21st day of your cycle..I don't know is this after your period and not on your period? I know during my period and just before, your estrogen and progesterone drops off, androgens increase causing oily skin and acne.

Lip hair can simply be genetic. If you do have an imbalance of estrogen and progesterone (too much of one), then yes I could think it could cause acne... Also, maybe yours is not really hormonal but environmental and external? Are you drying your skin out too much making it produce more oil? How does your skin feel after cleansing? Also, chin and jaw line are mostly hormonal acne. Cheeks sound like irritation from diet or external causes.

Thanks for replying!

21st day = 7 days before my period. My skin was feeling a bit dry post cleansing using quinoderm face wash, but I've recently switched to an oatmeal cleansing method. My skin got really red because of epiduo so I wanted to be gentle, and heard oatmeal was pretty good. My skin colour has since gone back to something very, very pale and even, which is great! Still hella congested, though. I'm not sure what in my diet or environment would cause weirdness with my cheeks.. I've always had pimples there (and sometimes on my jaw), but they were usually inflamed. About a year ago it changed from purely inflamed pimples + otherwise smooth skin to bumpy, waxy looking pores that still feel soft but are raised from the skin and very oddly shaped (rectangular). They're so bad and so numerous that my cheeks are basically puffed up.

Right now on the oatmeal cleanse + cerave moisturizer, my skin doesn't feel dry at any point. Sometimes at night though when I'm lying down, I feel a tingling sensation in my right cheek alone. It's very odd.

Regarding my diet, I eat a lot of fish and rice because my family is Chinese. I don't eat takeout at all, and I only drink water and the occasional glass of freshly squeezed orange juice as a treat. I'm supplementing zinc/cod liver oil/tumeric and selenium right now.

It seems a mystery! Glad your cleanser is no longer drying you out though, your skin should feel soft after cleansing, not tight and dry. Do you have any allergies? Are you avoiding dairy?

And just a thought, have you ever taken the birth control pill? Did it have an effect on your skin?

I don't have any allergies that I know of in the sense that I don't get allergic reactions. If I'm allergic, then my acne is the only symptom, hehe. I've tried three different types of washing powder, one being a completely natural plant based one, and that didn't help. I am avoiding diary but not religiously anymore, as I went a month or two without any kind of diary and it didn't seem to do anything at all. Plus, I had a few months in June 2012 where I was clear and drank milk every morning during those, so I don't think diary is a real cause.

My skin is soft after cleansing now and to the touch, my cheeks actually don't feel bumpy, they only look it. The bumps themselves are soft, there's no hard plug or anything. I'm starting to think that my skin's natural shedding process is just completely messed up, as these bumps don't come and go. If I get a 'soft' bump, it's there forever. I can still see the first bump I got over a year ago. If I get an inflamed pimple, it stays as a hard, painless, tiny lump for weeks to months. Sometimes it just keeps flaring over and over again.

I've actually been on two different types of bcp now. Before I started the first one (microgynon), my skin was flawless. I began the pill at 17 and I gradually began getting cheek acne, which was entirely of the inflammatory kind. My skin texture was great otherwise. After I used the regimen, I was mostly clear but usually had one of these bumps at least on my face. I swapped to Marvelon at 21 to try and help with my skin. The first three months were bliss. Amazing texture, no pimples. Then I got my first non inflamed soft bump and I've not been clear of them since. My skin has gradually gotten worse with more and more bumps appearing and now they're pretty much covering my entire cheeks. No inflamed acne, though. I came off of Marvelon in July 2013. My skin got more oily, but the bumps haven't faded. I also got inflamed breakouts quite badly on my cheeks and jaw once I came off of the pill, though those have mostly subsided. It does seem like the pill influences my acne in various ways.

I attached a picture of my weird skin bumps for you. I took it a couple of weeks ago -- my skin is muuuch less red and flaky now. The actual red pimples on the outer areas of my cheeks are hard, while the skin coloured stuff is completely soft to the touch but looks absolutely awful in most lights. They don't respond at all to salicylic peels or any kind of exfoliation.

So I got the results of my blood tests back, and I'm very confused. I have oily skin, HEAVILY congested cheeks (they look puffed up they're so lumpy), inflammatory acne here and there and dark upper lip hair (and lower lip hair) that I have to remove. I'm also quite prone to fast growing, dark leg hair and arm hair. I recently started spironolactone, but I started it AFTER my blood test. My results were this on the 21st day of my cycle:

Sex hormone binding globulin - 44 nmol/L.

Serum TSH level - 2.66 mU/L. This is my thyroid, I've been hypo for about a decade. It's a little higher than usual so I increased my dose a bit.

Testosterone level - 1.4 nmol/L.

Progesterone level - 17.6 nmol/L.

