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Important Lab Tests for PCOS
Many women who have PCOS have not had the correct blood work done or don't know what blood tests to ask to have done.I would like to post some important labs used to diagnose and monitor PCOS
1. Total testosterone (elevated levels are > 50ng/dl
2. Free testosterone
3. Luteinizing Hormone (LH) (plays a role in ovulation and egg development)
4. Follicle Stimulating Hormone (FSH) (responsible for egg release from the ovaries)
5. LH/FSH ratio (results should be under 2)
6. DHEA-sulfate (this test tells how much androgens or"male hormones" your body is producing) DHEA sulfate converts into testosterone.
7. Prolactin
8. Thyroid Stimulating Hormone (TSH) this test will help to rule out hypo or hyperthyroidism (slow vs fast metabolism issues)
9. Liver Function tests (LFT's). Important since medications pass through the liver, to check for possible damages. Checking every 3-6 months is recommended.
10. Fasting Lipid Profile: Total Cholesterol (<>45 mg/dl is ideal)Low Density Lipoproteins (LDL) (<130 mg/dl is ideal)Triglycerides (fat in blood) (<150 mg/dl is ideal)
11. Fasting Insulin (results should be <10) difficult to do, it needs to be frozen when brought to the lab and tested before it reaches a certain temperature, expensive but would be very beneficial in determining and monitoring insulin resistance.
12. Fasting blood chemistry panel (includes glucose, electolytes and sometimes renal labs)
13. Fasting glucose to insulin ratio (used to diagnose and monitor insulin resistance, ratio under 4.5 usually indicated insulin resistance)

Ellen Reiss Goldfarb, RD
11500 W. Olympic Blvd, Suite 400
Los Angeles, CA
310-408-1770
info@ellenreissgoldfarb.com

This past Wednesday, Sasha Ottey of PCOS Challenge interviewed Walter Futterweit, MD, a longtime PCOS researcher and advocate. He provided a great summary of the laboratory tests you should be getting and why. I'm providing that summary here.

If you'd like to listen to the interview with Dr. Futterweit in its entirety, please visit Sasha's Blog Talk Radio page.

Adrenal hormones--these test rule out an adrenal problem, necessary to do to be sure it's actually PCOS

17 hydroxy progesterone (drawn between 5 and 9 of a menstrual cycle)--rules out the diagnosis of nonclassic congenital adrenal hyperplasia.

(Normal levels are 15-70 ng/dl prior to ovulation, and 35-290 ng/dl during the luteal phase. )

DHEAS (dehydroepiandrosterone sulfate)

Typical normal ranges, according to NIH, for females, are:

•Ages 18 — 19: 145 — 395 ug/dL
•Ages 20 — 29: 65 — 380 ug/dL
•Ages 30 — 39: 45 — 270 ug/dL
•Ages 40 — 49: 32 — 240 ug/dL
•Ages 50 — 59: 26 — 200 ug/dL
•Ages 60 — 69: 13 — 130 ug/dL
•Ages 69 and older: 17 — 90 ug/dL

Prolactin levels, which rule out a prolactin producing tumor, as well as the effects of some medications such as Risperdal, which can elevate prolactin levels

•Non-pregnant females: 2 — 29 ng/mL

•Pregnant women: 10 — 209 ng/mL

Tests to monitor thyroid function

T4

A typical normal range is 4.5 to 11.2 micrograms per deciliter (mcg/dL).

TSH

Normal values are 0.4 — 4.0 mIU/L.

SHBG (sex hormone binding globulin) — helps to evaluate how much of your testosterone is bound/inactive and how much is free and available to cause androgen-related symptoms.

Normal values:

Follicular phase of menstrual cycle 24 — 200 nmol/L
Luteal phase of menstrual cycle 48 — 185 nmol/L
Contraceptive use 89 — 379 nmol/L
Postmenopausal 46 — 200 nmol/L

Insulin function

Fasting insulin level
Normal values: less than 13 mIU/ml

2 h glucose tolerance test
Depends on the laboratory's protocol. Typical values can be found at the link directly above.

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Dr. Futterweit did not mention vitamin D testing but since low vitamin D levels are commonly found in women with PCOS, I'd recommend that as well.

25-hydroxy vitamin D

Normal levels are 30 — 74 ng/ml