Private endo strongly suspects I have PCOS

[Zazbag]

Hello,

I have Hashimoto's and hypothyroidism and am on 162.5 mcg levo and 25 mcg T3. I'm slightly over medicated and trying to lower my dose gradually.

Today I saw a private endo for the first time who looked at my fasting insulin (6.6) and said it shows I have insulin resistance. My testosterone is normal (1.3, 1.7 is top of range). My oestrogen is 521 and my progesterone is low at 15 (day 21 of 27-day cycle). My progesterone indicates that I didn't ovulate this month, but I was moving house and extremely stressed and wondering if that might have affected it, since I know the precursor to progesterone is also the precursor to cortisol so if you're stressed your body favours cortisol production over progesterone.

She said that she strongly suspects that I have PCOS because of my insulin resistance and low progesterone despite the fact that:

I've never been overweight/obese

I don't have hirsutism

I don't have acne

I've never had irregular periods or missing periods

My fasting blood sugar was 4.7 and HbA1c was 29.

I'm really confused and upset and don't know what to think. She told me she wants to prescribe me progesterone and metformin.

I've always had a pretty healthy diet and trained hard at the gym and she said that has masked my symptoms and is the reason I'm not presenting as a typical PCOS case.

Does anyone have any thoughts?

I've been over medicated for about 18 months and I'm wondering whether that might have pushed up my fasting insulin, but she said that's not possible.

[SlowDragon Administrator]

liothyronine can raise sugar levels

medicines.org.uk/emc/files/...

drugs.com/cdi/liothyronine-...

[Zazbag in reply to SlowDragon]

Yeah I thought that, so I asked her if it can raise insulin levels too and she said it can't. Do you have any idea about that? There's no history of PCOS in my family.

[SlowDragon Administrator in reply to Zazbag]

Your HBA1C is impressively low

Regenallotment has been working on measuring/improving sugar levels I think

She might have some ideas

[Zazbag in reply to SlowDragon]

Thank you for saying that and for tagging Regenallotment . I'm going to book an appointment with my GP (I finally have a good one who seems to genuinely care and listen). I don't fit any of the criteria to be diagnosed with PCOS under the NHS which only makes me more confused.

[Regenallotment Ambassador in reply to Zazbag]

Morning!

I’ve just done 2 weeks with a continuous blood sugar monitor as part of the Zoe nutrition program.

My HBA1C is also low (not as low as yours) I’m also slim and always was until I went very hypo before diagnosis. Also no acne also nothing unusual with my periods until recently although they did start later than friends . I’m 49 and very likely perimenopausal. On a waiting list for a women’s health appointment at the local GP. My cholesterol is also low and I haven’t tested my cortisol but I have symptoms of both high and low cortisol.

What I learned from the Zoe monitoring and the fake food they give you is that my blood fat control is excellent and my blood sugar control is appalling, they say that gut microbiome, sleep, stress are the factors that control this not diet or genetics. It can be different in twins. So those awful crashes in the afternoon for me can just be because I had rice or potatoes at lunch. It’s such an eye opener, my evening Tesco crinkly crisp habit has had the boot. Those feelings of chasing and craving something I fancy in the evenings are gone and I’m lasting a whole day without slumping. Or going from carb to carb to chocolate to keep me going are gone too. Although I must confess to dabbling with an OTC adrenal support supplement which has weirdly felt like it slowed the world down around me which is nice.

The pattern follows reactive hypoglycaemia where the insulin is SO good at its job it brings things back to balance a bit too effectively. On reading more it suggests that later in life I’d be more likely to get type 2 despite living like I’m on a health farm.

Personally I would research hard and swerve the metformin.

I don’t know much about PCOS but have wondered about my daughter who has symptoms.

flattening the blood glucose curve for me means zero sugar, even being careful about certain fruits. Complex carbs only occasionally and masses of green veg and good fats. But we are all different. I’m still learning but please feel free to ask questions.

🌱

[Gilbo72]

I was diagnosed with PCOS in my 20’s. At the time I was too slim and I thought, healthy. Gym once a day, eating healthy (but not much of it), I weighed 7st 4lbs. I was very surprised. My periods had been a bit painful so had gone on the pill. When I came off, they didn’t come back. I assumed it was my weight. They gave me clomide to kick start my periods again. The nurse told me, whatever I was doing, keep doing it as I wasn’t presenting as your typical PCOS. She also gave me the impression it is a syndrome, which can be to some extent controlled with diet and exercise. It has never been mentioned since in my thyroid journey. However, there is a connection between PCOS and hashimotos. You are more likely to develop an autoimmune thyroid problem if you have PCOS, which is what I did 10 years after that incident, fast forward another 20 years. I am now nearer 10 stone, the doctors still refer to me as ‘normal weight and slim’. I go to the gym once in a blue moon, and pretty much eat what I want. I am also now on combo therapy, previous to that I was on mono and had to have high amounts of levo to bring my T4 over range whilst my T3 was below range. I have no idea what my insulin is doing. I don’t have acne, I have a few hairs on my chin that I need to pluck once a week! You could ask to be tested again, as it is just a one time snapshot, and suggest you want to try Regenallotments before considering medication. Ps, I have never had my insulin tested, perhaps I should… but then, ingnorance is a kinda bliss!

[Miffie]

I personally think whoever formulated Metformin is basically spawn of the Devil.! Loathsome product! I finally succumbed to T2 diabetic diagnosis in my mid to late fifties. This despite eating a diet rich in fresh veg, lean protein with some fruit, mostly berries and being active. Virtually no processed food at all. My GP and diabetic nurse were very much of the ‘how long did you expect to avoid this given other autoimmune conditions “ school of thought. I had been battling my weight for years, but that’s a thyroid ( and different) story. I was immediately given Metformin and a statin. Neither are desirable medications. Over the years I have learnt that for me Metformin serves no purpose whatsoever apart from make me feel hungry? Weird I know, against all medical advice I stopped taking Metformin and the only difference was not getting as hungry. No effect on blood glucose levels at all! I know others who take it and to be honest it hasn’t seemed to make a measurable difference except quite a few need slow release. In all honesty I’d never suggest anyone try it .

[Zazbag in reply to Miffie]

Thank you so much for sharing this. I only know of one person who took metformin for PCOS and it helped her conceive after being told she'd never be able to.

I don't relate to any PCOS symptoms, I think I have mild insulin resistance caused by stress and being over medicated and now I'm determined to reverse it. I'm not even entertaining the idea of taking progesterone or metformin now. I'm feeling much more rational about it today as I realised there's a good chance she's wrong, and my gut tells me I don't have PCOS.