Please help interpret lab results (female)

[miquelangeles]

A close friend, she is 45 years old. Her symptoms are complete lack of libido, mood disturbances, fatigue, increased abdominal fat, inability to lose weight despite proper eating and regular exercise. Not obese, just somewhat overweight with a BMI of 26 (165cm height and 71kg weight).
Lab reference ranges for age/gender are in round brackets. Tests were done between the 3rd and 5th day of her period.
Prolactin and cortisol are out of range, but I'd be grateful if someone can provide more insight for everything else, how does it correlate with symptoms, what should the optimal values be, as well as what to do next/how to treat.

Thank you!


Free T4 = 0.87 ng/dL (0.7 - 1.48 ng/dL)
TSH = 3.1391 µIU/mL (0.35 - 4.94 µIU/mL)
Antithyroglobulin = 2.66 IU/mL (< 4.11 IU/mL)
Anti-TPO = 0.29 IU/mL (< 5.61 IU/mL)
Prolactin = 39.17 ng/mL (5.18 - 26.53 ng/mL)
Testosterone = 0.97 nmol/L (0.48 - 1.85 nmol/L)
Cortisol @7am = 21.95 µg/dL (6-10am: 6.02-18.4 µg/dL, 4-8pm: 2.68-10.5 µg/dL)
ACTH = 55.69 pg/mL (7-10am: 7.2 - 63.3 pg/mL)
DHEA-S = 71.3 µg/dL (35.4 - 256 µg/dL)
SHBG = 83.2 nmol/L (18-144 nmol/L)

 

[miquelangeles]

Bumping this thread, hoping someone can offer their insight.

 

[sweetpeat]

At 45, she's probably in peri-menopause. A lot of women are estrogen dominant during this time because progesterone levels start dropping off. She could get estrogen and progesterone tested, or she could trial some progesterone during the last two weeks of her cycle.
TSH is rather high and t4 is rather low, but estrogen could be affecting the thyroid.
DHEA is pretty low for her age and could account for a lot of her symptoms.

 

[danishstargazer]

I agree with sweetpeat above - i would say at that age get hormones tested and make sure to have enough iodine .

 

[miquelangeles]

I agree with sweetpeat above - i would say at that age get hormones tested and make sure to have enough iodine .

Thank you. Regarding iodine - another symptom is painful breast lumps but she's had this for ~10 years. Several months ago, after reading that breasts are one of the main storage and utilization sites for iodine, and iodine also has antioxidant effect in the breasts, I told her to try 600mcg potasium iodide for a month. Told her not to supplement more than a month because I know Ray doesn't recommend supplementing iodine. At that time she was consuming quite a lot of dairy too, and it was unlikely that she'd be deficient. The lumps shrunk and pain went away, and the relief lasted 1-2 months after cessation.
How would one know if they get too much or too little iodine? I assume you were referring to iodine from food sources - seafood etc and not supplements? I know Ray says that dairy contains more than enough iodine, especially because cows are given iodine otherwise milk production decreases.

 

[miquelangeles]

At 45, she's probably in peri-menopause. A lot of women are estrogen dominant during this time because progesterone levels start dropping off. She could get estrogen and progesterone tested, or she could trial some progesterone during the last two weeks of her cycle.
TSH is rather high and t4 is rather low, but estrogen could be affecting the thyroid.
DHEA is pretty low for her age and could account for a lot of her symptoms.

Thank you for these suggestions. That makes sense, yes.
She is going to get progesterone and estrogen tested, and she is also looking for another doctor because the last one was very dismissive of her symptoms and considered it rather normal to have a non-existent libido, "why would this bother you" were the words.

 

[danishstargazer]

I think the Everlywell home test is pretty good for estrogen / progesterone .

 

[Razvan]

Thank you for these suggestions. That makes sense, yes.
She is going to get progesterone and estrogen tested, and she is also looking for another doctor because the last one was very dismissive of her symptoms and considered it rather normal to have a non-existent libido, "why would this bother you" were the words.

Romania i guess.

 

[miquelangeles]

Romania i guess.

Well, they are largely uneducated on this kind of issues and they already get enough business from in vitro fertilizations and such, actually more than they can handle. So they'd rather scare you with outdated information instead of actually helping you, which would require more effort, knowledge and expertise on their part.

 

[Razvan]

Well, they are largely uneducated on this kind of issues and they already get enough business from in vitro fertilizations and such, actually more than they can handle. So they'd rather scare you with outdated information instead of actually helping you, which would require more effort, knowledge and expertise on their part.

Exactly, also the ignorance is too much.