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[Hippymade]

Hi!

So many symptoms - where to start! Insomnia, night sweats, tinnus, racing heart, joint pain and swollen inflamed joints (all inflammitory markers normal including gout and arthritis on a previous blood test recently) .... the list goes on! GP ran a menopause screen and I would value some feedback on what to do next. Thank you!


Serum oestradiol level (4465.) 199 pmol/L Information about this test   
Serum prolactin level (XaELX) 156 mu/L Information about this test   
Serum LH level (XM0lv) 6.6 iu/L Information about this test   
CSerum follicle stimulating hormone level (XM0lx) 18.4 iu/L Information about this test   
Serum testosterone level (XE2dr) 0.6 nmol/L [0 - 2.5] Information about this test
   
Serum 25-Hydroxy vitamin D3 level (XaEQa) 38 nmol/L
Reference ranges in accordance with National Osteoporosis Society
guidelines April 2013.
Vitamin D <30 nmol/L is deficient
Vitamin D 30-50 nmol/L may be inadequate in some people
Vitamin D >50 nmol/L is sufficient for most people. Information about this test
   
Free androgen index (XE2pm) 1.4 % [0 - 5] Information about this test   
Serum sex hormone binding globulin level (44CD.) 42 nmol/L Information about this test

[laszla]

Hi Hippymade, writing in haste but just to say that in my opinion you need both more estrogen and yes, also testosterone as both are low. I would also supplement with vitamin D as ideally it should be significantly higher.

[Hippymade]

Hi laszla,

Thank you. So just more estrogen and testosterone but my progesterone is ok? Is there a file/website I can see the normal and low/high ranges for blood test results?  I will definitely supplement with vitamin D! Waiting on a call back from my GP.

Thanks again!

[ATB]

Definitely discuss with your doctor but Free testosterone should be between 2-5%, mine with taking Androfemme is 1.9% and my doctor hasn’t increased my dose based on that but you’d want to factor in how you feel and what symptoms you have. Do you take HRT? Usually the amount you take of progesterone or if you take it at all depends on if you have a uterus or not.
You do need to supppement Vit D based on this though, for sure. If not taking testosterone you might benefit from it. Estrogen, are you taking any? I think your symptoms and levels indicate you probably need to. Usually they base going on HRT on symptoms alone depending on your age. I believe there are some resources here to help you understand tests, I have info from my meno specialist.

[shoppingqueen]

Hello
I’m not up to speed on the sex hormone levels but I do know you need vitamin D. Your doctor should prescribe loading doses to bring up to levels. Low Vit D can cause a lot of the symptoms you describe such as joint pain etc. Mine was at 15 and I had 7 weeks of loading doses one 30000 tablet per week. Made a huge difference to my well-being and I’m sure reduced some meno symptoms.
Important to ask your doctor about it as should prescribe at your level x

[Hurdity]

Hi hippymade

 

The blood tests alone cannot tell you what you need to do ( apart from the vit D which should be much higher than this ESPECIALLY at this time of year when the sun is strong - I presume you are not outside much?). Important to get sunshine directly on your skin ( though not to burn of course) - the best way to get vit D into your body at this time of year but in the meantime improve your diet to include more vit D rich foods and maybe as it is inadequate and we are in mid May then take a supplement until it increases.

In terms of the other tests - more important is to know what your natural menstrual cycle is doing - unless you have a Mirena or taking POP, or don't have a womb in which case you won't know, as well as your age. If you do have a cycle also to know when in your cycle the blood tests were taken.

Levels of all of these hormones vary hugely throughout the cycle so one tests on its own can't tell you anything much really, though on the face of it oestrogen seems low (but it is low at certain points in the cycle and when taking certain contraceptive hormones).

Re testosterone - for the time being I would not take any notice of this result - the tests for T are inaccurate at the low end of the scale which is where most women's testosterone levels are -  the tests is designed for men and is not sensitive enough to pick up subtle differences. More important is to know where you are in menopause in terms of your cycle and your age, and if along with other symptoms, you also have low libido, pain after exercise, general lethargy etc this could indicate your T is low - but some medications affect libido anyway.

Progesterone is unimportant and would only be measured in women trying to get pregnant to see if they are ovulating, as I understand.