EDIT: I actually found another chart that says my levels are normal, so I'm just gonna throw my hands up and trust my Doctor on this one. Now if only I could get them to do the proper set of thyroid tests instead of just TSH, I'd be pretty content. The one other thing I noticed is that while 17.6 nmol/L for progesterone indicates successful ovulation, it's supposedly not ideal according to charts. My periods were very regular at that point, but they've been thrown out of whack by Spiro. Two periods this month.

There seems to be a lot of opinion/variation thrown around on optimum hormone levels, which is kind of annoying. Also, the nmol/l vs ng/ML differences are a pain.

Always test female hormones on day 21 of cycle. Day 1 is first day of bleeding.

Unfortunately your doc ordered an incomplete female hormone panel. What we need are the following:

Total Testosterone

Free Testosterone (not as important as total as free fluctuates)

SHBG

DHEA Sulfate

FSH

Estradiol

Progesterone

LH

Cortisol 8 am

I can comment on what we have but it isn't complete. Without Estradiol we can't go very far as this is the hormone that neutralizes the side effects of elevated testosterone.

The following are optimal levels:

Progesterone: 41-73 nmol/L; YOU ARE DEFICIENT at 17.6

Free Testosterone: 1.2 nmol/L: YOU ARE ABOUT OPTIMAL AT 1.4

Serum TSH; 1; YOU ARE PROBABLY DEFICIENT AT LEVES OVER 2.5. YOU NEED FREE T4 AND FREE T3 PLUS THYROID ANTIBODIES TO KNOW MORE. most patients do the best on Armour Thyroid. It's desicated porcine thyroid that consists of approximately 35% T3 and 65% T4. Your doc will give you a million reasons why it doesn't work. He/she are mistaken.

SHBG. 65 pmol/L; Your levels are reported in nmol/L. Converting it makes the number too large. What is the reference range reported on your lab report?

YOU REALLY NEED:

DHEA SULFATE

LH

FSH

ESTRADIOL

CORTISOL 8 AM

Please test on day 21 of cycle

Yes, progesterone is low, but we don't want to supplement until we know what is going on with estradiol. If it's also low, then progesterone can amplify the effects of androgens.

The LH/FSH ratio will tell us if the source of our androgens is adrenal or ovarian. If adrenal, and your cortisol is low, then you can supplement with Medrol. This will inhibit DHEA production and also act as a anti-androgen. It also will block the action of DHT and help with any facial hair.

If the source of the androgens is ovarian, then estradiol is used to neutralize the side effects of testosterone.

Also work to reduce insulin by not eating grains, sugar, dairy. Try and eat meat, vegetables and fruit 5 days per week.

Fruit increases the conversion of T4 to T3 and may help with your thyroid problem.

So I got the results of my blood tests back, and I'm very confused. I have oily skin, HEAVILY congested cheeks (they look puffed up they're so lumpy), inflammatory acne here and there and dark upper lip hair (and lower lip hair) that I have to remove. I'm also quite prone to fast growing, dark leg hair and arm hair. I recently started spironolactone, but I started it AFTER my blood test. My results were this on the 21st day of my cycle:

Sex hormone binding globulin - 44 nmol/L.

Serum TSH level - 2.66 mU/L. This is my thyroid, I've been hypo for about a decade. It's a little higher than usual so I increased my dose a bit.

Testosterone level - 1.4 nmol/L.

Progesterone level - 17.6 nmol/L.

EDIT: I actually found another chart that says my levels are normal, so I'm just gonna throw my hands up and trust my Doctor on this one. Now if only I could get them to do the proper set of thyroid tests instead of just TSH, I'd be pretty content. The one other thing I noticed is that while 17.6 nmol/L for progesterone indicates successful ovulation, it's supposedly not ideal according to charts. My periods were very regular at that point, but they've been thrown out of whack by Spiro. Two periods this month.

There seems to be a lot of opinion/variation thrown around on optimum hormone levels, which is kind of annoying. Also, the nmol/l vs ng/ML differences are a pain.

Always test female hormones on day 21 of cycle. Day 1 is first day of bleeding.

Unfortunately your doc ordered an incomplete female hormone panel. What we need are the following:

Total Testosterone

Free Testosterone (not as important as total as free fluctuates)

SHBG

DHEA Sulfate

FSH

Estradiol

Progesterone

LH

Cortisol 8 am

I can comment on what we have but it isn't complete. Without Estradiol we can't go very far as this is the hormone that neutralizes the side effects of elevated testosterone.

The following are optimal levels:

Progesterone: 41-73 nmol/L; YOU ARE DEFICIENT at 17.6

Free Testosterone: 1.2 nmol/L: YOU ARE ABOUT OPTIMAL AT 1.4

Serum TSH; 1; YOU ARE PROBABLY DEFICIENT AT LEVES OVER 2.5. YOU NEED FREE T4 AND FREE T3 PLUS THYROID ANTIBODIES TO KNOW MORE. most patients do the best on Armour Thyroid. It's desicated porcine thyroid that consists of approximately 35% T3 and 65% T4. Your doc will give you a million reasons why it doesn't work. He/she are mistaken.

