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
I've had two different clients share a similar observation in the last couple of weeks, and I thought I'd write about it since it's not uncommon to feel this way in early recovery.
First of all, I want to share with you an article on depression that was recently in the Boston Globe.
This article presents the argument that depression is not about a deficiency of neurotransmitters that need to be balanced with medication, but rather, a condition in which neurons are dying a slow death and gradually losing their function. I've had this premise for awhile; it is the basis of my treatment philosophy for PCOS. Fish oil is the best compound nature has for restoring life to neurons, and when you put it into your diet, the brain begins to function again.
My two clients have both observed that as they began taking fish oil, they felt more alert and their memory and concentration seemed to be better. Signs that Elvis is back in the building!
These two clients also observed, though, that they were feeling more emotional. Not all emotions, especially anger and sadness, are easy to feel. So when you begin to feel these emotions, it can feel like things are getting"worse", not better.
Keep in mind, when neurons are malnourished, that means ALL neurons stop functioning, not just the ones affecting memory. The ones affecting emotion, the ones affecting appetite, and the ones affecting hormones.
If you've had PCOS, your hormones have not been functioning as they should, perhaps for a very long time. And that means you've not had the experience other women have, of fluctuating energy, emotions, you name it. Those fluctuations are normal!
So I often get the question,"What can I do?" The most important advice I can give is, be patient with yourself. Become used to what it means to truly cycle. Get to know what a healthy body feels like. It means it is normal to feel bloated, even constipated, just before your period. Your weight might fluctuate. The cycle should be around 28 days when you're back on track, and every single day within that 28 days may feel different. There may be no such thing as getting on the scale and weighing the same thing every single day.
With regard to your emotions, perhaps as your brain becomes more aware, this is an opportunity to experience what emotions might be about. Emotions are messages from the brain, telling you how you are with regard to balance, and what you need to do to restore balance if it isn't there. Anger is often a clue that a boundary has been violated. Loneliness means you need to seek companionship of some sort. Fear suggests that you need to remove yourself from danger. If they didn't feel uncomfortable, you would not be motivated to engage in behaviors that keep you healthy and safe. So rather than running from emotions, embrace them! They're telling you that your health is returning and things are getting back to normal.
PCOS is so hormone driven that emotions end up on the back burner. Excesses of androgens and stress hormones put anxiety and anger in control. But if you find that these feelings are persistent and do not wane after time, or that they seem to be there even when nothing in your life can explain them, they may be signs of hormone excesses and not really environmentally or event-stimulated emotions. When your hormones have you constantly revved up, it can feel strange to not have that kind of energy rush.
I couldn't figure out why, when I first started recommending yoga to clients, they would come back after one class and tell me they hated it. I figured out eventually, that yoga slowed their bodies down but their heads were still spinning. And being pinned to the floor in a yoga pose while your head is thinking angry thoughts can be a very uncomfortable place to be. Those clients got the same advice I'm giving you. Give the new changes some time. Don't abandon your new lifestyle because it initially feels uncomfortable. It's been a long time since your body has felt normal. Be gentle with your self and get to know/understand that"normal" involves hourly, daily, weekly, and monthly cycles. There is no such thing as being the same weight, temperature, size, or temperament every single minute of every single day.
Our philosophy is a little different than what many physicians will have you do. We're not trying to control your hormones, your weight, or even your diet. We're not trying to force a cycle, a pregnancy, or a clothing size. We're guiding you toward healthy choices that allow your body to be in balance. Sometimes giving up control, and letting the body speak to you instead of the other way around, is the absolute best way to get there.
So if things seem a little chaotic and you feel like you're charting uncharted territory, welcome to the world of female physiology! Ask questions, observe, and embrace the wonderful lesson you're learning, that your body will heal if you let it. There is no such thing as being past the point of no return or"stuck" where you are.
Thanks to Twitter, I learned that your PCOS management is being directly affected by the medication shortage being experienced by the UK.
It must be stressful to feel like something you feel is essential is just beyond the grasp of your fingers. I'm very sorry to hear about this and I hope the situation resolves quickly.
My first thought on hearing about this dilemma was wondering what this kind of situation does to a woman's psyche--being told she has a certain diagnosis, that she needs to take medications for that diagnosis, and then being told she cannot get those medications. Likely dredges up the same kind of feelings you had if you've ever, on your PCOS journey, been told you're infertile. And…if you're not careful, some self-destructive ways to deal with the anxiety and frustration these kinds of situations have the potential to generate.
I hope, in those of you affected who are reading this, that you don't allow this situation to control you. In times like this, there can be a temptation to engage in behaviors (such as binge eating), to manage the stress. To feel like there is nothing you can do, so why bother? And those are exactly the times when you cannot let those feelings get the best of you.
This may actually be a time of opportunity for you, if you choose to frame the situation in that way! It can be your chance to revisit lifestyle changes and try some new things. Maybe tighten up the eating a bit, become more committed to regular activity. Focus on as many good things as you can do for yourself as possible. The name inCYST is a very intentional choice, as it encourages a more active involvement in your own well being. There is much more you can control than you can sometimes be told!
Of course, this blog is one resource. I also recommend www.pcoschallenge.com for emotional support and accountability.
Flutamide is not approved in the US because of toxicity concerns(for those of you unfamiliar with it, it is an androgen binder), so natural options for balancing androgens is something we're always looking to write about. Because it's never been a treatment option here, everything we write about on this blog is from the perspective of helping the woman who doesn't have access to that medication. So take some time and browse.
Lifestyle change is not the be-all-end-all solution. But it is an essential foundation. Take a few minutes and browse our archives. Find a new food to try. A reason to put the running shoes on. A coping technique that averts stress eating (if you haven't read Dr. HOUSE's post on how to avoid binge eating, now's the time!).
