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PCOS Lab Testing
Lab testing helps you and your doctor know how well our body is responding to your maintenance routine. It is recommended that you have these tests minimally, annually, although you would be best to have these done semiannually, to make any adjustments to medications, supplements, nutrition or exercise to ensure that you are at your optimal health!
A special thanks to Angela Grassi and Stephanie Mattei for this list and results, listed originally in their amazing book The PCOS Workbook.
1. Testosterone:
Elevated total testosterone levels are > 50 ng/dL.
Elevated free testosterone levels are > 6pg/mL
2. Sex hormone-binding globulin (SHBG):
SHBG is a protein that binds to testosterone and controls the amount of testosterone that your tissues use. Low levels correlate with high levels of free testosterone and are associated with insulin resistance
3. Luteinizing hormone (LH):
LH plays a role in eff development and release. Usually LH levels are elevated in people with PCOS. LH may be used to help make a diagnosis of PCOS, but it isn't always useful, because levels fluctuate quite frequently during the different phases of the menstrual cycle.
4. Follicle stimulating hormone (FSH):
FSH is responsible for egg maturation. Levels can be normal or low in people with PCOS.
5. LH:FSH ratio:
This test compares the levels of LH to FSH. Many (but not all) people with PCOS have abnormal FSH to LH ratios. Normally this ration is about 1:1. In people with PCOS, the LH to FSH is often higher.
6. DHEA-sulfate:
This test detects the level of androgens (male hormones) your body is producing. DHEA-sulfate is an androgen that is converted into testosterone in the body. This test also rules out adrenal problems which can mimic PCOS symptoms.
7. Prolactin:
Prolactin is a hormone secreted from the pituitary gland. This test is used to rule out a prolactin-secreting pituitary tumor.
8. Anti-Mullerian hormone (AMH):
AMH is a hormone secreted by cells developing in the follicles of the ovaries. THis test can assess your ovarian reserve or the amount of follicles your body has. Low AMH is an indicator of low follicle count, or the decline in the ovaries ability to produce good-quality eggs. People with PCOS (even those who are pregnant or are past menopause) tend to have high AMH levels
9. 7-Alpha-Hydroxyprogesterone (12-OHP):
This test is used to screen for congenital adrenal hyperplasia (CAH) and rule out PCOS
10. Human Chorionic gonadotropin (HCG):
HCG is a hormone produced by the placenta and indicates pregnancy
11. Thyroid panel includes:
a. Thyroid-stimulating hormone (TSH):
A blood test used to assess thyroid functioning. A hypothyroid indicates a slow metabolism and causes elevated TSH levels, possibly indicating thyroid damage. A hyperthyroid may indicate a faster metabolism, resulting in low levels of TSH in the blood. Normal levels of TSH are .4 to 2.5 IU/mL. TSH should NOT be the only test used to detect thyroid function.
b. T4 or free T4 (FT4):
This test measures the amount of protein-bound or free levels of thyroxine, the main thyroid hormone. Individuals who have hyperthyroidism will have an elevated level, whereas patients with hypothyroidism will have a low level of FT4
c. Free T3 (FT3) or Reverse T3 (rT3):
Test often used to diagnose hyperthyroidism.
d. Thyroid antibodies (TAB):
This test can be uses to detect an autoimmune thyroid disorder known as Hashimoto's thyroiditis, when the thyroid gland attacks itself.
12. Liver Function Tests (LFTs):
Tests used to monitor liver functioning, including the levels of the liver enzymes AST and ALT. Since most medications (and many supplements) pass through the liver, monitoring the liver function every three to six months is essential. Elevated LFT levels indicate liver damage or non-alcoholic fatty liver disease.
13. Fasting lipid profile includes:
a. Total Cholesterol:
The total amount of cholesterol in your body. Ideal is < 200 mg/dL
b. High-density lipoproteins (HDL):
The "good" cholesterol. The higher the better, ideal is > 55mg/dL. You are at risk for heart disease with low levels of HDL.
c. Low-density lipoproteins (LDL):
The "bad" cholesterol. Optimal is < 100mg/dL. The higher the level of LDL, the greater your risk for heart disease and stroke.
d. Triglycerides (TG):
The level of fat in your bloodstream. High TG levels are correlated with high insulin levels. Ideal levels is < 150 mg/dL.