SHBG. 65 pmol/L; Your levels are reported in nmol/L. Converting it makes the number too large. What is the reference range reported on your lab report?

YOU REALLY NEED:

DHEA SULFATE

LH

FSH

ESTRADIOL

CORTISOL 8 AM

Please test on day 21 of cycle

Yes, progesterone is low, but we don't want to supplement until we know what is going on with estradiol. If it's also low, then progesterone can amplify the effects of androgens.

The LH/FSH ratio will tell us if the source of our androgens is adrenal or ovarian. If adrenal, and your cortisol is low, then you can supplement with Medrol. This will inhibit DHEA production and also act as a anti-androgen. It also will block the action of DHT and help with any facial hair.

If the source of the androgens is ovarian, then estradiol is used to neutralize the side effects of testosterone.

Also work to reduce insulin by not eating grains, sugar, dairy. Try and eat meat, vegetables and fruit 5 days per week.

Fruit increases the conversion of T4 to T3 and may help with your thyroid problem.

I had such a long post typed up and then actually backed out of the window. Here we go again. I found the other test information - it was halfway down the page because the receptionist printed the results twice onto the same piece of paper and it's all overlapping. Heh. I think I have everything but cortisol and DHEA sulfate. I've put the reference ranges in, too. I think the only thing that I'm missing is cortisol, which is unfortunate. The tests were originally ordered to check for PCOS, and were done on the 21st day as you said.

For some reason there doesn't seem to be any reference ranges for SHBG, which is weird. I thought I found a conversion tool that said my SHBG was actually on the low side of normal, but I could be wrong.

EDIT: Found the chart, it says my SHBG is normal? On the low side of normal, but still normal. I read that low SHBG is related to hypothyroidism, so that's not surprising, I guess.

Progesterone level: 17.6 nmol/L.

Follicular: <5.4 nmol/L.

Periovulatory: 1.2 - 18.7 nmol/L.

Mid Luteal: 19.1 - 76.2 nmol/L.

Luteal: 3.3 - 71.2 nmol/L.

Oestradiol level: 617 pmol/L.

Follicular: 90 - 716. pmol/L.

Luteal: 147 - 958 pmol/L.

Pre ovu: 243 - 1509 pmol/L.

Post menopausal: 37 - 145 pmol/L.

LH level: 12.7 IU/L.

Follicular: 3 - 12 IU/L.

Mid cycle: 2- 80 IU/L.

Luteal: 3 - 16 IU/L.

Post meno: >30 IU/L.

FSH level: 3.3 IU/L.

Follicular: 0.5 - 5 IU/L.

Mid cycle: 8 - 15 IU/L.

Luteal: <8 IU/L.

Post meno: >30 IU/L.

I thought my LH was high originally because people claim a 1:1 ratio is best for LH/FSH, but I was on the 21st day of my cycle which is apparently when LH levels soar, so that looks fine.

Regarding my thyroid tests.. I would LOVE it if I could get the full tests for my thyroid. I'm diagnosed hypo already and I'm getting treatment, but I'm on a very standard dose and they like to keep me at a level of 2.5ish, for some reason. I caught a glimpse of my history and they'd actually marked 1.9 as 'low'. The NHS refuse to order the full panel of tests, saying that TSH is enough. Hypothyroidism runs in my family. My brother is hypo to the point where they don't think his thyroid is functioning at all. My aunt was hypo up until she hit 50ish, then she kept swinging between hypo and hyper so rapidly that they just killed her thyroid with radiation to make medication easier. Neither of them suffer with acne or skin problems, outside of the occasional teenage spot my brother gets (he's 18). His skin texture is sublime. EDIT: They do have keratosis pilaris on their arms, which I've somehow dodged. My arms and legs are very smooth, so I don't think it's KP on my face.

I mostly just dose by my symptoms these days. I've noticed that if my dose is too low, I'm cold/tired and the outer third of my eyebrows falls out. My elbows also crust over. When I increase my dose a little, my eyebrows grow in, my elbows smooth out and I'm not as tired and cold.

Thank you very much for your posts and help!

Another edit: I'm a normal weight (107 @ 4'11"). I'm also 22. I was recently tested for diabetes as well and I'm all good there.

So I got the results of my blood tests back, and I'm very confused. I have oily skin, HEAVILY congested cheeks (they look puffed up they're so lumpy), inflammatory acne here and there and dark upper lip hair (and lower lip hair) that I have to remove. I'm also quite prone to fast growing, dark leg hair and arm hair. I recently started spironolactone, but I started it AFTER my blood test. My results were this on the 21st day of my cycle:

Sex hormone binding globulin - 44 nmol/L.

Serum TSH level - 2.66 mU/L. This is my thyroid, I've been hypo for about a decade. It's a little higher than usual so I increased my dose a bit.

Testosterone level - 1.4 nmol/L.

