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High testosterone in women does NOT automatically mean PCOS. When I see elevated testosterone on a blood test, I’m much more interested in why it is elevated and where those androgens are coming from. Women naturally produce androgens. They’re produced predominantly by the ovaries and adrenal glands, with additional peripheral conversion occurring in other tissues. In the ovaries, LH stimulates theca cells to produce androgens. But there’s another important driver that can amplify this process: insulin. When insulin is persistently elevated, it can act alongside LH to increase ovarian androgen production. This is one reason hyperinsulinaemia can be such an important driver of androgen excess in some women with PCOS. But insulin can affect testosterone from another direction too. Higher insulin can suppress hepatic production of SHBG — sex hormone-binding globulin. SHBG binds circulating testosterone, so when SHBG falls, the proportion of testosterone that is free and biologically available can increase. This means you can experience clinical signs of androgen excess without having an extraordinarily high total testosterone result. And PCOS isn’t the only explanation. The adrenal glands also produce androgens, including DHEA and DHEAS. If these are elevated, I start thinking about whether there may be a greater adrenal contribution. Medications can influence androgen levels, and significant or rapidly developing androgen excess can require further medical investigation to exclude less common ovarian or adrenal causes. This is why I don’t interpret testosterone in isolation. I want to understand total testosterone, SHBG, calculated free testosterone/free androgen index, DHEA/DHEAS, alongside menstrual patterns, ovulation, clinical symptoms and metabolic markers such as insulin. Because “high testosterone” is a finding. It isn’t the diagnosis. The more important clinical question is: what is driving it? If you’ve been told you have elevated testosterone or you’re investigating PCOS, this is something we can work through at Nourishing Apothecary. Danielle and Toni both work extensively with women’s hormonal and metabolic health. You can book a free discovery call to discuss your case and determine the right practitioner for you at nourishingapothecary.com. #HighTestosterone #PCOS #Androgens #WomensHormones #HormoneHealth
High testosterone in women does NOT automatically mean PCOS. When I see elevated testosterone on a blood test, I’m much more interested in why it is elevated and where those androgens are coming from. Women naturally produce androgens. They’re produced predominantly by the ovaries and adrenal glands, with additional peripheral conversion occurring in other tissues. In the ovaries, LH stimulates theca cells to produce androgens. But there’s another important driver that can amplify this process: insulin. When insulin is persistently elevated, it can act alongside LH to increase ovarian androgen production. This is one reason hyperinsulinaemia can be such an important driver of androgen excess in some women with PCOS. But insulin can affect testosterone from another direction too. Higher insulin can suppress hepatic production of SHBG — sex hormone-binding globulin. SHBG binds circulating testosterone, so when SHBG falls, the proportion of testosterone that is free and biologically available can increase. This means you can experience clinical signs of androgen excess without having an extraordinarily high total testosterone result. And PCOS isn’t the only explanation. The adrenal glands also produce androgens, including DHEA and DHEAS. If these are elevated, I start thinking about whether there may be a greater adrenal contribution. Medications can influence androgen levels, and significant or rapidly developing androgen excess can require further medical investigation to exclude less common ovarian or adrenal causes. This is why I don’t interpret testosterone in isolation. I want to understand total testosterone, SHBG, calculated free testosterone/free androgen index, DHEA/DHEAS, alongside menstrual patterns, ovulation, clinical symptoms and metabolic markers such as insulin. Because “high testosterone” is a finding. It isn’t the diagnosis. The more important clinical question is: what is driving it? If you’ve been told you have elevated testosterone or you’re investigating PCOS, this is something we can work through at Nourishing Apothecary. Danielle and Toni both work extensively with women’s hormonal and metabolic health. You can book a free discovery call to discuss your case and determine the right practitioner for you at nourishingapothecary.com. #HighTestosterone #PCOS #Androgens #WomensHormones #HormoneHealth

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