Where Do I Start? So Many Things Wrong

[CaliforniaKat]

Hi all,
I have lurked on the forum for a while but haven't posted much and haven't implemented much that is Peat-y.

I'll try to keep this short. Been low carb on and off for years. Lose when I am LC, gain back when I'm not. I currently have 30 or so pounds to lose. I'm 5'7 and 195.

In the last year these are my issues, tho some have been issues for much longer than a year.
1. High stress at my job, which is now lessened but was bad for 2 years.
2. Mid-brain stroke in January. I am 46 years old.
3. Bad periods.
4. Horrible high cortisol and insomnia, leading to panic attacks for the first time in my life.
5. Since start of July I am taking gabapentin through day and night (600-700 mg total) and 7.5 mg of mirtazapine.
6. Am a hypothyroid sufferer for decades. Currently taking 2 grains Armour. Had sky high Rt3 years ago and used cytomel to banish it and symptoms then. Was great on t3 only for years until cortisol issues came up in past year.
7. Teeth have become partly translucent and have been using Pronamel toothpaste for years already. Recently added remineralizing drops and earth paste every other day.

What do I do first? I want off the GP meds as soon as possible, but not sure where panic is coming from and truly frightened of GP and possible withdrawal while tapering. Also need to sleep! GP works for that for now, but don't want to be on it.

I need to fix the cortisol issue too, but don't know where to start. I'm a single parent so I have to work and need viable suggestions to get all this under control.

Food first? Meds taper first? Progesterone? T3 only?

Please help!! And thank you in advance. There is a ton of info on this forum and my searching just leads to more questions.

What to do first? Then what to do next, etc., to make this all get better?

 

[CaliforniaKat]

My vitamin D is good. Was 80 when tested on March. I take Mg, D, K2, and Thorne brand multi with B complex daily/minerals daily.

I am still eating low carb-ish. Decaf coffee with coconut oil, half and half and hydrolyzed gelatin in a.m. 2 eggs with zucchini and mushrooms, cooked in butter or coconut oil. 1 cup blueberries. Or whole milk Faye Greek yogurt instead of eggs. Lunch is usually cheese and Turkey or ham slices with raw carrots and cup of whole milk. Dinner is a meat, veggies meal. Powerade zero, 32 oz, at some point in the day. Milk before bed, sometimes with a little cereal.

Cheese and butter are grass fed. Meat, eggs, yogurt, and milk are not. Grass fed/pastured is expensive, though from my understanding it is much lower in PUFA when grass fed.

 

[Blossom]

Welcome @dodg4kat. I understand your desire to get off the meds.
I personally think getting adjusted to adding in more carbs first would make the med titration/weaning process less stressful but that's just my personal opinion.
Ultimately I don't think there's one absolute correct way to go about achieving your goals. I think it's more a matter of what is most tolerable and sensible for your life and situation.
I'm sure you'll get lots of suggestions here.
Also pulse and temps would be helpful to know.

 

[CaliforniaKat]

Morning temps are in the 97.2-97.5 range. Was 97.31 yesterday and I'm on day 17 of my cycle. Haven't been tracking midday temps since before going on the Gabapentin and Mirt. Prior to that they were not 98.6, were lower.
Last time cholesterol was checked, early June, it was 158. Pulse is usually in the mid 70s during the day at rest, upper 60s overnight according to my Fitbit.

Last tsh and thyroid labs were way back in march. New labs coming at the end of August. The newly surfacing panic put adjusting thyroid on hold. I know it is not high. Last labs were tsh of 0.8 and t4/t3 were on the bottom of the range. Was taking 90 mg of Armour at that time. Now taking 120 mg of Armour.

I wonder if the panic was high serotonin, or new high cortisol symptoms, or cross reaction to meds I was (but no longer) taking. It was so bad for about a month, including insomnia, hence the current meds. That month is a long story that I won't get into now. Conventional doc/psych still can't tell me what happened, whether it was a cross-reaction to other meds (was taking berberine for several months after high insulin test in Feb), or what, and whether it is still there or not. Ugh!

 

[Travis]

Hi all,
I have lurked on the forum for a while but haven't posted much and haven't implemented much that is Peat-y.