Progesterone level - 17.6 nmol/L.

EDIT: I actually found another chart that says my levels are normal, so I'm just gonna throw my hands up and trust my Doctor on this one. Now if only I could get them to do the proper set of thyroid tests instead of just TSH, I'd be pretty content. The one other thing I noticed is that while 17.6 nmol/L for progesterone indicates successful ovulation, it's supposedly not ideal according to charts. My periods were very regular at that point, but they've been thrown out of whack by Spiro. Two periods this month.

There seems to be a lot of opinion/variation thrown around on optimum hormone levels, which is kind of annoying. Also, the nmol/l vs ng/ML differences are a pain.

Always test female hormones on day 21 of cycle. Day 1 is first day of bleeding.

Unfortunately your doc ordered an incomplete female hormone panel. What we need are the following:

Total Testosterone

Free Testosterone (not as important as total as free fluctuates)

SHBG

DHEA Sulfate

FSH

Estradiol

Progesterone

LH

Cortisol 8 am

I can comment on what we have but it isn't complete. Without Estradiol we can't go very far as this is the hormone that neutralizes the side effects of elevated testosterone.

The following are optimal levels:

Progesterone: 41-73 nmol/L; YOU ARE DEFICIENT at 17.6

Free Testosterone: 1.2 nmol/L: YOU ARE ABOUT OPTIMAL AT 1.4

Serum TSH; 1; YOU ARE PROBABLY DEFICIENT AT LEVES OVER 2.5. YOU NEED FREE T4 AND FREE T3 PLUS THYROID ANTIBODIES TO KNOW MORE. most patients do the best on Armour Thyroid. It's desicated porcine thyroid that consists of approximately 35% T3 and 65% T4. Your doc will give you a million reasons why it doesn't work. He/she are mistaken.

SHBG. 65 pmol/L; Your levels are reported in nmol/L. Converting it makes the number too large. What is the reference range reported on your lab report?

YOU REALLY NEED:

DHEA SULFATE

LH

FSH

ESTRADIOL

CORTISOL 8 AM

Please test on day 21 of cycle

Yes, progesterone is low, but we don't want to supplement until we know what is going on with estradiol. If it's also low, then progesterone can amplify the effects of androgens.

The LH/FSH ratio will tell us if the source of our androgens is adrenal or ovarian. If adrenal, and your cortisol is low, then you can supplement with Medrol. This will inhibit DHEA production and also act as a anti-androgen. It also will block the action of DHT and help with any facial hair.

If the source of the androgens is ovarian, then estradiol is used to neutralize the side effects of testosterone.

Also work to reduce insulin by not eating grains, sugar, dairy. Try and eat meat, vegetables and fruit 5 days per week.

Fruit increases the conversion of T4 to T3 and may help with your thyroid problem.

I had such a long post typed up and then actually backed out of the window. Here we go again. I found the other test information - it was halfway down the page because the receptionist printed the results twice onto the same piece of paper and it's all overlapping. Heh. I think I have everything but cortisol and DHEA sulfate. I've put the reference ranges in, too. I think the only thing that I'm missing is cortisol, which is unfortunate. The tests were originally ordered to check for PCOS, and were done on the 21st day as you said.

For some reason there doesn't seem to be any reference ranges for SHBG, which is weird. I thought I found a conversion tool that said my SHBG was actually on the low side of normal, but I could be wrong.

EDIT: Found the chart, it says my SHBG is normal? On the low side of normal, but still normal. I read that low SHBG is related to hypothyroidism, so that's not surprising, I guess.

Progesterone level: 17.6 nmol/L.

Follicular: <5.4 nmol/L.

Periovulatory: 1.2 - 18.7 nmol/L.

Mid Luteal: 19.1 - 76.2 nmol/L.

Luteal: 3.3 - 71.2 nmol/L.

Oestradiol level: 617 pmol/L.

Follicular: 90 - 716. pmol/L.

Luteal: 147 - 958 pmol/L.

Pre ovu: 243 - 1509 pmol/L.

Post menopausal: 37 - 145 pmol/L.

LH level: 12.7 IU/L.

Follicular: 3 - 12 IU/L.

Mid cycle: 2- 80 IU/L.

Luteal: 3 - 16 IU/L.

Post meno: >30 IU/L.

FSH level: 3.3 IU/L.

Follicular: 0.5 - 5 IU/L.

Mid cycle: 8 - 15 IU/L.

Luteal: <8 IU/L.

Post meno: >30 IU/L.

I thought my LH was high originally because people claim a 1:1 ratio is best for LH/FSH, but I was on the 21st day of my cycle which is apparently when LH levels soar, so that looks fine.

