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PCOS ~ What blood tests to have done

What blood tests should be done to diagnose Polycystic Ovarian Syndrome (PCOS)?


Many doctors will require the following blood tests be done to successfully diagnose Polycystic Ovary Syndrome in a patient:

  • Fasting comprehensive biochemical and lipid panel;
  • 2-hour GTT with insulin levels (also called IGTT);
  • LH:FSH ratio;
  • Total testosterone;
  • DHEAS;
  • SHBG;
  • Androstenedione;
  • Prolactin and
  • TSH

Polycystic Ovary Syndrome

How common is PCOS?

It is currently believed that approximately 5 to 10% of women have Polycystic Ovary Syndrome (PCOS). It is the most common hormonal disorder in women of reproductive years and the leading cause in women for infertility. Since many women can have PCOS without exhibiting any symptoms, the actual number of women affected could be as much as 10% more of the population.

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What are the symptoms of PCOS?

Photo of a polycystic ovary courtesy of http://www.ovarian-cysts-pcos.com

Photo of a polycystic ovary courtesy of http://www.ovarian-cysts-pcos.com

Some of the most common symptoms include:

  • Amenorrhea (no menstrual period), infrequent menses, and/or oligomenorrhea (irregular bleeding) Menstrual cycles can often be scant, irregular and infrequent or may also exhibit in the form of spotting throughout the month.
  • Oligo or anovulation (infrequent or absent ovulation) Women with PCOS generally produce an egg but they don’t fully mature. Instead, these immature egg sacs can create ovarian cysts.
  • Hyperandrogenism Women who have PCOS generally also have an increase in serum levels of male hormones such as testosterone, androstenedione, and dehydroepiandrosterone sulfate (DHEAS).
  • Infertility
  • Cystic ovaries Classic PCOS ovaries have a “string of pearls” or “pearl necklace” appearance with many cysts.
  • Enlarged ovaries Polycystic ovaries are usually 1.5 to 3 times larger than normal.
  • Chronic pelvic pain
  • Obesity or weight gain Most commonly referred to as an “apple figure”. PCOS women will generally gain weight primarily in the abdomen and waistline.
  • Insulin resistance, hyperinsulinemia, and diabetes Insulin resistance is a condition where the body’s use of insulin is inefficient.
  • Hirsutism (excess hair) Excess hair growth such as on the face, chest, abdomen, thumbs, or toes.
  • Alopecia (female-pattern baldness or thinning hair) The thinning most commonly occurs on the top of the head.
  • Acne/Oily Skin/Seborrhea
  • Acrochordons (skin tags)

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What causes PCOS?

The exact cause of PCOS is unknown. However, there are studies that may lead us to believe that there may be a genetic link. Just as one may have a genetic predisposition to diabetes, one might also have a disposition to PCOS.

Cipro Interacts with Thyroid Medication

Popular Antibiotic Interacts with Thyroid Medication

The British Medical Journal has reported on a several cases of unexplained hypothyroidism in thyroid patients (on levothyroxine) who were taking the popular antibiotic ciprofloxacin. Ciprofloxacin is the generic name for the fluoroquinolone antibiotic sold under the brand names Cipro, Ciproxin and Ciprobay, Cirpoxine, and Ciflox. The drug is primarily used to treat urinary tract infections, pneumonia, and sexually transmitted diseases. Ciprofloxacin was also in the news during the anthrax scare, given its use in treatment for anthrax exposure.
What the researchers found in these cases were evidence that oral ciprofloxacin interacts with levothyroxine (i.e., Synthroid, Levoxyl, Levothroid) if taken together. It’s thought that the ciprofloxacin may somehow decrease the absorption of the levothyroxine.

In one case, a woman taking 125 mcg a day of levothyroxine took ciprofloxacin (750 mg twice a day) and her TSH level rose to 44 after four weeks. Even when her dosage was raised to 200 mcg a day, her TSH didn’t respond. Only when the ciprofloxacin was stopped did the TSH return to normal. In another case, a woman who was stabilized on 150 mcg a day of levothyroxine saw her TSH go from 1.6 to 19 after 3 weeks of treatment with ciprofloxacin at 500 mg twice a day.

What Can You Do?

If you’re a thyroid patient who is taking ciprofloxacin, what should you do?

The research suggested that thyroid tests were normalized if patients took the levothyroxine and ciprofloxacin at least six hours apart.

