what do you think of my labs?

[calmwaters]

Alright, I got my doc to order me some blood tests (tried to get saliva - per advise I read from Dr. Lee and others - but the lab doesn't even do them). I have been having tons of PCOS Sx for months: anxiety, depression, non-menstrual spotting, fairly regular but looooong periods 8-10 days (not heavy though), ovulatory cramping (more severe than menstrual cramps), decreased libido, acne, one sparse but dark and wiry long chin hair and nipple and "happy trail" hairs. Ugh, there's more but you get the idea.

I had thought for sure it was estrogen dominance but here's my results on day 13 of my cycle:
(lab reference "normal range")
Total Testosterone 51.7 ng/dL 15-70
Free testosterone *14.2 pg/mL 0.6-6.8 *high
% free testosterone *2.7 0.4-2.4 *high
SHBG *13.7 18-114 *low
Progesterone 1.48 0.31-1.52
DHEA 343 65-380
FSH 8.0 6-26
Estradiol *40 66-411 *low
Triglycerides 92 <150total
cholesterol 180 <200
HDL *28 40-60 *low
LDL 134 <130 *high

Over the last year I have changed my diet and added lots of exercise and have lost 25 pounds. My lipid levels were way worse a year ago. But, no hormone testing or even any Sx at that time. I have a Hx of a very large ovarian serous cystadenoma (supposedly completely unrelated to PCOS), which was removed by laparotomy 2 years ago. I'm 29, no kids, not trying yet, so no idea of fertility status.

Now, from what I read on all the lovely links and post provided here (thanks!), the free testosterone and SHBG levels as well as lipids are of concern for PCOS. I am personally also concerned about the lab reference values for "normals" as the ones I have found listed here are much less liberal. I don't think it is normal to have such a low progesterone level around the time of presumed ovulation.

My GP says she is not all concerned about my results and said if I am still worried I should go to a gyn or endo. Am I being hypervigilant about my abnormal results? I feel like a hypochondriac here! Thanks so much for any imput you have for me! God bless!

[calmwaters]

OMG, that's looks so terrible with the format. I had it all typed out pretty and easy to read and stuff, I don't know what happened!

[Navi]

You're not overreacting by any means. It's true, most of the real normal and high numbers for labs aren't as vague as doctors would have you think. I don't know much about interpreting labs myself, but there are some good links around here, especially on the Newbie Road Map.

A gyno or endo would be a better choice to treat your PCOS, as both specialize in reproductive health and hormones.

Welcome to SC!

[Eva37]

welcome to sc

[Future Doc Cyster]

Seeing either an endo or a GYN would probably be a good idea, especially because your testosterone levels are elevated. Don't let your doctor(s) feel like you are being hypervigilant. I went to a GYN at age 18, because I first noticed that my symptoms looked like PCOS symptoms. She threw me 3 months of BCPs and that was that. I asked about a hormone profile to check for PCOS, and she said that was an expensive test and that I didn't have PCOS. Two doctors and a hormone profile later, I got my diagnosis. I could have had my diagnosis and began treatment 3-4 years earlier had the first doctor listened to me.

Don't give up until you figure out exactly what's wrong and you have a treatment plan you are comfortable with.

Also, you mention your FSH level, but I don't see your LH level. Do you know what your LH level was? The LH/FSH ratio is important in the diagnosis of PCOS, along with androgen (and/or testosterone) levels. An LH/FSH ratio greater than 2:1 is generally indicative of PCOS.

Best of luck with whatever you decide!

[calmwaters]

Thanks for the support and welcome. I did forget to mention I am a newbie here!

My doc didn't order an LH level for some reason and I overlooked it when I asked her to check my hormone levels. Actually, like I mentioned before, prior to getting the results I was conviced I had estrogen dominance based on my Sx. But (in my opinion) the estrogen came back low! So only after I got my labs back did I research and ponder PCOS as a Dx. I'm a nurse, admittedly no experience in gyn/endo, but the whole lab values and clinical picture interests me and I tend to learn everything there is to know about a Dx I have been given or am suspicious I have. Hence, the worry that I am just a hypochondriac and reading into things.

The thing that burns me up is that I literally had to ask my doc to order the tests. I even listed some of the ones I wanted and some Dxs I was concerned my Sx might be correlated to. In previous months I had seen her and had a huge list of complaints and Sx which she just kind of apprently assumed would go away. Maybe it's just me and the way I present myself as a patient but almost every medical issue I've had in the past (even with different docs), I have had to be the one to push the idea of testing to diagnose it. What the heck? Just a rant, sorry!

So I have to say as a nurse and a patient, be proactive for yourself! I have an appt with an endo in 2 weeks, and perhaps I will end up not having PCOS. But, my point is, don't whine to the nurse, don't assume you're over reacting to your signs and symptoms. Just make a list, do some research and present your case to the doc if need be.