Regarding my thyroid tests.. I would LOVE it if I could get the full tests for my thyroid. I'm diagnosed hypo already and I'm getting treatment, but I'm on a very standard dose and they like to keep me at a level of 2.5ish, for some reason. I caught a glimpse of my history and they'd actually marked 1.9 as 'low'. The NHS refuse to order the full panel of tests, saying that TSH is enough. Hypothyroidism runs in my family. My brother is hypo to the point where they don't think his thyroid is functioning at all. My aunt was hypo up until she hit 50ish, then she kept swinging between hypo and hyper so rapidly that they just killed her thyroid with radiation to make medication easier. Neither of them suffer with acne or skin problems, outside of the occasional teenage spot my brother gets (he's 18). His skin texture is sublime. EDIT: They do have keratosis pilaris on their arms, which I've somehow dodged. My arms and legs are very smooth, so I don't think it's KP on my face.

I mostly just dose by my symptoms these days. I've noticed that if my dose is too low, I'm cold/tired and the outer third of my eyebrows falls out. My elbows also crust over. When I increase my dose a little, my eyebrows grow in, my elbows smooth out and I'm not as tired and cold.

Thank you very much for your posts and help!

Another edit: I'm a normal weight (107 @ 4'11"). I'm also 22. I was recently tested for diabetes as well and I'm all good there.

Thanks for the follow up.

Optimal Estradiol: 550 pmol/L; You are slightly over at 617, however with the progesterone deficiency I would expect you are experiencing bloating, anxiety, breast tenderness, swollen breasts and excessive menstruation.

LH: 2-4 mIU/mL; you are 12.7. Elevated LH is likely due to progesterone deficit. (LH is highest at ovulation or day 14)

PCOS is probable when LH>FSH and Estrone greater than Estradiol on day 21 of cycle

So, it looks like you are experiencing estrogen dominance. This is resolved with bio-identical progesterone before bed. Generally micronized progesterone taken during the luteal phase.

Still need DHEA Sulfate and 8 am cortisol.

Most women with acne have elevated DHEA.

So I got the results of my blood tests back, and I'm very confused. I have oily skin, HEAVILY congested cheeks (they look puffed up they're so lumpy), inflammatory acne here and there and dark upper lip hair (and lower lip hair) that I have to remove. I'm also quite prone to fast growing, dark leg hair and arm hair. I recently started spironolactone, but I started it AFTER my blood test. My results were this on the 21st day of my cycle:

Sex hormone binding globulin - 44 nmol/L.

Serum TSH level - 2.66 mU/L. This is my thyroid, I've been hypo for about a decade. It's a little higher than usual so I increased my dose a bit.

Testosterone level - 1.4 nmol/L.

Progesterone level - 17.6 nmol/L.

EDIT: I actually found another chart that says my levels are normal, so I'm just gonna throw my hands up and trust my Doctor on this one. Now if only I could get them to do the proper set of thyroid tests instead of just TSH, I'd be pretty content. The one other thing I noticed is that while 17.6 nmol/L for progesterone indicates successful ovulation, it's supposedly not ideal according to charts. My periods were very regular at that point, but they've been thrown out of whack by Spiro. Two periods this month.

There seems to be a lot of opinion/variation thrown around on optimum hormone levels, which is kind of annoying. Also, the nmol/l vs ng/ML differences are a pain.

Always test female hormones on day 21 of cycle. Day 1 is first day of bleeding.

Unfortunately your doc ordered an incomplete female hormone panel. What we need are the following:

Total Testosterone

Free Testosterone (not as important as total as free fluctuates)

SHBG

DHEA Sulfate

FSH

Estradiol

Progesterone

LH

Cortisol 8 am

I can comment on what we have but it isn't complete. Without Estradiol we can't go very far as this is the hormone that neutralizes the side effects of elevated testosterone.

The following are optimal levels:

Progesterone: 41-73 nmol/L; YOU ARE DEFICIENT at 17.6

Free Testosterone: 1.2 nmol/L: YOU ARE ABOUT OPTIMAL AT 1.4

Serum TSH; 1; YOU ARE PROBABLY DEFICIENT AT LEVES OVER 2.5. YOU NEED FREE T4 AND FREE T3 PLUS THYROID ANTIBODIES TO KNOW MORE. most patients do the best on Armour Thyroid. It's desicated porcine thyroid that consists of approximately 35% T3 and 65% T4. Your doc will give you a million reasons why it doesn't work. He/she are mistaken.

SHBG. 65 pmol/L; Your levels are reported in nmol/L. Converting it makes the number too large. What is the reference range reported on your lab report?

YOU REALLY NEED:

DHEA SULFATE

LH

FSH

ESTRADIOL

CORTISOL 8 AM

Please test on day 21 of cycle

Yes, progesterone is low, but we don't want to supplement until we know what is going on with estradiol. If it's also low, then progesterone can amplify the effects of androgens.

The LH/FSH ratio will tell us if the source of our androgens is adrenal or ovarian. If adrenal, and your cortisol is low, then you can supplement with Medrol. This will inhibit DHEA production and also act as a anti-androgen. It also will block the action of DHT and help with any facial hair.

