I have been dealing with this issue for years trying to find a doctor that can help me find out what my body is doing. I have very high DHEA (not DHEA-S, that one is normal) Elevated Androsterione and Low estrogen. I am not sure what to do to address this issue....Docs have offered the BC pill, but I am not sure if this is the right thing for me since 15 years ago I had a bad reaction to it....Does anyone know what can make these androgens so high? Is it from the low estrogen? I am of normal weight, eat well. I have facial hair now, bald spots on head, and many other symptoms in addition to the many CFS symptoms. Appreciate any help anyone can offer...Am I the only one with these issue?? I am 35 years old. Thanks
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High DHEA, androsterione, Low Estrogen
- Thread starter suz9601
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Ema
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- Midwest USA
Do you have PCOS?
How did they measure the DHEA level? That one is very rarely done since it fluctuates widely.
Ema
How did they measure the DHEA level? That one is very rarely done since it fluctuates widely.
Ema
THe DHEA was in the blood at it was 1400 and the range was likedd (300-722) or something like that...it was about double the top. I also had a saliva test done and it was slightly elevated in that as well.
I am not sure if I have PCOS. I had an ultrasound of the ovaries years ago and was found to have many follicules but they did not see any cysts at the time...I do have a lot of the symptoms though.
I lost 45lbs a couple of years ago and that is when I noticed the facial hair, balding, also my period is only 1 day long, very light...I think I was making estrogen from the fat in my stomach and when I lost the weight, I lost some estrogen and now the androgens are elevated.
I'm trying to figure out what to do next...If I want to find a doc and take the bc pill or if I should try some bioidentical estrogen, etc...
Thanks for your reply. I appreciate it.
I just think these hormone levels are causing me a lot of symptoms..
I am not sure if I have PCOS. I had an ultrasound of the ovaries years ago and was found to have many follicules but they did not see any cysts at the time...I do have a lot of the symptoms though.
I lost 45lbs a couple of years ago and that is when I noticed the facial hair, balding, also my period is only 1 day long, very light...I think I was making estrogen from the fat in my stomach and when I lost the weight, I lost some estrogen and now the androgens are elevated.
I'm trying to figure out what to do next...If I want to find a doc and take the bc pill or if I should try some bioidentical estrogen, etc...
Thanks for your reply. I appreciate it.
I just think these hormone levels are causing me a lot of symptoms..
Ema
Senior Member
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- 4,729
- Location
- Midwest USA
Welcome to the forum! I forgot to add that in my reply the first time...
Have you measured all your sex hormones? Total/free testosterone and progesterone as well as the estrogen and DHEA? If so, could you please post all those labs (with ranges and dates)?
I think you need to be re-evaluated for PCOS.
I would NOT under any circumstances take the birth control pill. Synthetic hormones are a terrible choice for almost everyone.
You may need treatment with bioidentical hormones but it's important to get good baseline testing and a diagnosis first.
Hormones can and do cause many of us terrible troubles. Balancing the levels is tricky but I do believe it could help with your symptoms.
Ema
Have you measured all your sex hormones? Total/free testosterone and progesterone as well as the estrogen and DHEA? If so, could you please post all those labs (with ranges and dates)?
I think you need to be re-evaluated for PCOS.
I would NOT under any circumstances take the birth control pill. Synthetic hormones are a terrible choice for almost everyone.
You may need treatment with bioidentical hormones but it's important to get good baseline testing and a diagnosis first.
Hormones can and do cause many of us terrible troubles. Balancing the levels is tricky but I do believe it could help with your symptoms.
Ema
Thanks for the welcome.
These levels are from a couple of years ago. I need to find a new doc that can test AND know what to do about the results..my last doc just offered the bcpill...which I had a gut feeling was not good news, plus my bad reaction in the past. I kind of gave up and now my sympoms are getting worse, so time to get on the saddle again..=)
I think this was day 10 of cycle
Free test 39 (14-76)
Estradial 50 (64-183) for follicular phase
FSH 8.5 (2.5-10.2)
LH 12.9 (0.0-76.3)
TSH 2.67 (.45-4.5)
DHEA-S 171 (45-270)
DHEA 1246 (112-722)
progesterone .7 (.2-1.4)
I ovulate (based on temperatures) but it is late, about day 20 or so...period is about 34 days apart and very light, 1 day long..
What causes the low estrogen...is it the HPA axis dysfunction....it isn't my ovaries based on what I have read because the FSH isn't high, so it is as if the brain isn't telling the ovaries to make more...so complex
Endos have not offered much help, and gynos want to give me the pill. I think people are afraid to give me estrogen because I am young..(not menopausal)...
Thanks for your time, I appreciate it.
