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Re: Question for DRs - testosterone (Dr Marchbein)
From: anonymous (anonymous@obgyn.net)
Fri, 29 Sep 2000 16:37:13 -0500 (CDT)
Thanks Dr Marchbein - that's very helpful. The reference range for
testosterone on my results letter shows 20-80, and they really prefer it
to be under 50. Apparently if it gets to 200 that's very bad news, and
now I'm getting up there. I think my doctor wants to re-test on day 3
of my next cycle and if still high, do 1 more ultrasound to look for a
(presumably new?) tumour. The procedure you mention doesn't sound very
appealing, but it's good to know that there are other diagnostic options
if the us doesn't show anything. I appreciate your advice.
Thanks
At Thu, 28 Sep 2000, Harvey S. Marchbein, M.D. wrote:
>
>It's not inconceivable that weight loss can reduce the fasting insulin/
>fasting glucose ratio to a more favorable ratio. In that other tests
>have returned to normal or near normal, the testosterone needs to be
>looked at as a separate issue. Different labs use different normal
>levels and use different units of measure so I don't know what the
>normals are for your lab, but presuming they are in the abnormal range,
>it would be helpful to know that the elevation is in the free
>testosterone and not just the bound testosterone (bound to SHBG).
>
>Elevated androgens are either from the ovary or the adrenal gland (the
>latter usually being DHEA and not testosterone). Diagnosis may require
>special testing including interventional radiological procedures like
>ovarian vein blood sampling for testosterone to evaluate the origin of
>the increased hormone levels.
>
>HSM
>
>At Thu, 28 Sep 2000, anonymous wrote:
>>
>>Hi,
>>
>>I was diagnosed with PCOS in June of this year. At the time of
>>diagnosis, these were my blood test results:
>>
>>Fasting Insulin 26
>>Fasting Glucose 83
>>testosterone 36
>>Shbg 15.4
>>fr. andr index 130
>>Cholesterol 190
>>
>>Since then, I have been dieting - mostly avoiding processed foods and
>>sugar in all forms. I've been exercising almost every day and lost
>>about 30lbs. I have not been on any medication yet, because I wanted to
>>see what I could achieve without medication - and also, I hadn't
>>suffered any visible signs of excess testosterone.
>>
>>Early this month, I had the tests again, to see if my diet/exercise had
>>made any improvement. Now, my insulin is 11.5, my glucose 78, shbg
>>22.5, cholesterol 153, and the ratio of HDL:LDL is improved. I also
>>have had 2 spontaneous periods, which I hadn't had for more than 5
>>years. I was obviously excited by these results.
>>
>>However, during this time, my testosterone went from 36 to 144. My
>>doctor (and I) initially wondered if it was a lab error. I had it
>>tested again last week just in case, and now my testosterone has climbed
>>again, to 170. The fr androgen index is now about 480.
>>
>>I had thought that the testosterone would go down with all the other
>>blood levels - not increase 5 times!!
>>
>>An ultrasound in May, showed cysts but no tumour. All other tests, for
>>Cushing's, LOCAH, etc, are all OK. Do you have any suggestions as to
>>what could be affecting my testosterone?
>>
>>Thanks a lot for any advice.
>
>--
>Harvey S. Marchbein, M.D. FACOG, FACS
>Great Neck, New York
>
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>
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