If the source of the androgens is ovarian, then estradiol is used to neutralize the side effects of testosterone.

Also work to reduce insulin by not eating grains, sugar, dairy. Try and eat meat, vegetables and fruit 5 days per week.

Fruit increases the conversion of T4 to T3 and may help with your thyroid problem.

I had such a long post typed up and then actually backed out of the window. Here we go again. I found the other test information - it was halfway down the page because the receptionist printed the results twice onto the same piece of paper and it's all overlapping. Heh. I think I have everything but cortisol and DHEA sulfate. I've put the reference ranges in, too. I think the only thing that I'm missing is cortisol, which is unfortunate. The tests were originally ordered to check for PCOS, and were done on the 21st day as you said.

For some reason there doesn't seem to be any reference ranges for SHBG, which is weird. I thought I found a conversion tool that said my SHBG was actually on the low side of normal, but I could be wrong.

EDIT: Found the chart, it says my SHBG is normal? On the low side of normal, but still normal. I read that low SHBG is related to hypothyroidism, so that's not surprising, I guess.

Progesterone level: 17.6 nmol/L.

Follicular: <5.4 nmol/L.

Periovulatory: 1.2 - 18.7 nmol/L.

Mid Luteal: 19.1 - 76.2 nmol/L.

Luteal: 3.3 - 71.2 nmol/L.

Oestradiol level: 617 pmol/L.

Follicular: 90 - 716. pmol/L.

Luteal: 147 - 958 pmol/L.

Pre ovu: 243 - 1509 pmol/L.

Post menopausal: 37 - 145 pmol/L.

LH level: 12.7 IU/L.

Follicular: 3 - 12 IU/L.

Mid cycle: 2- 80 IU/L.

Luteal: 3 - 16 IU/L.

Post meno: >30 IU/L.

FSH level: 3.3 IU/L.

Follicular: 0.5 - 5 IU/L.

Mid cycle: 8 - 15 IU/L.

Luteal: <8 IU/L.

Post meno: >30 IU/L.

I thought my LH was high originally because people claim a 1:1 ratio is best for LH/FSH, but I was on the 21st day of my cycle which is apparently when LH levels soar, so that looks fine.

Regarding my thyroid tests.. I would LOVE it if I could get the full tests for my thyroid. I'm diagnosed hypo already and I'm getting treatment, but I'm on a very standard dose and they like to keep me at a level of 2.5ish, for some reason. I caught a glimpse of my history and they'd actually marked 1.9 as 'low'. The NHS refuse to order the full panel of tests, saying that TSH is enough. Hypothyroidism runs in my family. My brother is hypo to the point where they don't think his thyroid is functioning at all. My aunt was hypo up until she hit 50ish, then she kept swinging between hypo and hyper so rapidly that they just killed her thyroid with radiation to make medication easier. Neither of them suffer with acne or skin problems, outside of the occasional teenage spot my brother gets (he's 18). His skin texture is sublime. EDIT: They do have keratosis pilaris on their arms, which I've somehow dodged. My arms and legs are very smooth, so I don't think it's KP on my face.

I mostly just dose by my symptoms these days. I've noticed that if my dose is too low, I'm cold/tired and the outer third of my eyebrows falls out. My elbows also crust over. When I increase my dose a little, my eyebrows grow in, my elbows smooth out and I'm not as tired and cold.

Thank you very much for your posts and help!

Another edit: I'm a normal weight (107 @ 4'11"). I'm also 22. I was recently tested for diabetes as well and I'm all good there.

Thanks for the follow up.

Optimal Estradiol: 550 pmol/L; You are slightly over at 617, however with the progesterone deficiency I would expect you are experiencing bloating, anxiety, breast tenderness, swollen breasts and excessive menstruation.

LH: 2-4 mIU/mL; you are 12.7. Elevated LH is likely due to progesterone deficit. (LH is highest at ovulation or day 14)

PCOS is probable when LH>FSH and Estrone greater than Estradiol on day 21 of cycle

So, it looks like you are experiencing estrogen dominance. This is resolved with bio-identical progesterone before bed. Generally micronized progesterone taken during the luteal phase.

Still need DHEA Sulfate and 8 am cortisol.

Most women with acne have elevated DHEA.

Thanks for your post. I might not be able to get DHEA Sulfate and Cortisol for a while as my Doctor referred me to a derm and doesn't seem interested in going the hormonal route anymore. If I do, I'll make sure to post it up.

Thanks a lot for all your advice, though. I did some reading on estrogen dominance and symptoms of hypothyroidism like tiredness, lethargy and cold hands and feet are all estrogen dominance related. My hands and feet are sometimes so cold that when I touch people, they'll yell at me or shriek because my fingers are ice. It's worth reading into a little more, I suppose!

