EllaDx home
Transparency

Every claim.
Every source.

We believe you deserve to know exactly what evidence backs the numbers we report and the guidance we provide. This page lists every peer-reviewed source behind every health claim on the EllaDx platform.

39
Cited claims
43
Source references
12
Topic areas
100%
Peer-reviewed sources
Hormones panelThyroid panelFertility panelMetabolic panelCardiovascular panelNutrients panelInflammation panelGut panelStress & cortisol panelLongevity panelReference rangesThe women's health gap

Why we publish this

Functional medicine and women's health are full of claims that sound scientific but aren't. We want to be different. Every statistic, every reference range target, and every clinical statement on this platform traces to a specific peer-reviewed publication. If you find a claim without a source, tell us and we'll fix it.

01 - Hormones panel

Hormones

Estradiol varies roughly 8-fold across a single menstrual cycle.

01
Reed BG, Carr BR. (2018). The Normal Menstrual Cycle and the Control of Ovulation. Endotext (NCBI Bookshelf).

Female testosterone drops approximately 50% by age 40.

11
Davison SL, Bell R, Donath S, Montalto JG, Davis SR. (2005). Androgen levels in adult females: changes with age, menopause, and oophorectomy. J Clin Endocrinol Metab. 90(7): 3847–3853.

Women spend an average of 2–10 years in perimenopause before formal diagnosis.

21
The North American Menopause Society. (2022). Menopause Practice: A Clinician's Guide, 6th edition. NAMS.
02 - Thyroid panel

Thyroid

1 in 8 women will develop a thyroid disorder in her lifetime; women face 5–8× higher risk than men.

01
American Thyroid Association. (2023). General Information / Press Room - thyroid disease prevalence. ATA.

Up to 60% of people with thyroid disease are unaware of their condition.

11
Canaris GJ, Manowitz NR, Mayor G, Ridgway EC. (2000). The Colorado Thyroid Disease Prevalence Study. Arch Intern Med. 160(4): 526–534.

A preconception TSH target below 2.5 mIU/L is recommended for women of reproductive age.

21
Alexander EK, Pearce EN, Brent GA, et al. (2017). 2017 Guidelines of the American Thyroid Association for the Diagnosis and Management of Thyroid Disease During Pregnancy and the Postpartum. Thyroid. 27(3): 315–389.
22
Korevaar TIM, Medici M, Visser TJ, Peeters RP. (2017). Thyroid disease in pregnancy: new insights in diagnosis and clinical management. Nature Reviews Endocrinology. 13(10): 610–622.

TSH alone is an unreliable single marker for diagnosing thyroid dysfunction; full panel testing is required.

31
Razvi S, Bhana S, Mrabeti S. (2019). Challenges in interpreting thyroid stimulating hormone results in the diagnosis of thyroid dysfunction. Journal of Thyroid Research. 4106816.
03 - Fertility panel

Fertility

1 in 8 U.S. couples experience infertility; female-factor causes account for approximately one-third of cases.

01
CDC National Center for Health Statistics. (2023). National Survey of Family Growth - Infertility in the United States. CDC NCHS.

8–10% of reproductive-age women have PCOS; most are undiagnosed.

11
Teede HJ, Misso ML, Costello MF, et al. (2018). Recommendations from the International Evidence-Based Guideline for the Assessment and Management of Polycystic Ovary Syndrome. Fertil Steril. 110(3): 364–379.

AMH is the preferred marker of ovarian reserve due to cycle-independence and predictive accuracy.

21
Tal R, Seifer DB. (2017). Ovarian reserve testing: a user's guide. Am J Obstet Gynecol. 217(2): 129–140.
22
Practice Committee of the American Society for Reproductive Medicine. (2020). Testing and interpreting measures of ovarian reserve: a committee opinion. Fertil Steril. 114(6): 1151–1157.
04 - Metabolic panel

Metabolic Health

Insulin resistance typically precedes a diagnostic A1c elevation by 5–10 years.

01
Tabák AG, Herder C, Rathmann W, Brunner EJ, Kivimäki M. (2012). Prediabetes: a high-risk state for diabetes development. Lancet. 379(9833): 2279–2290.

