Tests, Results, Interpretations

I finally have been able to go to a doctor who has at least read a book or two about PCOS since 1975! I don't mean to sound bitter here, but as many of you know from reading my history with doctors and PCOS, I haven't had much luck in getting tests run or getting treatment that goes beyond a packet of birth control pills and a sharp warning to "get off [my] fat a** and lose weight."

I started seeing Dr. Glueck in Cinncinnati, Ohio on June 2, 2000 after sliding through some sticky and very thick administrative tape. I thought that some of you might be interested in the kinds of tests that Dr. G. gave me while I was there and what the results actually mean. I have to go back and get these tests done every two months to measure my progress, so check back often to see how the metformin is working (or not). If anyone out there has any further insight on what these levels indicate send me an e-mail.

By the July 26 tests, I had been on 2550 mg of metformin per day for about one week. For the October 6 tests, I was one month pregnant. I had been on 2550 mg of met for nearly three months. For the May 4 tests, I was two months postpartum and taking 2000 mg of met XR for one month.

*Tests*	*Normal Range(accordingto Dr. G)*	*My Results (6/2/00)*	July 26, 2000	Oct 6, 2000	May 4, 2001	*Interpretations (based on info. found here and Dr. G.'s handouts)*
ANDROST	50-250 ng/dl	132	123	NA	NA	Androstenedione, along with DHEAS, is an androgenic-anabolic hormone made to varying degrees by both ovary and adrenal. Often high in PCOS. 132 seems on the upper side of high.
BUN	7-21 mg/dl	14	NA	NA	NA	Blood urea nitrogen. Measures kidney function. Usually normal in PCOS.
B-PAIFX	<26.9 U/ml	34.30	7.60	8.30	NA	Plasmogen activator inhibitor. Responsible for chopping up blood clots in the body. It is often elevated in women with PCOS. May increase the risk of stroke or heart disease. As you can see, mine is not too bad.
CREAT	O.7-1.4 mg/dl	.80	NA	NA	NA	Also a measure of kidney function and is usually normal in PCOS.
DHEA	130-980 ng/dl	NA	NA	NA	NA	NO INFO FOR THIS ONE
DHEA-S	32-308 mcg/dl	190.00	224.00	NA	198.00	Along with androstn, elevated DHEAS causes excess body hair and excess body weight. I think that 190 seems quite elevated.
E2	depends on time of test	49.00	50.00	319	77.50	DEPENDS ON TIME
FSH	depends on time of test	4.3	4.50		1.0	In a woman who is not ovulating, the FSH is useful when compared with LH (see below). In women with PCOS, LH is often much high than FSH.
LH	1-12 mIU/ml	7.80	7.60		7.40	Normal ratios of LH to FSH are 1:1. That ratio is usually 3:1 in women with PCOS. Although my levles are not quite that high, my elevated LH is a clear sign of PCOS.
HCG	N	N		Y	N	not pregnant :(
HGA1C	4.7-6.4%	5.0%	NA	NA	NA	Measures glucose levels over the past three months. It should be under 6% to show good control. Good control reduces the risk of miscarriage and birth defects.
HYDROXY	depends on time of test	68	NA	NA	NA
GLUCOSE	70-105 mg/dl	103	83	NA	95	A healthy fasting glucose level is between 70-90, but up to 110 is within normal limits. A level of 111-125 indicates impaired glucose tolerance/insulin resistance. A fasting level of 126+ indicates type II diabetes. Although 103 is within normal limits, it does demonstrate a high probability of insulin resistance, especially given my weight and high androgen levels.
INSULIN	<=20 uU/ml	16	12.0	14.0	11.30	A fasting insulin of 10-13 generally indicates some insulin resistance, and levels above 13 indicates insulin resistance. Well, gee, you think I might be insulin resistant?
LA	.3-1.3 mmol/L	1.50	NA	NA	NA	Lactic Acid. High levels of LA can demonstrate kidney disfunction and can be especially dangerous for patients using metformin.
TESTOST	0-83 ng/dl	74	59	141	21	Most would consider a level above 50 to be somewhat elevated. My level of testerone certainly seems high.
PROGEST	depends on time of test	.90	.80	7.70	4.40	According to the charts that I have read, .90 seems to be a good level for progesterone.
PROLACT	<19.9 ng/ml	7.30	NA	NA	NA	High prolactin levels can cause problems wit ovulation. They may also indicate the presence of a pituitary tumor and may indicate hyperprolactenemia. 7.30 seems to be a good level.
LPA	0-35 mg/dl	5	58	NA	70	High Lp(a) along with high LDL cholesterol increase the risk of heart attack and stroke. 5 seems good to me.
PAIG	5G5G	5G5G	5G5G	5G5G	5G5G	I don't have the gene that many researchers believe to be responsible for PCOS. Most patients with PCOS are 4G4G or 4G5G.
SHBG	8-85 nmol/l	11	8	NA	13	Increased androgen production often leads to lower SHBG. I think my androgen levels are high, and according to my SHBG levels, this seems to be true.
TTL CHOL	75-200 mg/dl	126	130	NA	149	Total cholesterol. A level of 200-239 is borderline high, and a level 240+ is high. Increased levels are associated with an increased risk of heart disease. I think that my total cholesterol is very good!
HDL	40-90 mg/dl	44	44	NA	48	Good cholestrol. It is usually estimated by taking the total cholestrol and subtracting LDL, rather than by direct measure. My good cholestrol could be even better. It is something to work on.
LDL	75-140 mg/dl	70	68	NA	88	Bad cholestrol. In someone with a risk of heart disease, <160 is recommended and with 2 risk factors <130, and those with documented coronary heart disease the target is <100. I can't believe my bad cholesterol is so good!
TRIGLYC	20-250 MG/DL	58	89	NA	63	Borderline high is 200-400, high is 400-1000, and very high is >1000. Elevated levels are a risk factor for coronary artery disease. Wow! 58. Not too bad.