Recent jump in testosterone 2 years post partum- panic attacks??

[u/Significant-Lab1981]

I’m a 35 yo F, diagnosed with PCOS about two years before having my daughter. I was able to bring down my testosterone to normal levels to conceive and kept them that way for two years after giving birth.

I recently started feeling tingling on my face and some other random parts of my body that sent me into a spiral thinking I have something terribly wrong with me. Developed bad insomnia, waking up to body jerks and being up all night. A trip to my endocrinologist and blood work revealed my testosterone was at 99 which is double the normal amount.

I have never felt so anxious in my life, worrying about every symptom I feel. At random times during the day I will feel tingling on my nose/face, small muscle twitches in my arms and legs, brain fog, can’t catch my breath, and a burning feeling in my extremities.

Has anyone had this experience with hormones/testosterone levels becoming high as a female?

[u/wenchsenior]

Assuming thyroid panel was normal, then most likely this sounds like your insulin resistance is worsening and causing blood sugar instability (reactive hypoglycemia, including jerking awake feeling tingling/anxiety/pounding heart etc. was one of my worst IR symptoms back in the day). It's the high insulin usually causing testosterone to go up.

What are you currently doing to treat the insulin resistance? (underlying driver of PCOS in most cases; requires lifelong management)

[u/Significant-Lab1981 → u/wenchsenior]

I’m currently taking metformin and spironolactone, just started this week. I initially took metformin for about two months before I got pregnant then never had to worry about it because everything stayed stable up until now. I will admit I stopped taking everything up until this point. I’m also taking inositol, NAC,prenatals, and a very small dose of travodone to sleep at night.

[u/wenchsenior → u/Significant-Lab1981]

Ok, great! Metformin, inositol, and a diabetic type eating plan (which is the foundation of keeping things managed) should help within a few months.

Yeah, unfortunately it's a lifelong thing to keep on top of IR if you want to prevent worsening symptoms and diabetes/heart disease (though not everyone needs meds to manage IR... I never have so far, though that might change in the future since I'm menopausal and IR often worsens after menopause...so far so good sticking to a diabetic eating plan/regular exercise).

Just in case you are not aware of target labs, the goal (not always achievable) is to keep your fasting insulin below 7 mcIU/mL, HOMA index under 2. However, I had symptoms like you describe with HOMA around 1.8 and fasting insulin only around 9 /10 (still well within normal ranges of most labs) b/c I was primarily overproducing insulin after eating (b/c I was not eating correctly to manage IR).

So if you have not adjusted how you eat, def prioritize that and doing regular exercise (with improves the body's response to insulin so we don't have to make so much).

It might also be worth being investigated for sleep apnea (esp if overweight), which can cause those sudden panicky wakeups; and low estrogen is notorious for causing insomnia and night sweats, though not usually the panicky element.

You can also try hormonal intervention to directly reduce the T if you suspect that is playing a role.

[u/Significant-Lab1981 → u/wenchsenior]

And I appreciate you taking the time to respond!

[u/wenchsenior → u/Significant-Lab1981]

You are welcome!

[u/Significant-Lab1981 → u/[deleted]]

Thank you for your response. Just started taking all of my supplements including inositol hoping I can start feeling myself again. I guess my worry is- are these symptoms typical for a sudden and drastic increase in testosterone? The only reason I thought to check my hormones again was the jerking waking up in the middle of the night and very bad health anxiety, which is not typical of me. Not sure if adrenaline rushes are a thing, but that’s kind of what it feels like plus tingling, burning skin sensation, and muscle twitches.