01/25/2024
🩸Looking at a lot of bloodwork - my favourite to interpret, really gives us good motivation, good tracking, and good insight into what is happening!
Let's take a look at this, looking at hormones. Hormones can be quite difficult to assess, for a number of reasons.
If you take a look at this - nothing is flagged. Everything COULD be normal. However, once we get into it, we will realize that things are not normal.
1. They need to be tested on a certain day of your cycle. FSH, LH, estrogen (estradiol) are best looked at on day 3 of your cycle (day 1 is the first day of real bleeding). This is when are hormones start to build, and so this gives us an idea of how this is working. This is in the follicular phase. So, you'll notice, things start to get abnormal (BUT, still not flagged!!! Your GP may not be able to properly interpret that something is wrong)
2. Progesterone isn't tested here - for a reason! Progesterone doesn't come into play until your luteal phase, particularly 7 days after ovulation. So testing it on day 3, would mean nothing. This requires a separate test date and requisition, and then to get the best sense, it needs to be compared to the reading you get for estradiol (depending on your concerns, of course)
3. What does this actually tell us? These readings don't tell me that the patient has horrible cramping, or hormonal acne, or mood swings. Hormones can be completely normal and still exhibit those symptoms. What this does tell me is that the LH:FSH ratio is okay, so PCOS is less likely. It also tells me that hormone production is LOW. Because these were done on day 3 of the cycle, we can match it with the follicular phase of the cycle. FSH, LH, estradiol are all LOW. This could mean lack of period, that sometthing is happening in the pituitary gland. It could be excessive exercise, anorexia, a tumor - and therefore, it is incredibly important to look at the whole picture, the entire patient, and the full health history, to properly understand and treat!
#