PCOS Lab Testing- The Missing Piece
Guest post by Dr. Carrie Jones
Proper PCOS Testing is Important – Did You get a Full Work-up?
Many women struggle with symptoms for years until finally they get a PCOS diagnosis. Testing can be complicated and overwhelming especially in today’s healthcare system that seems to focus on one thing at a time and does not really look at you, an entire person. Then, the answer always seems to be to “take the birth control pill” and these only masks problems, causes problems, and doesn’t get to the root of any problems.
So, let’s talk proper testing. Most blood testing covers the basics such as estradiol (the potent form of estrogen), progesterone, testosterone, and DHEA. If these are “normal,” does that mean you do not have any hormone imbalances? Do you not have PCOS? Why do you have all these symptoms?
Comprehensive testing, such as by the DUTCH test, can provide a lot of answers beyond the basics to help point you in the right direction. DUTCH is an acronym that stands for Dried Urine Test for Comprehensive Hormones. It is a simple test that requires you to urinate on strips of paper throughout the day, then let them dry before mailing them back to the lab. From this, you will get your progesterone, all three of your estrogen markers, and your estrogen detoxification pathway mapped out. This is quite helpful when you are trying to determine estrogen dominant symptoms such as PMS, tender breasts, heavy periods, weight gain, acne and more. This pathway also gives insight into your body’s ability to clear estrogen because it is important to understand if it’s going the healthy or unhealthy direction.
The DUTCH test looks at testosterone and DHEAS, but digs even deeper to see what pathway those hormones are headed too. Women going down the “alpha” pathway directed by an enzyme known as 5a-Reductase are more at risk for cystic acne, hair in unwanted places like the upper lip and around the nipple, and hair loss from the scalp. The alpha pathway can also induce more angry or irritated mood swings. These symptoms are quite common in PCOS often resulting in a great deal of frustration and embarrassment.
Lastly, DUTCH testing gives you the complete adrenal picture which is important in PCOS as the adrenal glands make some of your testosterone and a great deal of your DHEA and DHEAS in addition to your infamous stress hormone, cortisol. Cortisol problems can result in fatigue, insomnia, weight gain around the middle, anxiety and hair loss.
Dr. Carrie Jones graduated from the National University of Natural Medicine, School of Naturopathic Medicine located in Portland, Oregon where she was adjunct faculty for many years teaching gynecology and advanced endocrinology. She completed a 2-year residency in advanced women’s health, gynecology, and hormones and later went on to complete her Master of Public Health at Grand Canyon University in Arizona. She has been the Medical Director for 2 large integrative clinics in Portland, Oregon and is currently the Medical Director at Precision Analytical, Inc. She often writes for women’s health websites and takes part in podcasts and interviews that promote hormone education to both the public and practitioners. She frequently lectures both nationally and internationally on the topics of adrenal and hormone health.