Tell us a bit more and then we can see if we can help you

Hurdity x

[ATB]

Re Vitamin D and sun exposure, it’s not a reliable way to get adequate levels. You would need most of your body exposed to the sun at the right time of day, dependent on where you live, to get enough and that would need to be daily. When I studied nutrition this was made real clear- you cannot get it from food unless it’s fortified and we don’t do that in the UK very much. It is the biggest vitamin deficiency in the developed world alongside iodine. I think supplementation is the only reliable way unless you work outside for a job and can do so with 75% of your body exposed, no sun block. It’s one of the few things I think everyone should supplement in the uk, govt recommend supplementation October to March and those who are black or Asian are very susceptible so need it throughout the year.  Even in places like NZ a third of the population has lower levels than recommended as they have to use high level sunblock.

[CrispyChick]

I agree. My GP told me they don't test as everyone is deficient in scotland!!! She did then test and I was low. I love sitting out in the sun.

I use a vitamin d spray, just off the shelf - got my levels up nicely myself x

[Winter]

Hi hippymade

 

The blood tests alone cannot tell you what you need to do ( apart from the vit D which should be much higher than this ESPECIALLY at this time of year when the sun is strong - I presume you are not outside much?). Important to get sunshine directly on your skin ( though not to burn of course) - the best way to get vit D into your body at this time of year but in the meantime improve your diet to include more vit D rich foods and maybe as it is inadequate and we are in mid May then take a supplement until it increases.

In terms of the other tests - more important is to know what your natural menstrual cycle is doing - unless you have a Mirena or taking POP, or don't have a womb in which case you won't know, as well as your age. If you do have a cycle also to know when in your cycle the blood tests were taken.

Levels of all of these hormones vary hugely throughout the cycle so one tests on its own can't tell you anything much really, though on the face of it oestrogen seems low (but it is low at certain points in the cycle and when taking certain contraceptive hormones).

Re testosterone - for the time being I would not take any notice of this result - the tests for T are inaccurate at the low end of the scale which is where most women's testosterone levels are -  the tests is designed for men and is not sensitive enough to pick up subtle differences. More important is to know where you are in menopause in terms of your cycle and your age, and if along with other symptoms, you also have low libido, pain after exercise, general lethargy etc this could indicate your T is low - but some medications affect libido anyway.

Progesterone is unimportant and would only be measured in women trying to get pregnant to see if they are ovulating, as I understand.

Tell us a bit more and then we can see if we can help you

Hurdity x

Hi Hurdity - I'm being tested next week - my specialist said there isn't a particular time of month that's best to test for Oestrogen if you are taking HRT - can test any day.

[Hurdity]

Hi Winter

If you are still having some sort of natural cycle that breaks through the HRT then you won't be able to tell much from the oestrogen blood tests. If you are post-meno definitely then a blood test will give some idea of absorption - depending on what type of oestrogen HRT you are taking and where on your body you apply eg if gel etc. So many factors. As this is hippymade's thread it wouldn't be fair of me to question you further about your situation!

Ditto re vitamin D - I'm not saying people are not deficient and it is vitally important that we are not - and my caveat should have been - depending on skin tone but yes diet and lifestyle too. So if women are living in the place they would have "originated from ethnically" so to speak - then we have evolved to get the right amount of vitamin D into our body according to the climate and would not need to expose 75 % of our body etc. In Scotland for example the "native " population - and don't take that the wrong way - will have skin that presumably has less melanin ie a fairer skin and as such will be able to manufacture vitamin D at lower levels of exposure, weaker sunshine etc without sunblock, than darker skinned people. This has to be the case in evolutionary terms.

Of course nowadays lifestyles are different but personally I think it is an opportunity for peope to examine their diet and lifestyle to make sure they are outside more - good for the soul and general well-being as well as vit D. So in places like NZ white or fairer skinned people would be able to get vit D without sunblock at eg earlier times of day and for shorter periods of time - if the sun is stronger.

I do think more research is needed on this issue because there are lots of myths put about. Crispychick I guess it depends on your skin tone, what you put on your skin and when you were tested? eg I have a skin tone that tans very easily so in Scotland with weak sun I might not get enough though would be interesting to test this out (not planning on going to live in Scotland though!).

Apologies hippymade for my digression....

Hurdity x