T Nation

Female: Very High DHEA, Very Low Free T, Normal T, No Libido, Few Periods

Hi all, I know it’s a male forum, and as a female, my hormonal balance is a bit different, but I hope you could help me see what’s wrong with my hormones.

I suspect an adrenal hyperactivity, and I don’t think I can do anything more than avoid stress, but I’m not sure what I should do with my low free T. Is it possible that my albumin is too high?

age: 26
height: 5’5" / 165 cm
weight: 127lb / 58kg No weight changes
body & facial hair: hirsutism since I had my periods
describe where you carry fat: low abdomen
health conditions/symptoms:

  • Irregular periods and amenorrhea (up to 6 months)
  • No libido (never had)
  • Hirsutism
  • Frequent insomnia

describe diet: a lot of vegetables, fruits, good meat, no junk food.
describe training: I used to do cardio and weight lifting, but because of my insomnia, not anymore.

Blood Testing

(Follicular phase)

FSH: 5.29 mUI/ml [3.5-12.5] 6.32 (2018) 6.66 (2016)
LH: 8.64 mUI/ml [2.4-12.6] 5.69 (2018) 7,13 (2016)

Prolactin: 21.26 ng/ml [4.79-23.3] 20.94 (2018) 22.62 (2016) Almost high

Estradiol: 38.94 pg/ml [15.5-165] 41.19 (2018) 20.1 (2016)
Progesterone: 0.361 ng/ml [0.2-1.5]

FSH: 1.37 mUI/L [0.27-4.2] (2018) 0.04 (2016)
T4: 1.03 ng/dl [0.7-1.8] (2018) 0.74 (2016)
T3 (2016): 1.89 pg/ml [1.8-4.6]

Total testosterone: 0.47 mcg/L [0.06-0.82] 0.57 (2018) 0.5 (2016)
Free testosterone: 0.028 nmol/L [should not be less than 0.25]
Albumin: 5.1 g/dL [3.5-5.2]
SHBG: 32.6 [26.1-110]

17-Hydroxyprogesterone: 1.16 ng/ml [0.3-1] 2.18 (2018)

DHEA-S: 8.7 mcmol/L [ 2.6-13.9] 12.6 [3.6-11.1] (2016)
DHEA: 18.10 ng/ml [0.9-9.5] 23.4 (2018)

Cortisol: 22.15 mcg/dL [6-19.4]

Androstenedione: 3.8 ng/ml [0.3-3.7]

Cholesterol (2016): 139 mg/dL [140 - 230]
Fasting glucose (2019): 77 mg/dl [70-110]

Thank you.

At what day in your cycle were these labs done (see image)? No TSH or vitamin D levels? The insomnia itself will throw your hormones into a tailspin.

Wen you say diet “could not be better” would you say you are the type of person to scrutinize every calorie? Saying there is not room in your diet for improvement is a bit brazen.

How is your blood pressure? Cholesterol level? Stress levels? What medications are you on?

I’m not saying I have any answers for you but trying to see a bigger picture.



As @NH_Watts said, the timing of your blood work makes all the difference, but without knowing any more details and looking at what you posted strictly within its own context, I would say that you are highly estrogen dominant and will probably need progesterone to get your ratios back in balance.

Your cortisol is also through the roof. Do you do a ton of cardio?

I would also say that you are on the verge of adrenal fatigue. An adrenal complex could probably help with that.

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Excess hair, slightly elevated prolactin and missing periods could be possibley be pcos related. Has this ever been mentioned by the doctors?

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Follicular phase all three, the lab reference ranges are also from follicular phase.

I have insomnia since 2018, in 2016 I also had the DHEA very high and a slightly high prolactin, and my periods have been irregular since the beginning, but I didn’t do many analysis before 2018.

I forgot my thyroid hormones, although I don’t have recent ones.

  • TSH (2016): 0.04 mUI/L [0.27-4.2] 1.37 (2018)
  • T3 (2016): 1.89 pg/ml [1.8-4.6]
  • T4 (2016): 0.74 ng/dl [0.7-1.8] 1.03 (2018)

I don’t count calories, I consider my diet to be very good because I eat a lot of home grown vegetables, fruits, home raised meat and no junk food. It would be better if I ate fish (I don’t since few years maybe) but I sometimes eat brown algae so I don’t think iodine is a problem (I guess).

