Advice For Getting Back On Track After A Miscarriage

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j2mugs

j2mugs

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I just listened to it this weekend actually. :) It's a really good episode, but unfortunately I didn't get any new insights from it.
Actually, @haidut since this episode prompted me to post this thread - I thought I'd reach out to see if you have any thoughts on this?
 
OP
j2mugs

j2mugs

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Keep us posted as able.

Thank you so much for your help and thoughts! I'll look into East West Healing for sure. I'll be sure to post her blood work once we've gotten the results to see if anyone has any thoughts at that point.
 

alywest

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Thanks again for all of your thoughts and support on this.

@Peatful - Yes I had read that article, thanks for sending it along. In regards to her calcium and vitamin A intake I would be open to additional suggestions if this seems inadequate. Currently she is getting a minimum of 1700mg of calcium from her diet each day. She is taking no calcium supplements. I know on many days she is approaching closer to 2000mg so I haven't worried about those levels at all. We also avoid phosphate rich foods (grains, beans, and eat muscle meats sparingly - maybe once every 10 days). I assumed that was more than enough calcium and since we were reducing the phosphate intake that it would help reduce prolactin. I also assumed between the weekly liver, the daily cheese, daily butter and well cooked vegetables like winter squash and spinach a few times a few week that she would be getting adequate vitamin A from her diet. Is there anything else we should add or change? I saw kale as a suggestion earlier, but I feel like that should already be sufficient on the dietary vitamin A.

@alywest - Incidentally, regarding Ona's Progesterone, Suzanne was topically using 800mg per day of it before I spoke with Ray Peat. It was basically doing nothing for her and since the amount was so high I was worried about a deeper problem at work. He suggested Progest-E at that point and she has been using it ever since. She always applies it to the gums and rubs it in as he suggests. I haven't read much of anything on people taking over 100mg of Progest-E per day which is why I assumed it was high for a non-pregnant woman. We were working with a "peaty" naturopath who was constantly freaking out about her taking 75mg per day - saying that was too high. She described the feeling as being "drunk" (which is funny because I don't think she has ever been drunk in her life), so it's probably not an accurate descriptor. She was VERY groggy though and did sleep well that night. But it was interfering with the last three hours of the day so she wanted to avoid that in the future.

Again, her case seems unique. We started "Peating" with zero supplements. And after two years of eating peat-like she saw some improvements in her pulse, temp, hair loss, etc. But she was never able to get her waking temp over 97.2, loose an ounce of weight, or have more than 2 periods in a year until we started supplementing. We have helped several friends change their diet alone and seen tremendous changes (myself included), so I know this can be done without supplementation. I would prefer for her to not be on any supplements but without them her issues only worsen. Which is why I keep circling back to the fact that there must be something much more systemic at work. I have read everything I can get my hands on by Ray Peat, listened to every KMUD episode and read this forum like crazy for over two years and I have not yet come across a case similar to hers which is why I'm reaching out for help.

@sweetpeat - I think you're right - bloodwork might be the next best step. We talked about it last night and she is going to stop taking all of the Progest-E and let this flow finish on its own. Then we figured that we would do blood work a couple of days after flow stops and without adding the progesterone back in. Any thoughts on what all should be included in the test? Our medical sharing provider has some basic panels that we can get done relatively inexpensively. Would this one suffice or should I be looking for something else?
CMP - Comprehensive Metabolic Panel w/ eGFR
Complete Blood Count with Differential - CBC w/Diff
Estradiol
FSH - Follicle Stimulating Hormone
LH - Luteinizing Hormone
Testosterone - Total - LC/MS/MS
TSH - Thyroid Stimulating Hormone
T-3 Uptake
T-4 Total
T-4 Free
Vitamin B12 and Folic Acid
Vitamin D


Thanks again for the generosity of your time and for your input as we try to figure this thing out!
Another thing to consider is going to a reproductive health specialist/ob-gyn who will do all of those labs (although, annoyingly, in my experience I had to request progesterone labs) but she might want to get an ultrasound of her uterus. No doc or ob-gyn ever diagnosed me with endometriosis until I went to one and had an ultrasound without pregnancy. I've had two children and two miscarriages and none of those times did a doctor think to check for that, so...
 
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j2mugs

j2mugs

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Thanks again to everyone who posted their thoughts. My wife got her blood test back today and so I'm throwing it up here to see if there are any thoughts.

