Functional Hypothalamic Amenorrhea (FHA)

FIRST VISIT LABS: 

CYCLE DAY 3- FASTING: 

Health Labs: 

• CBC: Complete blood count
• CMP: Comprehensive Metabolic Panel - to look at baseline kidney and liver function
• Vitamin D level 
• glucose, 3 specimen & insulin, 3 specimen

*note glucose and insulin handout below

Reproductive Labs: 

• FSH/LH and estradiol 
• Prolactin: no nipple stim, sex or rigorous exercise 48 hrs prior to draw. 
• 17OH progesterone: drawn prior to 8AM. 

Comprehensive Thyroid Panel: 

• TSH/FT4
• Total T3/Free T3
• anti-TPO and anti-Thyroglobulin antibodies
• Thyroid Stimulating Immunoglobulins 
• Iodine levels 

Androgen Panel: 

• Testosterone, Total
• Testosterone, Free
• SHBG (Sex Hormone Binding Globulin)
• DHEAs
• androstenedione

SECOND VISIT LABS: 

 Hormone Panels: 

• Peri ovulatory estradiol panel: start on CD8, go to the lab EOD for an estradiol draw, until you have one draw post-peak. 
• post-Peak estradiol and progesterone panel: P+3, 5, 7, 9, and 11. See Handout #3 on the the Patient Handout webpage 
• Hormone panels require 2 mos of CrMS charting AND the patient must be able to confidently identify her Peak day.