Suz
These levels are from a couple of years ago. I need to find a new doc that can test AND know what to do about the results..my last doc just offered the bcpill...which I had a gut feeling was not good news, plus my bad reaction in the past. I kind of gave up and now my sympoms are getting worse, so time to get on the saddle again..=)
I think this was day 10 of cycle
Free test 39 (14-76)
Estradial 50 (64-183) for follicular phase
FSH 8.5 (2.5-10.2)
LH 12.9 (0.0-76.3)
TSH 2.67 (.45-4.5)
DHEA-S 171 (45-270)
DHEA 1246 (112-722)
progesterone .7 (.2-1.4)
I ovulate (based on temperatures) but it is late, about day 20 or so...period is about 34 days apart and very light, 1 day long..
What causes the low estrogen...is it the HPA axis dysfunction....it isn't my ovaries based on what I have read because the FSH isn't high, so it is as if the brain isn't telling the ovaries to make more...so complex
Endos have not offered much help, and gynos want to give me the pill. I think people are afraid to give me estrogen because I am young..(not menopausal)...
Thanks for your time, I appreciate it.
Suz
Ema
Senior Member
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- 4,729
- Location
- Midwest USA
Low estrogen certainly can be caused by HPA dysfunction.
You're right - it certainly seems like your FSH is high enough to cause your ovaries to release estrogen. My estrogen dropped like a rock along with cortisol though due to HPA dysfunction. I think that the adrenals contribute a lot more to sex hormone production than previously thought.
That testosterone result looks odd to me - was it in saliva?
Have you run your thyroid hormone levels again - specifically your FT4 and FT3? I would say you are probably a bit hypo based on that result from a few years ago. I would follow up on that.
Progesterone should be low on day 10 so that result doesn't mean much.
How is your weight? Fasting blood sugar?
If it were me, I would look into the following tests:
Estradiol, cycle day 21
Progesterone, cycle day 21
Testosterone, free and total, any cycle day
FSH and LH, cycle day 3
DHEAs
CMP (glucose and electrolytes)
Saliva cortisol test 4x/day
Thyroid levels (TSH, FT4, FT3, RT3)
Cholesterol panel
Fasting insulin
An integrative doctor is probably a better choice than either a traditional endo or a gyno. You're right about the treatment that they will likely suggest and it is not good.
I have a lot of notes on PCOS from a friend who was diagnosed last year. Let me re-read them this afternoon and see if there is anything else that you might find useful.
Ema
You're right - it certainly seems like your FSH is high enough to cause your ovaries to release estrogen. My estrogen dropped like a rock along with cortisol though due to HPA dysfunction. I think that the adrenals contribute a lot more to sex hormone production than previously thought.
That testosterone result looks odd to me - was it in saliva?
Have you run your thyroid hormone levels again - specifically your FT4 and FT3? I would say you are probably a bit hypo based on that result from a few years ago. I would follow up on that.
Progesterone should be low on day 10 so that result doesn't mean much.
How is your weight? Fasting blood sugar?
If it were me, I would look into the following tests:
Estradiol, cycle day 21
Progesterone, cycle day 21
Testosterone, free and total, any cycle day
FSH and LH, cycle day 3
DHEAs
CMP (glucose and electrolytes)
Saliva cortisol test 4x/day
Thyroid levels (TSH, FT4, FT3, RT3)
Cholesterol panel
Fasting insulin
An integrative doctor is probably a better choice than either a traditional endo or a gyno. You're right about the treatment that they will likely suggest and it is not good.
I have a lot of notes on PCOS from a friend who was diagnosed last year. Let me re-read them this afternoon and see if there is anything else that you might find useful.
Ema
No the testosterone was blood. I got it mixed up...it is
total test serum 39 ( 14-76)
Free Testosterone .7 (0-2.2)
Weight is 130 5'6 so I am good there..Fasting b. sugar is 89
Insulin was tested and okay. It was 2 on a scale of (<17)..this was fasting
Just curious why you said day 21 for testing on Estrogen and progesterone? I have had estrogen on day 21 and it went up to 150 (18-480 for mid cycle range or (< or = 247) for luteal phase.. it was about my peak since I ovulate so late so not sure which range to go by. .Progesterone was 14.9 (4.4-28.0)
Thanks so much for your help. What did they do for your friend? Is it better now? I think I am different than the typical PCOS case since I dont seem to have the insulin resistance thing going on and I am not overweight..actually I lost 45 lbs a few years back and that is when I started having these issues....I dont know if that means it is more of an adrenal problem or what...so complicated...
thanks
suz
total test serum 39 ( 14-76)
Free Testosterone .7 (0-2.2)
Weight is 130 5'6 so I am good there..Fasting b. sugar is 89
Insulin was tested and okay. It was 2 on a scale of (<17)..this was fasting
Just curious why you said day 21 for testing on Estrogen and progesterone? I have had estrogen on day 21 and it went up to 150 (18-480 for mid cycle range or (< or = 247) for luteal phase.. it was about my peak since I ovulate so late so not sure which range to go by. .Progesterone was 14.9 (4.4-28.0)
Thanks so much for your help. What did they do for your friend? Is it better now? I think I am different than the typical PCOS case since I dont seem to have the insulin resistance thing going on and I am not overweight..actually I lost 45 lbs a few years back and that is when I started having these issues....I dont know if that means it is more of an adrenal problem or what...so complicated...
thanks
suz
Ema
Senior Member
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- 4,729
- Location
- Midwest USA
OK, that makes more sense for the T. Your total is fine and your free is a little low.