So I got the results of my blood tests back, and I'm very confused. I have oily skin, HEAVILY congested cheeks (they look puffed up they're so lumpy), inflammatory acne here and there and dark upper lip hair (and lower lip hair) that I have to remove. I'm also quite prone to fast growing, dark leg hair and arm hair. I recently started spironolactone, but I started it AFTER my blood test. My results were this on the 21st day of my cycle:

Sex hormone binding globulin - 44 nmol/L.

Serum TSH level - 2.66 mU/L. This is my thyroid, I've been hypo for about a decade. It's a little higher than usual so I increased my dose a bit.

Testosterone level - 1.4 nmol/L.

Progesterone level - 17.6 nmol/L.

EDIT: I actually found another chart that says my levels are normal, so I'm just gonna throw my hands up and trust my Doctor on this one. Now if only I could get them to do the proper set of thyroid tests instead of just TSH, I'd be pretty content. The one other thing I noticed is that while 17.6 nmol/L for progesterone indicates successful ovulation, it's supposedly not ideal according to charts. My periods were very regular at that point, but they've been thrown out of whack by Spiro. Two periods this month.

There seems to be a lot of opinion/variation thrown around on optimum hormone levels, which is kind of annoying. Also, the nmol/l vs ng/ML differences are a pain.

Always test female hormones on day 21 of cycle. Day 1 is first day of bleeding.

Unfortunately your doc ordered an incomplete female hormone panel. What we need are the following:

Total Testosterone

Free Testosterone (not as important as total as free fluctuates)

SHBG

DHEA Sulfate

FSH

Estradiol

Progesterone

LH

Cortisol 8 am

I can comment on what we have but it isn't complete. Without Estradiol we can't go very far as this is the hormone that neutralizes the side effects of elevated testosterone.

The following are optimal levels:

Progesterone: 41-73 nmol/L; YOU ARE DEFICIENT at 17.6

Free Testosterone: 1.2 nmol/L: YOU ARE ABOUT OPTIMAL AT 1.4

Serum TSH; 1; YOU ARE PROBABLY DEFICIENT AT LEVES OVER 2.5. YOU NEED FREE T4 AND FREE T3 PLUS THYROID ANTIBODIES TO KNOW MORE. most patients do the best on Armour Thyroid. It's desicated porcine thyroid that consists of approximately 35% T3 and 65% T4. Your doc will give you a million reasons why it doesn't work. He/she are mistaken.

SHBG. 65 pmol/L; Your levels are reported in nmol/L. Converting it makes the number too large. What is the reference range reported on your lab report?

YOU REALLY NEED:

DHEA SULFATE

LH

FSH

ESTRADIOL

CORTISOL 8 AM

Please test on day 21 of cycle

Yes, progesterone is low, but we don't want to supplement until we know what is going on with estradiol. If it's also low, then progesterone can amplify the effects of androgens.

The LH/FSH ratio will tell us if the source of our androgens is adrenal or ovarian. If adrenal, and your cortisol is low, then you can supplement with Medrol. This will inhibit DHEA production and also act as a anti-androgen. It also will block the action of DHT and help with any facial hair.

If the source of the androgens is ovarian, then estradiol is used to neutralize the side effects of testosterone.

Also work to reduce insulin by not eating grains, sugar, dairy. Try and eat meat, vegetables and fruit 5 days per week.

Fruit increases the conversion of T4 to T3 and may help with your thyroid problem.

I had such a long post typed up and then actually backed out of the window. Here we go again. I found the other test information - it was halfway down the page because the receptionist printed the results twice onto the same piece of paper and it's all overlapping. Heh. I think I have everything but cortisol and DHEA sulfate. I've put the reference ranges in, too. I think the only thing that I'm missing is cortisol, which is unfortunate. The tests were originally ordered to check for PCOS, and were done on the 21st day as you said.

For some reason there doesn't seem to be any reference ranges for SHBG, which is weird. I thought I found a conversion tool that said my SHBG was actually on the low side of normal, but I could be wrong.

EDIT: Found the chart, it says my SHBG is normal? On the low side of normal, but still normal. I read that low SHBG is related to hypothyroidism, so that's not surprising, I guess.

Progesterone level: 17.6 nmol/L.

Follicular: <5.4 nmol/L.

Periovulatory: 1.2 - 18.7 nmol/L.

Mid Luteal: 19.1 - 76.2 nmol/L.

Luteal: 3.3 - 71.2 nmol/L.

Oestradiol level: 617 pmol/L.

Follicular: 90 - 716. pmol/L.

Luteal: 147 - 958 pmol/L.

Pre ovu: 243 - 1509 pmol/L.

Post menopausal: 37 - 145 pmol/L.

LH level: 12.7 IU/L.

Follicular: 3 - 12 IU/L.

Mid cycle: 2- 80 IU/L.

Luteal: 3 - 16 IU/L.

Post meno: >30 IU/L.

FSH level: 3.3 IU/L.

Follicular: 0.5 - 5 IU/L.