Approximately 38% of U.S. adults have prediabetes; roughly 80% are unaware.

Visceral fat increases ~30% during perimenopause independent of total body weight changes.

21
Greendale GA, Sternfeld B, Huang M, et al. (2019). Changes in body composition and weight during the menopause transition. JCI Insight. 4(5): e124865.
05 - Cardiovascular panel

Cardiovascular

Heart disease is the #1 cause of death in U.S. women.

01
Tsao CW, Aday AW, Almarzooq ZI, et al. (2024). Heart Disease and Stroke Statistics - 2024 Update. Circulation. 149(8): e347–e913.

Approximately 1 in 5 people carry elevated Lipoprotein(a) - a genetic risk marker not measured on standard lipid panels.

11
Tsimikas S. (2017). A Test in Context: Lipoprotein(a): Diagnosis, Prognosis, Controversies, and Emerging Therapies. JACC. 69(6): 692–711.

ApoB is a better single-number predictor of cardiovascular events than LDL-C.

21
Sniderman AD, Thanassoulis G, Glavinovic T, et al. (2019). Apolipoprotein B particles and cardiovascular disease: a narrative review. JAMA Cardiol. 4(12): 1287–1295.

Persistent hs-CRP elevation (>2 mg/L) is a stronger cardiovascular predictor in women than LDL-C alone.

31
Ridker PM, Buring JE, Cook NR, Rifai N. (2002). C-Reactive Protein, the Metabolic Syndrome, and Risk of Incident Cardiovascular Events. Circulation. 107(3): 391–397.
06 - Nutrients panel

Nutrients & Micronutrients

Approximately 35% of U.S. adults have insufficient vitamin D (below 20 ng/mL).

01
Herrick KA, Storandt RJ, Afful J, et al. (2019). Vitamin D status in the United States, 2011–2014. Am J Clin Nutr. 110(1): 150–157.

20–30% of menstruating women are iron-deficient.

Ferritin below 50 ng/mL is associated with fatigue and hair loss in non-anaemic women.

21
Vaucher P, Druais PL, Waldvogel S, Favrat B. (2012). Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin: a randomized controlled trial. CMAJ. 184(11): 1247–1254.
22
Rushton DH. (2002). Nutritional factors and hair loss. Clin Exp Dermatol. 27(5): 396–404.

~50% of U.S. adults fail to meet the recommended daily intake for magnesium.

31
Rosanoff A, Weaver CM, Rude RK. (2012). Suboptimal magnesium status in the United States: are the health consequences underestimated? Nutr Rev. 70(3): 153–164.
07 - Inflammation panel

Inflammation & Autoimmunity

Women face approximately 4× higher autoimmune disease risk than men; ~24 million Americans are affected.

01
NIH / NIEHS. (2005). Progress in Autoimmune Diseases Research - Report to Congress. National Institutes of Health.

Over 40% of perimenopausal women show elevated hs-CRP.

11
Cioffi M, Esposito K, Vietri MT, et al. (2002). Cytokine pattern in postmenopause. Maturitas. 41(3): 187–192.
08 - Gut panel

Gut Health

Women are approximately 2× more likely than men to be diagnosed with irritable bowel syndrome.

01
Lovell RM, Ford AC. (2012). Effect of gender on prevalence of irritable bowel syndrome in the community: systematic review and meta-analysis. Am J Gastroenterol. 107(7): 991–1000.

Approximately 70% of the immune system resides in the gastrointestinal tract.

11
Vighi G, Marcucci F, Sensi L, Di Cara G, Frati F. (2008). Allergy and the gastrointestinal system. Clin Exp Immunol. 153(Suppl 1): 3–6.

Zonulin is a validated biomarker of intestinal barrier permeability ("leaky gut").

21
Fasano A. (2011). Zonulin and Its Regulation of Intestinal Barrier Function: The Biological Door to Inflammation, Autoimmunity, and Cancer. Physiol Rev. 91(1): 151–175.
09 - Stress & cortisol panel

Stress & HPA Axis

60–80% of primary-care visits are estimated to be stress-related.

01
American Psychological Association. (2023). Stress in America - Annual Report. APA.

Melatonin production declines approximately 20% per decade from age 30 onward.

