High DHEA Low Cortisol High Testosterone

Dear Ask The Doctor:  I am a 32 yr old woman who is overweight, but not obese. I work out at least 4 times per week including weight training. I was a competitive gymnast for 10 years, but even with the extreme exercise have always had issues with fat around the middle. I have never had any problems with my menstrual cycle or with conceiving children. I did have to take progesterone during pregnancy in order to keep from miscarrying, but I now have two beautiful children. I would appreciate your OPINION on the following results from my saliva test. Cortisol morning was 5.3 with normal range 7 to 10. Cortisol midday was 1.6 with normal range 3 to 6. Cortisol evening was 1.3 with normal range 2 to 4. Cortisol night was 0.7 with normal range of less than 1.5. DHEA morning was 1,080 with normal range of 33 to 496.1. No supplementation. Estradiol was 1.2 with normal range 1.2 to 8.4. Estrone was 1 with normal range 1 to 4.5. Progesterone was 80.1 with normal range 99.1 to 332.6. Testosterone was 68.5 with normal range 7.0 to 50.4. My doctor thought this possibly suggested PCOS or adrenal insufficiency. However, I do not have a lot of the normal PCOS symptoms. Thanks in advance for any advice you can give me as I am at a loss of where to go from here.
 

Dear Patient:    I would tend to agree with the diagnosis of your doctor. You have increased DHEAS and decresead progesterone. In order to confirm or check for PCOS i would advice you to check you FSH and LH levels along with also checking for your blood glucose levels and having an ultrasound of the pelvis to check the ovaries for any cyst. As mentioned it could also be a adrenal gland problem and you could get a ultrasound of the same area along with a coritsol challenge test which would help us identify where the problem lies. I hope this helps. All the best.

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