Mid cycle: 8 - 15 IU/L.

Luteal: <8 IU/L.

Post meno: >30 IU/L.

I thought my LH was high originally because people claim a 1:1 ratio is best for LH/FSH, but I was on the 21st day of my cycle which is apparently when LH levels soar, so that looks fine.

Regarding my thyroid tests.. I would LOVE it if I could get the full tests for my thyroid. I'm diagnosed hypo already and I'm getting treatment, but I'm on a very standard dose and they like to keep me at a level of 2.5ish, for some reason. I caught a glimpse of my history and they'd actually marked 1.9 as 'low'. The NHS refuse to order the full panel of tests, saying that TSH is enough. Hypothyroidism runs in my family. My brother is hypo to the point where they don't think his thyroid is functioning at all. My aunt was hypo up until she hit 50ish, then she kept swinging between hypo and hyper so rapidly that they just killed her thyroid with radiation to make medication easier. Neither of them suffer with acne or skin problems, outside of the occasional teenage spot my brother gets (he's 18). His skin texture is sublime. EDIT: They do have keratosis pilaris on their arms, which I've somehow dodged. My arms and legs are very smooth, so I don't think it's KP on my face.

I mostly just dose by my symptoms these days. I've noticed that if my dose is too low, I'm cold/tired and the outer third of my eyebrows falls out. My elbows also crust over. When I increase my dose a little, my eyebrows grow in, my elbows smooth out and I'm not as tired and cold.

Thank you very much for your posts and help!

Another edit: I'm a normal weight (107 @ 4'11"). I'm also 22. I was recently tested for diabetes as well and I'm all good there.

Thanks for the follow up.

Optimal Estradiol: 550 pmol/L; You are slightly over at 617, however with the progesterone deficiency I would expect you are experiencing bloating, anxiety, breast tenderness, swollen breasts and excessive menstruation.

LH: 2-4 mIU/mL; you are 12.7. Elevated LH is likely due to progesterone deficit. (LH is highest at ovulation or day 14)

PCOS is probable when LH>FSH and Estrone greater than Estradiol on day 21 of cycle

So, it looks like you are experiencing estrogen dominance. This is resolved with bio-identical progesterone before bed. Generally micronized progesterone taken during the luteal phase.

Still need DHEA Sulfate and 8 am cortisol.

Most women with acne have elevated DHEA.

Thanks for your post. I might not be able to get DHEA Sulfate and Cortisol for a while as my Doctor referred me to a derm and doesn't seem interested in going the hormonal route anymore. If I do, I'll make sure to post it up.

Thanks a lot for all your advice, though. I did some reading on estrogen dominance and symptoms of hypothyroidism like tiredness, lethargy and cold hands and feet are all estrogen dominance related. My hands and feet are sometimes so cold that when I touch people, they'll yell at me or shriek because my fingers are ice. It's worth reading into a little more, I suppose!

Very good.

Cold hands and feet are unquestionably signs of hypothyroidism. Your thyroid controls metabolism and temperature. Your doc probably doesn't know this but when you are dosed correctly there is between a 5 and 20% difference between your winter and summer thyroid dosage (lower in the summer).

Hypothyroidism will affect your other hormone levels as well. Correct the thyroid problem and some of the other issues may resolve or decrease in severity.

Also tell them not to treat the lab form but to treat you. You reach optimal hormone levels when your symptoms disappear, not when you reach some predetermined number like 2.5.

If you find at some point that you have elevated DHEA Sulfate, you can ask your doc about trying dexamethasone. It will inhibit your adrenals and reduce both cortisol and DHEA output. It will also tend to act as an anti-androgen.

Good luck!

Very good.

Cold hands and feet are unquestionably signs of hypothyroidism. Your thyroid controls metabolism and temperature. Your doc probably doesn't know this but when you are dosed correctly there is between a 5 and 20% difference between your winter and summer thyroid dosage (lower in the summer).

Hypothyroidism will affect your other hormone levels as well. Correct the thyroid problem and some of the other issues may resolve or decrease in severity.

Also tell them not to treat the lab form but to treat you. You reach optimal hormone levels when your symptoms disappear, not when you reach some predetermined number like 2.5.

If you find at some point that you have elevated DHEA Sulfate, you can ask your doc about trying dexamethasone. It will inhibit your adrenals and reduce both cortisol and DHEA output. It will also tend to act as an anti-androgen.

Good luck!

Thank you! And thanks again for all your help. Hopefully I can figure this out and get clear!

Cold hands and feet can also come from Reynauds Disease - it's worth getting checked out for it since women in their 20's are particularly susceptible.

Vitamin B deficiencies can also cause hair loss around the eyebrows and skin flaking...

Your acne doesn't look bad at all and I know it is bothersome for you.Funnily enough with lower progesterone I too seemed to get cheek acne which I never had before, usually only my chin and jaw line. Taking 'Loette' pill now and it's helping a lot...just a thought.