So, if you are on levothyroxine, it makes sense to allow at least six hours apart from taking your ciprofloxacin. And if you have to take the antibiotic for a lengthy period, you should discuss the potential impact on your thyroid with your doctor, and possibly request period thyroid testing to ensure that your thyroid treatment is not affected.

Source: Cooper, John, “Ciprofloxacin interacts with thyroid replacement therapy,” British Medical Journal, 2005

Thyroid levels affect Alzheimer’s risk – study

WASHINGTON (Reuters) – Women with low or high levels of a hormone that affects thyroid gland function and thyroid hormone levels may have a higher risk of Alzheimer’s disease, researchers reported Monday.

While it is not clear whether Alzheimer’s affects thyroid function or the other way around, the findings dovetail with long-standing knowledge that having an underactive or overactive thyroid can affect memory.

Dr. Zaldy Tan of Hebrew SeniorLife, Beth Israel Deaconess Medical Center and Harvard Medical School in Boston and colleagues looked at measured levels of a thyroid-regulating hormone called thyrotropin in 1,864 healthy men and women with an average age of 71.

They had blood drawn as part of the larger Framingham Health Study in which practically everyone in a Massachusetts town has had their health scrutinized for decades.

Writing in the journal Archives of Internal Medicine, Tan and colleagues said 209 of the volunteers had developed Alzheimer’s disease after nearly 13 years.

Women with the lowest and highest levels of thyrotropin had more than double the risk of developing Alzheimer’s disease. No such relationship was seen in men.

Changes in the brain caused by Alzheimer’s disease may reduce the amount of thyrotropin released, Tan’s team said. Alternately, low or high thyrotropin levels could damage brain cells or blood vessels.

They said the findings should be tested in a larger population. (Reporting by Maggie Fox; editing by Todd Eastham)

Source: Reuters North American News Service

Temperature Regulation for Thyroid Testing

One of the ladies here sent me a wonderful article on Basal Temperature taking… I found some more info and wanted to share it with you…

Do you ever experience fatigue, depression, difficulty concentrating, difficulty getting up in the morning, cold hands and feet or intolerance to cold, constipation, loss of hair, fluid retention, dry skin, poor resistance to infection, high cholesterol, psoriasis, eczema, acne, premenstrual syndrome, loss of menstrual periods, painful or irregular menstrual periods, excessive menstrual bleeding, infertility (male or female), fibrocystic breast disease, or ovarian cysts? If so, you may have an underactive thyroid. It is often seen in people who suffer from multiple allergies, immune disorders and chronic fatigue.

Normal temperature regulation in the body is essential for enzyme functions and preservation of health. Whenever our molecular and immune defenses are stressed, three body organs take the brunt of the injury; the thyroid, pancreas and adrenal glands. The evaluation of the functional status of the thyroid gland — hypothyroidism or under-active thyroid gland — requires blood tests as well as temperature records.

There is considerable evidence, however, that blood tests fail to detect many cases of hypothyroidism (underactive thyroid). It appears that many individuals have “tissue resistance” to thyroid hormone. Therefore, their body may need more thyroid hormone, even though the amount in their blood is normal (or even on the high side of normal). A low axillary temperature suggests (but does not prove) hypothyroidism. Optimal temperature regulation is an essential aspect of holistic therapy for these disorders.

There is a simple way to test this. Simply follow the instructions below and bring your results to your next visit with the doctor.

INSTRUCTIONS:

1. Use any digital or mercury thermometer. Shake it down before going to bed to 96 degrees or less and put it by your bedside.

2. In the morning, as soon as you wake up, put the thermometer deep in your armpit for ten minutes and record the temperature. Do this before you get out of bed, have anything to eat or drink, or engage in any activity. This will measure your lowest temperature of the day, which correlates with thyroid gland function. The normal underarm temperature averages 97.8-98.2 degrees F. We frequently recommend treatment if the temperature averages 97.4 or less. The temperature should be taken for four days.

3. Each time you are taking your temperature, it is imperative that you take both axillary (underarm) and oral (mouth) temperatures. Both temperatures need to be taken upon waking up as well as three hours later and then six hours after that. It is important to do this for four days and to follow these instructions carefully in order to get accurate results.

4. For women, the temperature should be taken starting the second day of menstruation. The reason is because a considerable temperature rise may occur around the time of ovulation and give incorrect results. If you miss a day, that is okay, but be sure to finish the testing before ovulation. For men, and for postmenopausal women, it makes no difference when the temperatures are taken. However, do not do the test when you have an infection or any other condition which would raise your temperature.