I'll try to keep this short. Been low carb on and off for years. Lose when I am LC, gain back when I'm not. I currently have 30 or so pounds to lose. I'm 5'7 and 195.

In the last year these are my issues, tho some have been issues for much longer than a year.
1. High stress at my job, which is now lessened but was bad for 2 years.
2. Mid-brain stroke in January. I am 46 years old.
3. Bad periods.
4. Horrible high cortisol and insomnia, leading to panic attacks for the first time in my life.
5. Since start of July I am taking gabapentin through day and night (600-700 mg total) and 7.5 mg of mirtazapine.
6. Am a hypothyroid sufferer for decades. Currently taking 2 grains Armour. Had sky high Rt3 years ago and used cytomel to banish it and symptoms then. Was great on t3 only for years until cortisol issues came up in past year.
7. Teeth have become partly translucent and have been using Pronamel toothpaste for years already. Recently added remineralizing drops and earth paste every other day.

What do I do first? I want off the GP meds as soon as possible, but not sure where panic is coming from and truly frightened of GP and possible withdrawal while tapering. Also need to sleep! GP works for that for now, but don't want to be on it.

I need to fix the cortisol issue too, but don't know where to start. I'm a single parent so I have to work and need viable suggestions to get all this under control.

Food first? Meds taper first? Progesterone? T3 only?

Please help!! And thank you in advance. There is a ton of info on this forum and my searching just leads to more questions.

What to do first? Then what to do next, etc., to make this all get better?

There are melatonin receptors on the adrenal cortex that lower cortisol output.

 

[CaliforniaKat]

There are melatonin receptors on the adrenal cortex that lower cortisol output.

So you're saying to take melatonin?

 

[Travis]

So you're saying to take melatonin?

Melatonin most certainly has the potential to lower cortisol output, but the timing of the dose matters a good deal. The first convincing demonstration of melatonin's cortisol-lowering effect had been done using adrenals from monkeys, in vitro,⁽¹⁾ and a similar demonstration in human cells had shortly followed.⁽²⁾ Yet, melatonin does not lower basal cortisol directly; melatonin abrogates the adrenals' response to ACTH by partially-inhibiting its' induction of 3β-hydroxysteroid dehydrogenase, thereby lowering 3-oxo sterol synthesis and cortisol output a few hours in advance.⁽¹⁾⁽²⁾⁽³⁾ This effect has also been demonstrated in live humans: Six milligrams of melatonin had reduced the ACTH-induced cortisol response from +14.6 μ/dl to +10.8 μ/dl, in eight males, as measured one hour later.⁽³⁾ Two milligrams taken at six p.m. has been shown to cause a slight cortisol reduction the next day,⁽⁴⁾ yet melatonin could have been acting through a more indirect mechanism. Since ACTH peaks at six a.m.,⁽⁵⁾ it might be fair to assume that ~400 μg of melatonin taken at five a.m. would lower cortisol concentrations for the rest of the day.

[1] Torres-Farfan, C. "mt1 Melatonin receptor in the primate adrenal gland:" The Journal of Clinical Endocrinology & Metabolism (2003)
[2] Campino, C. "Melatonin exerts direct inhibitory actions on ACTH responses in the human adrenal gland." Hormone and Metabolic Research (2011)
[3] Campino, C. "Melatonin reduces cortisol response to ACTH in humans." Revista medica de Chile (2008)
[4] Terzolo, M. "Effects of long‐term, low‐dose, time‐specified melatonin administration on endocrine and cardiovascular variables in adult men." Journal of pineal research (1990)
[5] Motomatsu, T. "Human plasma proopiomelanocortin N-terminal peptide and adrenocorticotropin: circadian rhythm, dexamethasone suppression, and corticotropin-releasing hormone stimulation." The Journal of clinical endocrinology and metabolism (1984)​

 

[Broken man]

What about your energy levels?

 

[CaliforniaKat]

What about your energy levels?

They are ok but not great. I get tired in day, but can't nap because of cortisol.

This morning's waking temp was 97.9, but two days ago it was 97.3. Yesterday's noon temp was 98.6, and 3 PM temp was 98.4. But two days ago I had no temps above 98.0 for the whole day.

Still looking for help and some concrete steps to take.

