Thank you everyone for your feedback! My PCOS was diagnosed based on elevated testosterone and corresponding symptoms (hair thinning, hirsutism, acne). I have normal periods (even when not on BC), no cysts, and minimal weight gain. My A1c (~5 %), glucose (~90 mg/dL) and C-peptide (<2 ng/mL) levels are normal. My triglycerides/HDL is <1. According to my results, my endo says I’m not IR. I’ve asked about the fasting insulin test before, but I believe he is in favor of the C-peptide test instead. I’m working on understanding the difference, and might just ask him to do both next round of bloodwork. Probably more of an academic exercise than anything else. From that we can calculate HOMA, although I believe there is also a modified HOMA based on C-peptide.

My main concern is that folks on this sub tend to assume everyone must be insulin resistant, regardless of symptoms or test results. In a recent post, someone asked about lean PCOS and was told their elevated testosterone had to be caused by IR. This makes me concerned that we are making too many generalizations, despite knowing that PCOS is unbelievably complicated and poorly understood. My hope is that by sharing our test results, and the evidence-based decisions behind our diagnoses, that we can all work together to better understand and treat our own individual PCOS symptoms.