I don’t know my vitamin D levels, but I am supplementing with 1000IU since November, just in case.

My blood pressure was fine the last time my doctor checked (I think it was last October). Cholesterol was low in 2016 (139 mg/dL [140 - 230]).

I do have stress, and I’m trying to lower it.

I don’t take medications, only vitamin D and sometimes natural sleep aids ( 3 g of glycine, 1 g of taurine and passiflora pills, mainly).

Thank you for your interest : )

No, I have stopped doing cardio since I started with insomnia, it was making it much worse.

I actually was quite fine in terms of stress some days before the analysis, and I was sleeping pretty well.

Yes, I’m thinking of taking ashwaganha and rhodiola to see if it improves.

Yes, this is what they initially thought about, but they wanted to do more tests to confirm that it was not another problem.

Pcos usually comes with high estrogen, high testosterone and insulin resistance, and I don’t have anything of this. The source of my pcos seems to be more of an adrenal issue, I usually have problems when my stress rises, I stop ovulating and everything seems to go down.

Any tests for thyroid antibodies? To rule Hashimoto’s or Graves?

What does your daily fat intake look like? What about grains? What you have described is a low-fat diet. Are you eating wild cold water fish or supplementing with a high quality EPA/DHA oil? Nut butters, grass fed butter, dairy, etc? What would you say your average daily caloric intake is?

No, I will ask my doctor about it.

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I use virgin olive oil in salads and also to cook on a daily basis. Depending on the season I often eat walnuts or hazels, and around two times a month I cook with pork lard.

I also eat pork meat, usually rich in fat, around once a week.

I drink a glass of whole milk kefir every day.

I don’t eat fish, I used to supplement with krill oil last year. Now I’m eating a lot of flaxseed (I started after the last analysis) so I have stopped supplementing.

I don’t eat much grains compared to other people, I don’t usually eat bread or pasta, but I eat brown rice and grains like quinoa at least one time a week, and I eat oats for breakfast.

I have no idea, but I eat more than average women, for what I have seen. I would say a minimum of 2000 calories.

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I can tell you my doc (Dr. Nichols) specializes in helping woman with hormones. He has almost an strong amount of woman to women ratio I believe and you might want to consult him. His wife is a NP and works with him. He brings allot of female hormonal science to the table when optimizing men and has a great insight.

Same doc told me the following . Woman are way way way more sensitive to thyroid then men are: men are more sensitive to hormonal changes like estrogen and Free T.

Keep that in mind and look at your thyroid levels. Your thyroid levels are very low, unless your in the 60s.

Quick google search says thyroid controls menstrul cycles in woman.

I would look into the thyroid. Potentially Take the t4 and t3 medication. Don’t waste your time with the t4 only. It’s a failed medicine.

Google “dr.rouzier thyroid”on YouTube he mentions this exact same issues…

Better yet here it is and he has many more.

Don’t forget to get a new thyroid panel. Get the free t3… I think @systemlord can tell u which labs to get.

Do not use an endo for this issue. They will never treat you. They’ll say it must be something else. Or give you t4… find a doc like Nichols who helps woman optimize hormones.

Why would you say this? One test her TSH was .04
I don’t think there is enough info to make that recommendation.

Her t4/t3 is low regardless of tsh. I know we want free t3 as an indicator but if those are low , then what else is low?

Good catch You are right. I will re word and say look into thyroid instead of outright optimize it… Apologies.


I know TSH is not the holy grail, but definitely agree it is worth checking into.

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Ya I hope that’s the answer for her.

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Were your thyroid tests free T4 and free T3? I would get those with TSH. Also, look into taking progesterone.

On the surface, it looks like pcos, about 20-25% of pcos patients are thin. But, insulin is fine and free test very low, in spite of low SHBG. PCOS patients are often hypersexed with high free test.

Please keep us posted.


I also think my thyroids are a bit low, and the 2016 analysis was just weird, with very low TSH and almost low T3 and T4.

I will do another thyroid analysis, as complete as possible.

Thank you all, I will keep you posted.

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