A couple of notes and to recap
  • This was a fasted test done Tuesday (1/29/2019) morning
  • Flow from her last cycle stopped on Friday (1/25)
  • Her last cycle was wonky because we were trying to stop it via high levels of progesterone so I'm counting her start date for this cycle as the first full day she did not take progesterone (she had been spotting for 2.5 weeks prior to that because of the attempted cycle suppression). This should be a pretty good guess because her days match up pretty well to a normal cycle once she stopped the progesterone completely (she stopped taking progesterone on 1/21).
  • Flow was from 1/22 -1/26 (she normally has 5 days of flow so nothing out of the ordinary here).
  • She technically took the blood test on day 8 of her cycle. However because her cycle is so short I'm not sure which phase she was actually in at the time of the test.
  • She "felt" like she was "ovulating" (we don't think that she actually is ovulating) on Monday the 28th (she usually feels this way 2 days after flow ends)
  • She started getting acne and a cold sore last night which typically means that today she is about 3-4 days away from flow starting (you can see why this is bothersome to her).
  • So all of that to say her blood test was taken on technical day 8 but in reality it might be closer cycle wise to day 15 or 16 because her cycle is so short.
  • Obviously the D level looks low, she is currently supplements 2,000IU per day via EstroBan applied topically in 2 half doses throughout the day (1,000 IU each dose)
  • Her TSH was shocking to me because almost exactly one year ago at her last OB/GYN appointment before her D&C her TSH was 0.06.
  • Her progesterone levels seem ok if she is in the follicular phase but very low if she was functionally in the luteal phase on Tuesday (which I suspect)
  • She is currently taking 120mcg of T3 per day topically with Tyronene (divided into 15 hourly doses throughout the day)
  • Remember we could not suppress her cycle with her taking 100+mg of Progest-E orally each day
  • Again her resting pulse is low (maybe peaking at 70 during the day) and her taking temp is 96.8-97.0 currently, her hands and feet are cold all of the time now. It's like everything basically rolled back to 2016 for her. So any thoughts on what to do next - I'm out of ideas.
Thanks in advance!

Blood Test 1/29/2019
FSH 5.6 mIU/mL
LH 6.8 mIU/mL
GLUCOSE 98 65-99 mg/dL
GLUCOSE 98 65-99 mg/dL 01
UREA NITROGEN (BUN) 15 7-25 mg/dL
CREATININE 0.70 0.50-1.10 mg/dL
eGFR NON-AFR. AMERICAN 113 > OR = 60 mL/min/1.73m2
SODIUM 142 135-146 mmol/L
POTASSIUM 4.2 3.5-5.3 mmol/L
CHLORIDE 105 98-110 mmol/L
CARBON DIOXIDE 27 20-32 mmol/L
CALCIUM 8.9 8.6-10.2 mg/dL
PROTEIN, TOTAL 6.8 6.1-8.1 g/dL
ALBUMIN 4.3 3.6-5.1 g/dL
GLOBULIN 2.5 1.9-3.7 g/dL (calc)
ALBUMIN/GLOBULIN RATIO 1.7 1.0-2.5 (calc)
BILIRUBIN, TOTAL 0.4 0.2-1.2 mg/dL
ALKALINE PHOSPHATASE 92 33-115 U/L
AST 15 10-30 U/L
ALT 17 6-29 U/L
ESTROGEN, TOTAL, SERUM ESTROGEN, TOTAL, SERUM 210.0 pg/mL 02
PROGESTERONE 0.6 ng/mL 01
PROLACTIN 14.1 ng/mL 01
T4, FREE 0.7 0.8-1.8 ng/dL 01
TSH 4.89 mIU/L 01
T3, FREE 3.0 2.3-4.2 pg/mL 01
VITAMIN D, 25-OH, TOTAL 28 30-100 ng/mL
VITAMIN D, 25-OH, D3 28 See Below ng/mL 03
VITAMIN D, 25-OH, D2 <4 See Below ng/mL 03
 

alywest

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Joined
Apr 19, 2017
Messages
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Thanks again to everyone who posted their thoughts. My wife got her blood test back today and so I'm throwing it up here to see if there are any thoughts.

