Anti Mullerian hormone very high - Metformin or not........

[sarahstevenson]

My daughter's, ( aged 34 ), recent blood test shows a result of 188pmol/L range says anything over 40 is high. She has been diagnosed with PCOS in 2007 and had a successful pregnancy in 2011. She has now been denied an appointment with either endo or gynae on the grounds she has PCOS.

Her GP has given a prescription for metformin 500mg daily to start.

Testosterone is also high at 3.2nmol/L range 0.2 - 1.8 ; progesterone low at 1nmol no range on results page.

Question - is it better to look first at adrenal reserve and to treat that or to go with Metformin in an attempt to rebalance hormones in the hopes of another pregnancy.

I have Hashi's responding well to T3 only and gluten free, and her brother is coeliac.

[gabkad]

No expert here. However, from what I have read, PCOS is being treated with metformin. But at the same time metformin has an adverse effect on thyroid function. I guess she'd need to have her thyroid panels done once she's on this medication.

I don't understand why she'd be excluded from appointments for endo or gyne. You'd think if someone with PCOS wants to have another child, then endo and gyne would be needed. Maybe a fertility clinic would be a good idea?

[sarahstevenson in reply to gabkad]

Thank you do you know why metformin would suppress thyroid function. It seems it is used if you have PCOS and raised insulin levels but her insulin levels are normal. Exactly our thoughts re endo and gynae - so frustrating

[gabkad in reply to sarahstevenson]

sarah, no idea. Just what I've read.

My daughter has some sort of problem too. She didn't get her periods until age 17 and then sporadically. She's was put on the birth control pill. She had pimples and the whole nine yards....and the acne cleared up from the bcp. Being her mother and all, what I think counts for zip, nada, zero............ she won't even tell me what her TSH was on the latest blood test......... The endo said she doesn't have PCOS>........... okay so what is it? 'Mom, mind your own business'.. okay, she's 30 years old and she knows if she wants to have a baby it will require hormone injections.................she didn't actually use those words but the avoidance of providing information amounts to the same thing. AT least you and your daughter are on the same page and she knows you sincerely care.

Honestly, I don't know what is happening with the young people today. Is it that there is corn in everything? I think this is the problem. PCOS is epidemic. I was chubby as a kid but I didn't get PCOS. The chubby girls today do. So what's the difference? Corn. Even microwave ovens have a setting for popcorn. Even the 'modified corn syrup' is part of the picture. High fructose corn syrup as opposed to cane sugar.

The companies claim that the difference in glucose/fructose ratio doesn't count for anything. Well maybe it does. Maybe 50:50 as opposed to 55:45 makes a difference. I'm no expert for sure but I wonder........

Even until today I don't consume processed foods just because who knows what's in them? My kids didn't get soda but they got plenty enough junk food because it wears a mother down when kids are seeing what their classmates are eating. But they got good food at home. Search me... I have no idea anymore. It is frustrating.

[sarahstevenson in reply to gabkad]

Grrrrr a frustatring, maddening maze isn't it . . . . . . my Daughter has cut out all bread and most gluten after her brother being diagnosed coeliac , still on the trail . . .

[Jackie]

HI Metformin is a diabetes drug. Has she been diagnosed with that? It must not be taken with kidney disease.She should try and insist on seeing an Endo but first find a good one!

Jackie

[sarahstevenson in reply to Jackie]

Thanks , we know it is usually for diabetes and no, her insulin is fine - hence our question . . . . endo's hard to find in Devon and refuse to see her on account of TSH in range! Private might be the only way .....

[Jackie in reply to sarahstevenson]

Hi Yes, I know docs in Devon a problem. Try and see a good Endo not a private doc as I was overdosed by a private doc. MY Endo would help you but in Leamington spa, Sat clinic but a long way for you.

Jackie

[Silver_Fairy]

This is a really interesting link about PCOS

progesterone-info.com/polyc...

I had PCOS and had to take a fertility pill for my second child. I had a lot of symptoms of oestrogen dominance (which if I had heard of at the time, I would have researched)

[sarahstevenson in reply to Silver_Fairy]

Thank you will do some more reading

[sarahstevenson in reply to sarahstevenson]

Really helpful article silverfairy thank you, especially as both her brother and I are on prescription VitD so many pieces fit with hypo treatment too. Autoimmune approach seems best way thank you . Think we live in the same area as you - will pm you if OK.

[Neeta-K]

Is your daughter hypothyroid? If so is she being treated optimally? I ask this because I was told I had PCOS. I was on Diannete, BCP used for PCOS, all my life. I had irregular periods, acne, and a lot of hypo/PCOS symptoms. Hypo and PCOS symptoms are very similar. Now I am on thyroid meds I'm told I dont have PCOS as my periods are regular & testosterone is in range. My periods are regular now, whether that's thyroid meds or evening primrose oil I can't be sure. I still have acne & am trying to figure out why. i read that T3 decreases androgens & PCOS sufferers have high androgens. I also read that sometimes PCOS is a symptom of being hypo. I think it's also all linked to low progesterone, which happens when your Hypo

[gabkad in reply to Neeta-K]

Exactly Neeta. This is why I wanted my daughter to get a full thyroid panel done. The doctor refused. Only did TSH and I have no idea what it is. I don't think my daughter even bothered to ask.

Since for whatever reason, and I suspect there is a genetic cause, the women in our family (mother's side) going back generationally all appeared to be low thyroid. Not zero thyroid, just 'low normal'..... which is how one of the endos described it to me back in 1986. Well, too bad he couldn't get a dose of how 'low normal' feels because he refused to prescribe anything except bromcriptine. His view was the prolactin needed to be reduced with this horrible drug.

A smart GP prescribed thyroxine because I had a goitre. The goitre is visible on photographs. It was obvious. Then the prolactin went to normal. I never went back to the endo. He was into reasearch and was publishing papers. I'm sure I was one of his success cases since I never went back to complain.

Right now my daughter looks exhausted. She told me last time we met "you don't tell me how tired I look and I won't say anything about how tired you look." Compared to how exhausted I used to be, I don't think I'm looking all that bad anymore, but who knows....

[Neeta-K in reply to gabkad]

Gabkad, I guess your daughter has to realise things for herself. I'm in the same situation with my mum. She's very hypo but won't listen. She complains a lot about her symptoms but won't do anything about it. Frustrating to say the least!

[sarahstevenson]

Thank you - can't be sure re hypo as stuck in the system due to in range TSH - debating whether to start adrenal support along with nutri thyroid approach OR to go with metformin. Erring towards genova tests to get some current figures first.

[Neeta-K in reply to sarahstevenson]

I would get a private full blood test done; TSH, FT4, FT3 and TPO and TGab antibodies, Sarah and then you can dose from there

[sarahstevenson]

Can anyone recommend best way to access private bloods. We have used Genova before but seems they are much more expensive than even 12 months ago. She needs hormone monitoring as she has no idea where she is in her cycle, so could be expensive to do weekly tests. She has health insurance but they won't insure her re the PCOS saying it's pre-diagnosed.

[Polaris]

Would be as well to have B12 tested or take a good vitamin B12 supplement, as Metformin is one of the medications that deplete B12.