TOBIN domain · BIO
Biological / Hormonal Imbalance
Estrogen, androgen and progesterone balance, thyroid, adrenal, insulin and leptin signaling, circadian hormones, growth factors and endocrine-active exposures.
Full description
Biological / Hormonal imbalance covers the endocrine system: insulin, thyroid, adrenal (cortisol), sex hormones (estrogen, progesterone, testosterone), and appetite hormones (leptin, ghrelin, GLP-1).
This domain is the main target of the Estrogen Pandemic (Quadpandemic I). It tracks too much estrogenic signaling from outside sources, relative estrogen excess against progesterone, and the androgen imbalance seen in PCOS — always against measured hormones, not assumptions.
Components
5 componentsInsulin and glucose regulation
AInsulin resistance is the most common hormonal disorder and the basis of type 2 diabetes, PCOS, fatty liver and much obesity.
How it works: Fat build-up in muscle and liver plus inflammation block insulin receptor signaling; the pancreas compensates with high insulin.
How it is assessed
- · Fasting glucose, insulin, HOMA-IR
- · HbA1c
- · Waist-to-height ratio (above 0.5)
Thyroid
AThyroid hormone sets metabolic rate. Hypothyroidism is common, especially in women, and is often autoimmune.
How it works: Iodine status, autoimmunity, and chemicals that block iodide uptake (perchlorate) or bind thyroid hormone carriers (PBDEs, PCBs).
How it is assessed
- · TSH, free T4
- · Anti-TPO antibodies
Sex hormones and estrogenic load
BEstrogen, progesterone and testosterone balance, plus exposure to outside estrogen-like chemicals (BPA, parabens, phthalates, some pesticides).
How it works: Endocrine-disrupting chemicals bind or block hormone receptors at low doses; fat tissue converts androgens to estrogen through aromatase.
How it is assessed
- · Cycle history; estradiol, progesterone, total testosterone, SHBG when indicated
- · Exposure audit (plastics, personal-care products)
Stress hormones (HPA axis)
BLong-term stress, poor sleep and trauma change cortisol rhythm and raise belly fat and blood sugar.
How it works: Ongoing cortisol increases glucose output from the liver and appetite, and suppresses immunity and reproductive hormones.
How it is assessed
- · Stress and sleep history
- · Morning cortisol or dexamethasone suppression only if Cushing's is suspected
Appetite and energy hormones
ALeptin, ghrelin and GLP-1 regulate hunger and fullness.
How it works: Leptin resistance in obesity; GLP-1 receptor agonists act on this system (STEP and SURMOUNT trials).
How it is assessed
- · Weight history and appetite patterns
Clinical bottom line: 'Adrenal fatigue' is not a recognized diagnosis (Endocrine Society). Hormone tests should be ordered for symptoms and interpreted by cycle phase, age and pregnancy status. Reducing outside estrogen-like chemicals is a lower-risk step with mechanistic and observational support.
What it covers
- · Sex-hormone balance
- · Thyroid & adrenal signaling
- · Insulin & leptin signaling
- · Circadian hormones
- · Endocrine-active exposures
Symptoms and exposures scored
4 questions- · Do you notice hormonal symptoms such as cycle irregularity, hot flushes, low libido or breast tenderness?
- · How much has your weight changed in the past two years without an intended change?
- · How often do you have cold intolerance, hair thinning, constipation or unexplained slowing?
- · How often is your stress level high enough to affect sleep or appetite?
Lab ranges
Graded 0–100 against published cutoffs| Test | Grading points (value → concern 0–100) | Source |
|---|---|---|
| HbA1c% · higher is worse | 5.6→0 5.7→40 6.5→80 8→100glycemic stress | ADA Standards of Care: 5.7–6.4% prediabetes, ≥6.5% diabetes range |
| Fasting insulinµIU/mL · higher is worse | 8→0 12→40 25→80 40→100insulin signaling load | Common functional reference; interpret only with a true fasting sample |
| TSHmIU/L · higher is worse | 4.5→0 10→70 20→100thyroid signaling (high) | ATA/Endocrine Society: 0.4–4.5 mIU/L; >10 overt range |
| TSHmIU/L · lower is worse | 0.4→0 0.1→70 0.01→100thyroid signaling (low) | ATA/Endocrine Society: 0.4–4.5 mIU/L; >10 overt range |
| Free T4ng/dL · lower is worse | 0.9→0 0.8→50 0.5→100low thyroid hormone | Typical reference 0.8–1.8 ng/dL (assay-specific); interpret with TSH (ATA) |
| Free T4ng/dL · higher is worse | 1.8→0 2.2→60 3.5→100high thyroid hormone | Typical reference 0.8–1.8 ng/dL (assay-specific); interpret with TSH (ATA) |
| Free T3pg/mL · lower is worse | 2.5→0 2.3→40 1.8→100low active thyroid hormone | Typical reference 2.3–4.2 pg/mL; low T3 also occurs in illness and calorie restriction |
| Free T3pg/mL · higher is worse | 4.4→0 5→60 7→100high active thyroid hormone | Typical reference 2.3–4.2 pg/mL; low T3 also occurs in illness and calorie restriction |
| Reverse T3ng/dL · higher is worse | 24→0 30→50 40→100stress / illness pattern of T4 conversion | Typical reference 9–24 ng/dL; guidelines (ATA) do not recommend rT3 for routine diagnosis — grade D |
| Anti-TPO antibodiesIU/mL · higher is worse | 34→0 35→40 100→70 500→100thyroid autoimmunity | Common cutoff >34–35 IU/mL (assay-specific); marks Hashimoto's risk (ATA) |
| Thyroglobulin antibodiesIU/mL · higher is worse | 4→0 5→40 40→70 200→100thyroid autoimmunity | Common cutoff ≤4 IU/mL (Roche) — assay-specific; positive in ~60–80% of Hashimoto's |
| Small LDL-Pnmol/L · higher is worse | 527→0 700→50 1000→100small dense LDL (insulin-resistance pattern) | NMR LipoProfile: ≤527 nmol/L reference |
| LDL particle sizenm · lower is worse | 20.5→0 20.3→40 19.5→100small LDL pattern B | NMR: >20.5 nm pattern A, ≤20.5 pattern B |
| sdLDL-C (small dense LDL)mg/dL · higher is worse | 30→0 40→40 60→100small dense LDL | Denka assay (Quest Cardio IQ, Boston Heart): <30 mg/dL optimal (lab-specific) |
Formulas
- Symptom score = average answer (0–4) × 25
- Lab score = 0.6 × worst marker + 0.4 × average marker
- B score = 60% symptoms + 40% labs (whichever exists if only one)
- HOMA-IR = fasting glucose (mg/dL) × fasting insulin (µIU/mL) ÷ 405; above about 2.5 suggests insulin resistance (Matthews 1985)
- Bands: 0–33 lower · 34–66 moderate · 67–100 higher
Symptom score = average of your answers in that domain (0–4 scale, shown as 0–100). Lab score = 0.6 × the most out-of-range marker + 0.4 × the average of that domain's markers, where each marker is graded 0–100 against published clinical cutoffs. When both exist, the domain score = 60% symptoms + 40% labs. If you logged your journal in the last 14 days, 20% of the score comes from it: daily symptoms (I, O), sleep under 7 hours (O, B), low energy (N, O) and low mood (B).
Conditions where this domain weighs heavily
iClinical organizational scores based on the TOBIN framework. They group signals for review and are not validated diagnostic instruments or a medical diagnosis.
iDetection of an exposure does not establish that it caused a disease. This platform separates exposure, association, plausible mechanism, clinical evidence and demonstrated causation.