RE: PCOS?

[Guest guest]

Hi Non,

About 14% of PCOS patients can actually present with no obvious cysts on the

ovaries - it is called the O+H (oligomenorrhoea +hyperandrogenism) or

non-polycystic ovaries phenotype. About 42% of patients with this phenotype

have metabolic syndrome.

I have a very similar patient, where the picture is more complicated by her

having had a hysterectomy a few years ago. Her GP finally believed me when I

asked for her LH and FSH (amongst other hormones to be checked) - the ratio

of LH to FSH was >2 which is indicative of PCOS (along with other symptoms)

(she also had raised testosterone, DHEAS, androstenedione, oestradiol and

oestrone, and decreased SHBG).

She responded well to " normal " herbal treatment and is asymptomatic now.

Best wishes,

Chris

J Etheridge

PhD MCPP MRSC CChem DoIC ARCS BSc(Hons) Chem BSc(Hons) Phyto

Medical Herbalist

Cheshunt Clinic of Herbal Medicine

62 Roundmoor Drive

Cheshunt

Hertfordshire

EN8 9HQ

M: 0

www.drchrisetheridge.co.uk

_____

From: ukherbal-list [mailto:ukherbal-list ]

On Behalf Of Non and Ric

Sent: Wednesday, December 17, 2008 8:44 AM

To: membersforum ; ukherbal-list

Subject: PCOS?

Hi All

Have a patient presenting with classic symptoms of PCOS - hirsutism,

obesity, her periods stop when she goes over a certain weight. She has had

eating problems all her life - yo-yo dieting and terrrible sugar cravings.

However her bloods are normal and no cysts on scans - because of this, her

GP will not refer her. I've not come across this particular presentation

before and wondered if anyone else had.

Any thoughts gratefully received.

Non

[Guest guest]

Hi Non

odd that her bloods are normal..... do you know where in the range

of " normal " they are? It might be that her response to " low normal "

is not sufficient for optimal function? It would also be interesting

to see if her GP has consulted evidence on how reliable a correlation

there is between blood results and PCOS? ;-)

I've not seen this presentation myself, but I did see a patient whom

I'm sure was coeliac, but had been dismissed as not by her GP and

consultant because her bloods and biopsy were negative. However she

presented to me with a skin condition that close resembled the

textbook description to be dermatitis herpetiformis and was clearly

related by her to the consumption of gluten, along with other classic

signs and symptoms of CD. (She responded well to treatment and

support in avoiding gluten, and I advised her to question her diagnosis)

I suspect that both we and GPs are often too ready to assume perfect

specificity and /or sensitivity of lab results when this is actually

not the case. We need to know the proportion of false negative

results (and false positives) to know how much relative weight to

give to lab results, and when the patient's presentation is, in fact,

more likely to be more useful.

(oops, sorry, on the soapbox again ;-) but you know what I mean....

best

Sally O

> Hi All

> Have a patient presenting with classic symptoms of PCOS -

> hirsutism, obesity, her periods stop when she goes over a certain

> weight. She has had eating problems all her life - yo-yo dieting

> and terrrible sugar cravings.

> However her bloods are normal and no cysts on scans - because of

> this, her GP will not refer her. I've not come across this

> particular presentation before and wondered if anyone else had.

> Any thoughts gratefully received.

> Non

>

>