, a board-certified OB-GYN with decades of hormone therapy experience. We support healthcare providers with Bio-Identical Hormone Replacement Therapy (BHRT), clinical education, and tools for building thoughtful hormone care protocols.
A Reference Range Is Not a Diagnosis
A reference interval reflects values found within a particular population. It does not automatically determine whether an individual patient has an endocrine disorder.¹ Symptoms, age, health history, medications, collection timing, and assay reliability still matter.
That distinction matters most when a result sits near a diagnostic cutoff or does not line up with the patient’s symptoms.
Testosterone is a useful example. The Endocrine Society recommends diagnosing male hypogonadism only when compatible signs or symptoms occur alongside unequivocally and consistently low testosterone levels.² Morning fasting testing should be repeated, and free testosterone may provide additional information when total testosterone is near the lower limit of normal or when sex hormone-binding globulin may be altered.²
Menopause requires a different approach. The 2025 European Society of Endocrinology guideline states that biochemical testing is generally unnecessary for diagnosing or managing perimenopause and menopause in women older than 45. Testing may be considered between ages 40 and 45 when the diagnosis is uncertain and is recommended when premature ovarian insufficiency is suspected before age 40.³
What Else Should Providers Consider?
When lab values and symptoms do not clearly align, a more complete review may include:
- Symptom pattern and severity
- Age and reproductive or menopausal stage
- Timing and conditions of the blood draw
- Medications and supplements
- Relevant binding proteins
- Other endocrine or metabolic conditions
- Changes compared with previous testing
Lab ranges still matter, but they are most useful when interpreted alongside symptoms, medical history, and repeat testing when indicated. This helps clinicians avoid treating a number in isolation.
Supporting More Individualized Hormone Care
For clinicians offering BHRT, careful lab interpretation can strengthen treatment planning and follow-up. Our provider training and licensing support give practices additional resources for incorporating hormone optimization into patient care.
Founded by Dr. Jacome, Pellecome® supports clinicians with BHRT products, education, and practice resources centered on thoughtful hormone management. Practices interested in learning more can contact us in Gladstone, NJ at 888-773-9969.
1.Lorde N, Elgharably A, Kalaria T. Impact of variation between assays and reference intervals in the diagnosis of endocrine disorders. Diagnostics (Basel) [Internet]. 2023;13(22):3453. Available from: http://dx.doi.org/10.3390/diagnostics13223453
2.Oup.com [Internet]. [cited 2026 Sept 2]. Available from: https://academic.oup.com/jcem/article/103/5/1715/4939465
3.Oup.com [Internet]. [cited 2026 Sept 2]. Available from: https://academic.oup.com/ejendo/article/193/4/G49/8281862