Basal Body Temperature: This is a test of your core body temperature and is a very useful test to determine if your thyroid hormonal system is underactive (ie hypothyroid).

What does being hypothyroid have to do with cardiovascular disease?

Hypothyroidism causes abnormal lipid metabolism which results in accelerated cardiovascular disease. Cholesterol and other lipids can become elevated due to diminished function of lipid metabolism enzymes caused by the lower body temperatures. Many body enzymes are highly temperature dependent, malfunctioning at abnormally low or high temperatures. The more abnormal the temperature, the more malfunctional the enzyme. On a molecular basis, this is why we become listless as our body temperatures go out of the normal range and we die at temperature extremes.

Although the frequency of hypothyroidism has been hotly debated for many decades, I am convinced that hypothyroidism is common and often unrecognized. The official normal range of thyroid blood tests are virtually useless except for obvious hypothyroidism and hyperthyroidism. These blood tests are useful if much tighter normal ranges are used. Additionally, accurate assessments of thyroid function can be obtained with basal body temperatures.

Ideally body temperature is taken immediately upon awakening and while still in bed, but it can be taken during the day at least 15 minutes after eating or drinking and when you haven’t been exercising. Men and post-menopausal women can take their temperatures on any day but menstruating women have some restrictions. Their temperature fluctuates with their menstrual cycle, lowest at ovulation and highest just before menstrual flow. They can most accurately measure the temperature on the second and third day of the period after the flow begins. Normal temperatures are: Armpit 98.0 +/- 0.2, Oral 98.6 +/- 0.2, and Rectal 99.0 +/- 0.2 degrees Fahrenheit.

Another useful assessment is an exceedingly low-tech question, “Do you tend to be very hot or cold when most others are not”? Characteristically, hypothyroid patients are very “cold blooded” and are cold to their core even when wearing warm clothes. As a corollary, these patients rarely can create any significant sweat. As an aside, two other conditions that can cause low body temperature are adrenal exhaustion and profound hypoglycemia but these diagnoses are usually quite obvious.

melanie

TE vs. CTE

Just wanted to summarize some research I’ve done over the past couple of years… for the benefit of my fellow TE shedders… Here goes…

Classic TE lasts roughly 3-6 months and has a very specific and temporary trigger… e.g. childbirth, major surgery, illness

CTE is basically TE lasting longer than 6 months and the insult or trigger is sort of a mystery…

Based upon my research… CTE in women can usually be attributed to a hormonal imbalance (e.g. too much estrogen or not enough) or other metabolic disturbance (e.g. thyroid) and also iron deficiency…

now… hormonal imbalances / metabolic disorders are pretty common with us chicks in this day and age… and there’s many reasons for this… too many to enumerate… but this link should help explain part of the problem:
http://womenlivingnaturally.com/articlepage.php?id=73

As far as iron deficiency… if you are menstruating and don’t eat alot of red meat or tons of green leafy veggies… chances are you are iron deficient on some level… as iron is stored in the blood… and blood loss = iron loss.

Anyway… hope this helps!!!
~ venus71, HHLH Forum Member

Photo trichogram findings in women with AGA

Phototrichogram findings in women with androgenetic alopecia.
Department of Dermatology, Sisli Etfal Research and Training Hospital, Istanbul, Turkey.

Background/purpose: Androgenetic alopecia (AGA) in women is characterized by diffuse thinning in the frontal and parietal areas of the scalp; preservation of the frontal hairline is norm. Hair over the occipital scalp is preserved. The purpose of this work was to investigate the findings of phototrichogram (PTG) of the affected and the spared areas in women with AGA and to compare them with those of healthy subjects.

Methods: Twenty-two controls and 60 untreated women with AGA (32 with Ludwig I, 28 with Ludwig II) were included in this study. Hair density, percentages of thin hair, and non-growing hair were estimated both on the midscalp and on the occiput by using PTG with digital camera attached to a dermoscope.

Results: In the control group, hair density was higher on the midscalp than the occiput. In AGA groups, hair density was lower on the midscalp than the occiput and percentages of thin hair and non-growing hair were higher on the midscalp than the occiput. These findings were more prominent in Ludwig II group. In the occiput there were findings mimicking the changes seen on the midscalp. These were less striking than those seen on the midscalp yet the difference between the control and Ludwig II group was statistically significant.