Food first? Taper gabapentin first? Add progesterone? I know cortisol steal was happening the last time cortisol was tested. Change to t3 only?

 

[Zpol]

Progest-e didn't work for me (no idea why), Rx progesterone vag suppositories helped a bit but not much, but Progestelle worked like a charm for all things menstrual related. I take 3 3/4 full droppers, massaged into inner thighs, on days 18 thru 28. Now my periods have normalized, no more spotting, and pain is so minimal I don't even need to take a pain killer on day one or during ovulation (I used to get stabbing pain during ovulation). This is in addition to eliminating body products that are estrogenic of course. I wish I could help more besides my n=1 experience but you are in the right place to find answers.

 

[Travis]

Bromocriptine also works reliably to lower ACTH, and cortisol in turn:

Atkinson, A. Brew. "Six year remission of ACTH-dependent Cushing's syndrome using bromocriptine." Postgraduate medical journal (1985)
Lamberts, S. W. "The mechanism of the suppressive action of bromocriptine on adrenocorticotropin secretion in patients with Cushing's disease and Nelson's syndrome." The Journal of clinical endocrinology and metabolism (1980)​

 

[CaliforniaKat]

@Zpol is progesterone supplementation what you would recommend first?

@Travis that is interesting about bromocriptene, I took it years ago for other reasons, mainly high prolactin after stopping breastfeeding. I *may* have pcos. Doc was sure, but I don't have the masculinization or the infertility. I *do* have high insulin even when low carb. Last blood work had fasting blood sugar at 85 and insulin at 28. (Out of range high, range ended at 22)

I have no idea how to go about switching up food to more Peat-y, partly because of the insulin/IR issue. I lost 60 pounds this year, and still have about 30 pounds I could lose to be 'normal' weight. I really, really don't want to gain weight with diet changes, and have read that several people here have. Plus I work in a school, so eating every few hours isn't always possible.

I have read the book by Kate Deering and read lots on the forum. I just have so much indecision...

 

[Kartoffel]

All of the three major steroids that Peat mentions most are likely to lower cortisol and help you cope with stress. Peat says that pregnenolone lowers cortisol levels by reducing ACTH but I haven't looked for a study to confirm this. DHEA has been shown to lower cortisol significantly in many studies, and the ratio of DHEA:Cortisol seems to be a very important factor in stress tolerance. I think progesterone is also likely to reduce cortisol in the long run. Of course, enough carbs are important.

"Lowering excessive cortisol to normal (via prevention of over-activation of ACTH) is its best known effect--in fact, it's the only effect that would be described as hormonal." (Ray)
​

J Clin Psychopharmacol. 2003 Feb;23(1):96-9.
Influence of DHEA administration on 24-hour cortisol concentrations.
Kroboth PD1, Amico JA, Stone RA, Folan M, Frye RF, Kroboth FJ, Bigos KL, Fabian TJ, Linares AM, Pollock BG, Hakala C.

Abstract
DHEA is marketed and readily available as a daily nutritional supplement to counteract the effects of aging. The effect of DHEA administration on 24-hour plasma cortisol profiles has not been investigated. In this single-blind placebo-controlled crossover study, the effect of DHEA administration on cortisol concentrations was evaluated in healthy older women and men. Once each morning, subjects took either placebo (Days 1 to 7, and 23 to 29) or oral DHEA 200 mg (Days 8 to 22: doses 1 to 15). Twenty-four hour DHEA and cortisol concentrations were measured on Day 1 (placebo), Day 8 (DHEA dose 1), Day 15 (DHEA dose 8), Day 22 (DHEA dose 15), and Day 29 (placebo washout dose 7). DHEA administration resulted in a decrease in plasma cortisol concentrations (mean, peak, and/or AUC) in healthy older women and men. The cortisol-lowering effect of DHEA was more pronounced in women than in men in our study; pairwise differences in concentrations between days showed that relative to Day 1, cortisol was lower on Days 15, 22, and 29 in women (p = 0.0001) and on Day 15 in men (p = 0.002). The mechanism by which DHEA lowers plasma cortisol concentrations merits further investigation.