11
Karasek M. (2004). Melatonin, human aging, and age-related diseases. Exp Gerontol. 39(11–12): 1723–1729.

Women experience insomnia at 2–3× the rate of men.

21
Zhang B, Wing YK. (2006). Sex differences in insomnia: a meta-analysis. Sleep. 29(1): 85–93.
10 - Longevity panel

Longevity & Biological Age

Perimenopause accelerates epigenetic aging by approximately 2 years.

01
Levine ME, Lu AT, Chen BH, et al. (2016). Menopause accelerates biological aging. PNAS. 113(33): 9327–9332.

Epigenetic age is modifiable: diet and lifestyle interventions can reverse measured biological age.

11
Fitzgerald KN, Hodges R, Hanes D, et al. (2021). Potential reversal of epigenetic age using a diet and lifestyle intervention: a pilot randomized clinical trial. Aging. 13(7): 9419–9432.

GrimAge and PhenoAge methylation clocks are the strongest predictors of healthspan and all-cause mortality.

21
Lu AT, Quach A, Wilson JG, et al. (2019). DNA methylation GrimAge strongly predicts lifespan and healthspan. Aging. 11(2): 303–327.
22
Levine ME, Lu AT, Quach A, et al. (2018). An epigenetic biomarker of aging for lifespan and healthspan. Aging. 10(4): 573–591.
11 - Reference ranges

Reference Range Science

Why we show functional targets alongside standard lab ranges

Phase-specific reference intervals for estradiol, LH, FSH, and progesterone exist and should be applied to cycling women.

01
Stricker R, Eberhart R, Chevailler MC, et al. (2006). Establishment of detailed reference values for luteinizing hormone, follicle stimulating hormone, estradiol, and progesterone during different phases of the menstrual cycle. Clin Chem Lab Med. 44(7): 883–887.

Iron supplementation reduces fatigue in non-anemic women with ferritin below 50 ng/mL.

11
Vaucher P, Druais PL, Waldvogel S, Favrat B. (2012). Effect of iron supplementation on fatigue in nonanemic menstruating women with low ferritin. CMAJ. 184(11): 1247–1254.

The Endocrine Society recommends targeting 25(OH)D ≥75 nmol/L for optimal bone and muscle health.

21
Holick MF, Binkley NC, Bischoff-Ferrari HA, et al. (2011). Evaluation, treatment, and prevention of vitamin D deficiency: an Endocrine Society Clinical Practice Guideline. J Clin Endocrinol Metab. 96(7): 1911–1930.

Iron supplementation reduces fatigue in non-anaemic women with low ferritin.

31
Verdon F, Burnand B, Stubi C-LF, et al. (2003). Iron supplementation for unexplained fatigue in non-anaemic women: double blind randomised placebo controlled trial. BMJ. 326: 1124.
12 - The women's health gap

The women's health research gap

Why building around women's symptoms requires its own evidence base

Women remain underrepresented in randomized controlled trials across most therapeutic areas.

01
Daitch V, Turjeman A, Poran I, et al. (2022). Underrepresentation of women in randomized controlled trials: a systematic review and meta-analysis. Trials. 23: 1038.

Diseases that disproportionately affect women receive less NIH funding than their disease burden would predict.

11
Mirin AA. (2021). Gender disparity in the funding of diseases by the U.S. National Institutes of Health. Journal of Women's Health. 30(7): 956–963.

Sex differences in pharmacokinetics and pharmacodynamics mean reference ranges built on male trial data don't translate cleanly to women.

21
Soldin OP, Mattison DR. (2009). Sex differences in pharmacokinetics and pharmacodynamics. Clinical Pharmacokinetics. 48(3): 143–157.
A note on clinical advice

Sources, not substitutes

The research cited here supports the context and education we provide. It does not replace a clinical evaluation. Your EllaDx results always recommend follow-up with a qualified healthcare provider for any actionable finding. If you have questions about a specific citation, email [email protected].

Ready to start?

Every result backed
by the research.

Your EllaDx report links each biomarker's optimal range directly to the peer-reviewed studies behind it.

Take the quiz Browse panels