Female, 30 years old, 208lbs, 5'5'' Disease: PCOS
Fasting Glucose: 101 H Insulin: 5 uIU/mL Hemoglobin A1c: 5.3 % total of Hgb AST: 32 H Cortisol, AM: <0.5 L Testosterone, Total, LC/MS/MS: 53 H Free Testosterone: 6.3 pg/mL
Waiting for doc to analyze but was curious of your thoughts!
Your fasting Bg is high but that can be from a lc/vlc diet. This happened to me. You might want to monitor it, at home, post-meal: 1 hour post, 2 hours post. On the other hand your A1C is below 5.4 so that is great.
Your Free Testosterone is OK/Good!
Your AM Cortisol is very VERY LOW for what is optimal. I personally would be taking 2 Isocort immediately upon waking. You may need more than two. With AM that low you are likely low at 12/noon as well. If this was me, I would do a saliva Adrenal test (four samples throughout the day).
This one is good and affordable (relatively): http://www.diagnostechs.com/Pages/AdrenalStressIndex.aspx
Also, have you had your Thyroid checked? Might want to do that since you are more at risk for low thyroid. Check FREE T3 and T4, not just TSH.
Free Testosterone is super high. I think the top of normal range is 2.2. There are tons of studies linking obesity, PCOS, acne, etc to high free testosterone. Here some examples:
So, absolutely do not let your doc not address the Testosterone issue. I would ask to be referred to an Endo if you're not already.. I think they might be better equipped to connect the dots.
Your FBG of 101 is negated by 5.3 A1c and fasting insulin of 5. Ideally, you want A1c to be closer to 5 and insulin to be <5 but nothing to worry. Your glucose metabolism is normal, though probably not idea. But your AST is a bit high at 32. How's your ALT? I'd focus on that and your other liver enzymes. But that's understandable if you are coming off of fatty liver and/or are in the process of losing some weight since going Paleo.
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