14. Fasting insulin:
A test used to detect elevated insulin levels or insulin resistance. A fasting insulin blood test may be performed alone or as part of an oral glucose tolerance test (OGTT). When tested every three to six months, fasting insulin can assess to use of insulin-lowering medications or dietary changes. Ideal fasting insulin level should be < 10 IU/mL.
15. Fasting Blood Glucose:
A test that measures the amount of glucose (sugar) in your blood. Ideally levels should be 70-99 mg/dL. Diabetes is diagnosed when fasting glucose levels are > 126 mg/dL.
16. Oral Glucose Tolerance Test (OGTT) with Insulin:
This is the best test used to screen for prediabetes, diabetes, or gestational diabetes. Your healthcare provider will draw our blood to check our blood glucose level. Next you will drink a very sugary beverage in five minutes. You will then have your blood drawn every hour for the next two to three hours to check your blood glucose and insulin levels.
17. Fasting Glucose to insulin ratio:
A test to diagnose prediabetes, diabetes, diabetes and gestational diabetes by determining the level of fasting glucose compared to the level of fasting insulin. A glucose to insulin ratio of less than 4:5 usually indicates insulin resistance. This test may also be part of the two to three hour OGTT.
18. Hemoglobin A1c (HA1c):
This measures the long term blood sugar levels during a three month period. The optimal levels is < 5.7%. Prediabetes is 5.7% - 6.4% and type 2 Diabetes is greater than 6.5%.
19. Vitamin D:
The optimal level of vitamin D in the blood is 30 to 50 ng/dL.
20. High-sensitivity C-reactivity protein (hsCRP):
This measures your level of high sensitivity C-reactive protein, which is a marker of inflammation. The optimal level is < 3mg/L
21. Vitamin B12:
The optimal level of vitamin B12 in blood is > 600 pg/mL.
Elevated total testosterone levels are > 50 ng/dL.
Elevated free testosterone levels are > 6pg/mL
2. Sex hormone-binding globulin (SHBG):
SHBG is a protein that binds to testosterone and controls the amount of testosterone that your tissues use. Low levels correlate with high levels of free testosterone and are associated with insulin resistance
3. Luteinizing hormone (LH):
LH plays a role in eff development and release. Usually LH levels are elevated in people with PCOS. LH may be used to help make a diagnosis of PCOS, but it isn't always useful, because levels fluctuate quite frequently during the different phases of the menstrual cycle.
4. Follicle stimulating hormone (FSH):
FSH is responsible for egg maturation. Levels can be normal or low in people with PCOS.
5. LH:FSH ratio:
This test compares the levels of LH to FSH. Many (but not all) people with PCOS have abnormal FSH to LH ratios. Normally this ration is about 1:1. In people with PCOS, the LH to FSH is often higher.
6. DHEA-sulfate:
This test detects the level of androgens (male hormones) your body is producing. DHEA-sulfate is an androgen that is converted into testosterone in the body. This test also rules out adrenal problems which can mimic PCOS symptoms.
7. Prolactin:
Prolactin is a hormone secreted from the pituitary gland. This test is used to rule out a prolactin-secreting pituitary tumor.
8. Anti-Mullerian hormone (AMH):
AMH is a hormone secreted by cells developing in the follicles of the ovaries. THis test can assess your ovarian reserve or the amount of follicles your body has. Low AMH is an indicator of low follicle count, or the decline in the ovaries ability to produce good-quality eggs. People with PCOS (even those who are pregnant or are past menopause) tend to have high AMH levels
9. 7-Alpha-Hydroxyprogesterone (12-OHP):
This test is used to screen for congenital adrenal hyperplasia (CAH) and rule out PCOS
10. Human Chorionic gonadotropin (HCG):
HCG is a hormone produced by the placenta and indicates pregnancy
11. Thyroid panel includes:
a. Thyroid-stimulating hormone (TSH):
A blood test used to assess thyroid functioning. A hypothyroid indicates a slow metabolism and causes elevated TSH levels, possibly indicating thyroid damage. A hyperthyroid may indicate a faster metabolism, resulting in low levels of TSH in the blood. Normal levels of TSH are .4 to 2.5 IU/mL. TSH should NOT be the only test used to detect thyroid function.