If you look at a chart that shows how E and P cycle through the month, you will see that they are very low until ovulation, then peak, and then have a steady-ish level through the second half of your cycle and then dropping down for menses to start. Ideally, anyway.
So it doesn't do much good to measure in the first part of the cycle because the result will be low (occasionally you may want to test on day 3 for reproductive purposes but that's another story). It doesn't do much good to measure around O because you don't know where on the spike you might be. So if you aim for 7 days post O (or thereabouts), that should give you a reasonably consistent level that is able to be compared across cycles and across women in general.
150 for estrogen on day 21 is great. It's not low at all. I would not want to supplement E personally with those results.
Progesterone is OK but many women find that they do better with a level in the high teens. Some women like to go all the way up to the top of the P range, but I think it is important to remember that P is a steroid hormone as well and it is possible to overdo it.
That is excellent news for your fasting blood sugar and insulin. It is possible to have PCOS and not have a weight problem or insulin resistance but it is less common.
I think you really are going to have to be re-tested and see where things stand now. Things could have totally changed for you.
You may also need a more specific saliva test that shows exactly how the hormones are being broken down. Here's an example of the one from Genova:
http://www.gdx.net/core/sample-reports/Complete-Hormones-FMV-Sample-Report.pdf
My friend is better now. I will write more about what she did later this evening or tomorrow though because I am short on time.
I think I read elsewhere that you have Lyme disease? I also have Lyme and it can cause immense dysregulation of the endocrine system.
Ema
If you look at a chart that shows how E and P cycle through the month, you will see that they are very low until ovulation, then peak, and then have a steady-ish level through the second half of your cycle and then dropping down for menses to start. Ideally, anyway.
So it doesn't do much good to measure in the first part of the cycle because the result will be low (occasionally you may want to test on day 3 for reproductive purposes but that's another story). It doesn't do much good to measure around O because you don't know where on the spike you might be. So if you aim for 7 days post O (or thereabouts), that should give you a reasonably consistent level that is able to be compared across cycles and across women in general.150 for estrogen on day 21 is great. It's not low at all. I would not want to supplement E personally with those results.
Progesterone is OK but many women find that they do better with a level in the high teens. Some women like to go all the way up to the top of the P range, but I think it is important to remember that P is a steroid hormone as well and it is possible to overdo it.
That is excellent news for your fasting blood sugar and insulin. It is possible to have PCOS and not have a weight problem or insulin resistance but it is less common.
I think you really are going to have to be re-tested and see where things stand now. Things could have totally changed for you.
You may also need a more specific saliva test that shows exactly how the hormones are being broken down. Here's an example of the one from Genova:
http://www.gdx.net/core/sample-reports/Complete-Hormones-FMV-Sample-Report.pdf
My friend is better now. I will write more about what she did later this evening or tomorrow though because I am short on time.
I think I read elsewhere that you have Lyme disease? I also have Lyme and it can cause immense dysregulation of the endocrine system.
Ema
Thanks Ema, You think 150 on day 21 is okay even if I ovulated the day before.? Remember I ovulate on day 20 or so...so it kind of messes things up as far as a normal cycle..I could have caught the spike from right before ovulation..On day 3 my estridial is 35. Day 10 it is around 50.
I do have facial hair and bald spots on my head and 1 day period..so I guess it could be the androgens and not as much the low estrogen, but am not sure..like you said I need new tests, but first I must find a doc that can help me with the results if I need to be treated.
yes I do have lyme ...well I am CDC IGM positive anyway on Igenex...My illness started gradually and with the BC pill so it is kind of a strange way for lyme to surface. Do you treat it with abx?
Good to hear your friend is better, that is good news.
I do have facial hair and bald spots on my head and 1 day period..so I guess it could be the androgens and not as much the low estrogen, but am not sure..like you said I need new tests, but first I must find a doc that can help me with the results if I need to be treated.
yes I do have lyme ...well I am CDC IGM positive anyway on Igenex...My illness started gradually and with the BC pill so it is kind of a strange way for lyme to surface. Do you treat it with abx?
Good to hear your friend is better, that is good news.