Conclusion: We concluded that the hair is not equally distributed on the scalp, the occiput may be affected in females with AGA and further studies are necessary to support these findings.

PMID: 17026665 [PubMed – in process]

Ludwig Scale of Hair Loss for Women

courtesy of www.dermalogix.net

courtesy of www.dermalogix.net

Photo of AGA in younger woman

Photo image of young woman with diagnosis of androgenetic alopecia (female pattern baldness) courtesy of www.trichologists.org.uk

Photo image of young woman with diagnosis of androgenetic alopecia (female pattern baldness) courtesy of www.trichologists.org.uk

Photo image of middle aged woman with AGA

Photo image of middle aged woman with female pattern baldness.  Courtesy of www.trichologists.org.uk

Photo image of middle aged woman with female pattern baldness. Courtesy of www.trichologists.org.uk

HHLH Forum Member has head tattoed on Miami Ink

One of our beautiful forum members, JoyceStock recently had her head tattooed on Miami Ink. It’s a lovely butterfly! Thank you, Joyce, for being such an inspiration!

melanie

Can I Pass Alopecia on to My Children?

It is possible, but not likely, for alopecia universalis to be inherited. Most children with alopecia universalis do not have a parent with the disease, and the vast majority of parents with alopecia universalis do not pass it along to their children.

Alopecia universalis is not like some genetic diseases in which a child has a 50-50 chance of developing the disease if one parent has it. Scientists believe that there may be a number of genes that predispose certain people to the disease. It is highly unlikely that a child would inherit all of the genes needed to predispose him or her to the disease.

Even with the right (or wrong) combination of genes, alopecia universalis is not a certainty. In identical twins, who share all of the same genes, the concordance rate is only 55 percent. In other words, if one twin has the disease, there is only a 55 percent chance that the other twin will have it as well. This shows that other factors besides genetics are required to trigger the disease.

What Causes Alopecia Universalis?

In alopecia universalis, immune system cells called white blood cells attack the rapidly growing cells in the hair follicles that make the hair. The affected hair follicles become small and drastically slow down hair production. Fortunately, the stem cells that continually supply the follicle with new cells do not seem to be targeted. So the follicle always has the potential to regrow hair.

Scientists do not know exactly why the hair follicles undergo these changes, but they suspect that a combination of genes may predispose some people to the disease. In those who are genetically predisposed, some type of trigger–perhaps a virus or something in the person’s environment–brings on the attack against the hair follicles.

There are, however, studies that have been done that show a genetic link for those people who are diagnosed as having Alopecia Universalis. According to MedicineNet.com, the “disorder is inherited as an autosomal recessive trait. It is caused by a mutation in a gene dubbed HR in chromosome band 8p21.2 that is the human homolog of the mouse “hairless” gene — the human version of the gene in the mouse that is responsible for hairless mice.” Huh?? Basically they are saying that a good majority of those who develop alopecia universalis have a hereditary gene that could be the possible cause of their hair loss. This is great news since pinpointing a gene may provide scientists a more targeted approach to treating hair growth disorders such as alopecia.

More information concerning studies such as this can be found at:

What Is Alopecia?

Alopecia is considered to be an autoimmune disease, in which the immune system, which is designed to protect the body from foreign invaders such as viruses and bacteria, mistakenly attacks the hair follicles, the tiny cup-shaped structures from which hairs grow. This can lead to hair loss on the scalp and elsewhere.

In most cases, hair falls out in small, round patches about the size of a quarter. In many cases, the disease does not extend beyond a few bare patches. In some people, hair loss is more extensive. Although uncommon, the disease can progress to cause total loss of hair on the head (referred to as alopecia areata totalis) or complete loss of hair on the head, face, and body (alopecia areata universalis).

Alopecia can occur at any age and is not life threatening, however the psychological impact on the person experiencing alopecia can be incredible. Such an impact can affect the person’s social life and may lead to a higher risk of major depression and/or anxiety disorders.

Images of Further Stages of Alopecia

Further stages of alopecia areata

Further stages of alopecia areata

Alopecia with diffuse thinning courtesy of www.meddean.luc.edu

Alopecia with diffuse thinning courtesy of www.meddean.luc.edu

Alopecia Universalis courtesy of www.dermatology.org

Alopecia Universalis courtesy of www.dermatology.org