 

[CaliforniaKat]

@Kartoffel are they safe? I already had a stroke last January. I am 46 and had none of the harbingers of stroke...not high blood pressure, not diabetes, not high cholesterol, etc. But I was using progesterone cream and dhea at that time. Docs in the hospital told me to stop because they can produce excess estrogen and lead to stroke. They never actually tested my hormones when they told me that. However, I did stop. Have been off since. High cortisol showed up in Feb.

 

[Zpol]

@Zpol is progesterone supplementation what you would recommend first?

I think you should check eliminate all body products that are estrogenic first, then add in progesterone. Reason being, most people have estrogen dominance, not necessarily low progesterone. Body products are one of the biggest contributors to this, in addition to environmental sources and some foods. Shampoos, soaps, cleansers, detergents are the easiest to change so I'd start there and then add in the Progesterone.
Progesterone needs to be 'in balance' with estrogen.
Dietary changes could be done simultaneously. I know it's hard to get in small snacks throughout the day. Perhaps you could have thermos full of OJ+collagen or lowfat milk that you could take a few swigs of between classes?

 

[Kartoffel]

@Kartoffel are they safe? I already had a stroke last January. I am 46 and had none of the harbingers of stroke...not high blood pressure, not diabetes, not high cholesterol, etc. But I was using progesterone cream and dhea at that time. Docs in the hospital told me to stop because they can produce excess estrogen and lead to stroke. They never actually tested my hormones when they told me that. However, I did stop. Have been off since. High cortisol showed up in Feb.

They told you that progesterone can produce excess estrogen? What kind of progesterone cream were you taking, and how much? What kind of DHEA product, and how much? Progesterone is extremely protective for the brain and has been used in clinical trials to protect from, and reverse brain damage. I don't think there is any way that natural progesterone can increase the risk of having a stroke.

Progesterone improves long-term functional and histological outcomes after permanent stroke in older rats
Progesterone in experimental permanent stroke: a dose-response and therapeutic time-window study
Progesterone in the clinical treatment of acute traumatic brain injury. - PubMed - NCBI

 

[CaliforniaKat]

These are what I was using. One pump of cream per day and was up to 3 sprays of dhea per day. Dhea spray says it can increase estrogen on the label.

 

[CaliforniaKat]

I think you should check eliminate all body products that are estrogenic first, then add in progesterone. Reason being, most people have estrogen dominance, not necessarily low progesterone. Body products are one of the biggest contributors to this, in addition to environmental sources and some foods. Shampoos, soaps, cleansers, detergents are the easiest to change so I'd start there and then add in the Progesterone.
Progesterone needs to be 'in balance' with estrogen.
Dietary changes could be done simultaneously. I know it's hard to get in small snacks throughout the day. Perhaps you could have thermos full of OJ+collagen or lowfat milk that you could take a few swigs of between classes?

Again, sorry for what might be a stupid question but....how do I know if soaps, shampoos, etc are estrogenic?

 

[Kartoffel]

These are what I was using. One pump of cream per day and was up to 3 sprays of dhea per day. Dhea spray says it can increase estrogen on the label.

These products look absolutely horrible, and it's good that you discontinued them. I doubt that you would absorb a lot of the topical progesterone, and the product contains a lot of terrible ingredients, and very likely a myriad of toxic impurities that are not listed - you probably absorbed much more of those than any progesterone. The only safe and effective vehicle for progesterone is vitamin E. The "liposomal" DHEA sounds like a Frankenstein creation, as well. If you want to take progesterone, the only product I can recommend (I know many women using it successfully) is Peat's Progest-E. As far as DHEA is concerned, I would buy it as a pure powder and dissolve it in some olive in order to take it orally in doses around 5-10mcg. It's true that DHEA can convert to estrogen, if aromatase is high and you take too much. Of the three steroids DHEA is definitely the one that should be used most carefully.

 

[CaliforniaKat]

And those products were recommended by a Naturopathic doc who was also helping me with thyroid...she is no longer someone I see for other reasons. I see a different Naturopathic doc for thyroid now. He recommended Great Lakes collagen and gelatin in my first appointment. But also recommended taking 5-htp..which caused me problems...so there's that.

I want a magic bullet please..lol..something that fixes everything!! (Mostly kidding, but it would make my day if there was one)