b. T4 or free T4 (FT4):
This test measures the amount of protein-bound or free levels of thyroxine, the main thyroid hormone. Individuals who have hyperthyroidism will have an elevated level, whereas patients with hypothyroidism will have a low level of FT4
c. Free T3 (FT3) or Reverse T3 (rT3):
Test often used to diagnose hyperthyroidism.
d. Thyroid antibodies (TAB):
This test can be uses to detect an autoimmune thyroid disorder known as Hashimoto's thyroiditis, when the thyroid gland attacks itself.
12. Liver Function Tests (LFTs):
Tests used to monitor liver functioning, including the levels of the liver enzymes AST and ALT. Since most medications (and many supplements) pass through the liver, monitoring the liver function every three to six months is essential. Elevated LFT levels indicate liver damage or non-alcoholic fatty liver disease.
13. Fasting lipid profile includes:
a. Total Cholesterol:
The total amount of cholesterol in your body. Ideal is < 200 mg/dL
b. High-density lipoproteins (HDL):
The "good" cholesterol. The higher the better, ideal is > 55mg/dL. You are at risk for heart disease with low levels of HDL.
c. Low-density lipoproteins (LDL):
The "bad" cholesterol. Optimal is < 100mg/dL. The higher the level of LDL, the greater your risk for heart disease and stroke.
d. Triglycerides (TG):
The level of fat in your bloodstream. High TG levels are correlated with high insulin levels. Ideal levels is < 150 mg/dL.
14. Fasting insulin:
A test used to detect elevated insulin levels or insulin resistance. A fasting insulin blood test may be performed alone or as part of an oral glucose tolerance test (OGTT). When tested every three to six months, fasting insulin can assess to use of insulin-lowering medications or dietary changes. Ideal fasting insulin level should be < 10 IU/mL.
15. Fasting Blood Glucose:
A test that measures the amount of glucose (sugar) in your blood. Ideally levels should be 70-99 mg/dL. Diabetes is diagnosed when fasting glucose levels are > 126 mg/dL.
16. Oral Glucose Tolerance Test (OGTT) with Insulin:
This is the best test used to screen for prediabetes, diabetes, or gestational diabetes. Your healthcare provider will draw our blood to check our blood glucose level. Next you will drink a very sugary beverage in five minutes. You will then have your blood drawn every hour for the next two to three hours to check your blood glucose and insulin levels.
17. Fasting Glucose to insulin ratio:
A test to diagnose prediabetes, diabetes, diabetes and gestational diabetes by determining the level of fasting glucose compared to the level of fasting insulin. A glucose to insulin ratio of less than 4:5 usually indicates insulin resistance. This test may also be part of the two to three hour OGTT.
18. Hemoglobin A1c (HA1c):
This measures the long term blood sugar levels during a three month period. The optimal levels is < 5.7%. Prediabetes is 5.7% - 6.4% and type 2 Diabetes is greater than 6.5%.
19. Vitamin D:
The optimal level of vitamin D in the blood is 30 to 50 ng/dL.
20. High-sensitivity C-reactivity protein (hsCRP):
This measures your level of high sensitivity C-reactive protein, which is a marker of inflammation. The optimal level is < 3mg/L
21. Vitamin B12:
The optimal level of vitamin B12 in blood is > 600 pg/mL.
DISCLAIMER: everyPCOSbody and it's contributors, unless otherwise stated, are NOT doctors. everyPCOSbody, and all whom run and contribute to anything that has the everyPCOSbody name do not make any medical claims. This is just the expression of opinions based on research, knowledge and being involved within the PCOS community. As always, with any medical condition, please speak with your medical team or a medical professional regarding diagnosis and any treatment or treatment changes.
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