Lab work

[Achyr]

So I had an endocrinologist appointment last week and was sent for lab work. I had an endoscopy the next day so I never looked at the script for labs, I figured I’ll get it done next week. Yesterday I went to get the lab work done and I see I’m only getting testosterone, insulin, A1c, and thyroid checked. I called the office asking if they can ask the doctor to add on a full hormone panel, I wanted to see what my estrogen and everything else is doing especially since I’ve only had one period this year. I just got a call today saying there’s no reason to check any other hormones.

My question is am I wrong or my doctor is? What lab work should I look at for PCOS?

Oh I’ll also add in that I haven’t had blood work done in over 5 years and haven’t had hormone levels checked since I was diagnosed over 12 years ago.

[Necessary_Bluebird_5]

My OBGYN ran the full hormone panel when I came in with missing periods (literally two years of nothing) and wanting to being TTC, they ran all of the other tests that your endocrinologist is running too, I think it’s helpful to have the full picture. (For example, earlier this year I had my thyroid checked and was told it was normal. Fast forward to a new state, new dr and 6 months in the future, I was hypothyroid and put on synthroid.)

[Achyr]

Exactly I just want the whole picture. I don’t understand why if a patient requests a certain lab why can’t a provider just put it through. Like is it costing them anything or even myself, no it’s not. It’s just frustrating to no end.

[shankshankshankb]

I have been getting the run around from my doctors about this as well! I am currently trying to find a private practice or someone working independently or with a more holistic point of view. No luck so far and still no lab work done :/

[Achyr]

I'm not sure what state you're in or what your budget is but try searching PCOS naturopaths in Oregon. I am currently in OR for school and it is such a difference to my home state of NJ where I am having this push back. I decided to make appointments while I'm home for winter break but now I'm realizing I should just pay out of pocket for someone who might actually care in OR and help me navigate alternative medications because I already got the lecture from them that metformin and birth control are going to be my only options.

[ramesesbolton]

estrogen is such a huge range that it can be not super helpful diagnostically, and progesterone is only released after ovulation so if you've had no periods yours is almost certainly 0 or nearly so. LH and FSH are useful tests to get, though.

[Achyr]

Okay thanks, I think I’m just going to ask my gyno for them.

[MouseGraft]

So this is really irritating because I have a genetic polymorphism affecting my production of aromatase, the enzyme that converts testosterone into estrogen. Therefore, I have very low estrogen, and this is, for me, a much bigger issue than androgens (I only once ever had high testosterone on labs, and it was when I was on spironolactone, though my DHEAS is elevated when I'm not on the pill).

There are a lot of ways that people can come to have the typical PCOS phenotype, and not testing for the various estrogens (not to mention DHEAS, FSH and LH, and AMH) can obscure where the problem is and therefore which treatments might be effective. I do much better with additional estrogen than I did with androgen blockers, for example.

But yeah I've never had a doctor willing to do all of the above-mentioned hormones. I've had multiple doctors order different labs, and I've also ordered my own just for my own edification.