A couple of notes and to recap
  • This was a fasted test done Tuesday (1/29/2019) morning
  • Flow from her last cycle stopped on Friday (1/25)
  • Her last cycle was wonky because we were trying to stop it via high levels of progesterone so I'm counting her start date for this cycle as the first full day she did not take progesterone (she had been spotting for 2.5 weeks prior to that because of the attempted cycle suppression). This should be a pretty good guess because her days match up pretty well to a normal cycle once she stopped the progesterone completely (she stopped taking progesterone on 1/21).
  • Flow was from 1/22 -1/26 (she normally has 5 days of flow so nothing out of the ordinary here).
  • She technically took the blood test on day 8 of her cycle. However because her cycle is so short I'm not sure which phase she was actually in at the time of the test.
  • She "felt" like she was "ovulating" (we don't think that she actually is ovulating) on Monday the 28th (she usually feels this way 2 days after flow ends)
  • She started getting acne and a cold sore last night which typically means that today she is about 3-4 days away from flow starting (you can see why this is bothersome to her).
  • So all of that to say her blood test was taken on technical day 8 but in reality it might be closer cycle wise to day 15 or 16 because her cycle is so short.
  • Obviously the D level looks low, she is currently supplements 2,000IU per day via EstroBan applied topically in 2 half doses throughout the day (1,000 IU each dose)
  • Her TSH was shocking to me because almost exactly one year ago at her last OB/GYN appointment before her D&C her TSH was 0.06.
  • Her progesterone levels seem ok if she is in the follicular phase but very low if she was functionally in the luteal phase on Tuesday (which I suspect)
  • She is currently taking 120mcg of T3 per day topically with Tyronene (divided into 15 hourly doses throughout the day)
  • Remember we could not suppress her cycle with her taking 100+mg of Progest-E orally each day
  • Again her resting pulse is low (maybe peaking at 70 during the day) and her taking temp is 96.8-97.0 currently, her hands and feet are cold all of the time now. It's like everything basically rolled back to 2016 for her. So any thoughts on what to do next - I'm out of ideas.
Thanks in advance!

Blood Test 1/29/2019
FSH 5.6 mIU/mL
LH 6.8 mIU/mL
GLUCOSE 98 65-99 mg/dL
GLUCOSE 98 65-99 mg/dL 01
UREA NITROGEN (BUN) 15 7-25 mg/dL
CREATININE 0.70 0.50-1.10 mg/dL
eGFR NON-AFR. AMERICAN 113 > OR = 60 mL/min/1.73m2
SODIUM 142 135-146 mmol/L
POTASSIUM 4.2 3.5-5.3 mmol/L
CHLORIDE 105 98-110 mmol/L
CARBON DIOXIDE 27 20-32 mmol/L
CALCIUM 8.9 8.6-10.2 mg/dL
PROTEIN, TOTAL 6.8 6.1-8.1 g/dL
ALBUMIN 4.3 3.6-5.1 g/dL
GLOBULIN 2.5 1.9-3.7 g/dL (calc)
ALBUMIN/GLOBULIN RATIO 1.7 1.0-2.5 (calc)
BILIRUBIN, TOTAL 0.4 0.2-1.2 mg/dL
ALKALINE PHOSPHATASE 92 33-115 U/L
AST 15 10-30 U/L
ALT 17 6-29 U/L
ESTROGEN, TOTAL, SERUM ESTROGEN, TOTAL, SERUM 210.0 pg/mL 02
PROGESTERONE 0.6 ng/mL 01
PROLACTIN 14.1 ng/mL 01
T4, FREE 0.7 0.8-1.8 ng/dL 01
TSH 4.89 mIU/L 01
T3, FREE 3.0 2.3-4.2 pg/mL 01
VITAMIN D, 25-OH, TOTAL 28 30-100 ng/mL
VITAMIN D, 25-OH, D3 28 See Below ng/mL 03
VITAMIN D, 25-OH, D2 <4 See Below ng/mL 03
Definitely get on some T4. Even though RP says T4 is hard to convert, he still recommends it, even if it's in a 1:1 ratio. Normally it would be 4:1 under normal circumstances. I would try lysine. Lysine is Peaty, good at fighting viral infections, and it's a 5-Ht4 receptor antagonist. Win win. It's weird how viral infections flare up around the period. This happens to me, too. I also read some interesting information about cutting down to a 2-3% progesterone cream two days before the period starts. I believe progest-e is around a 10% concentration. If I just stop taking progesterone right before my period it leaves my estrogen totally unopposed, meaning that I get severe migraine symptoms. So taking small amounts of 2% progesterone cream once you stop the high dosing of progest-e might be a better way to allow her period to start without totally cutting off the progesterone supply. It's normal for the estrogen to be high during the follicular phase, and she's probably about to ovulate. You can really predict the day of ovulation from the first day of flow. Use an app like "my calendar", it's free and after two months of tracking her flow days (record all of them, even if she's just spotting) it will be able to start predicting your ovulation. Also, buy a basal thermometer on Amazon and get one that comes with some free ovulation testing strips. That way you can really track her thyroid by under armpit temperature and also predict ovulation in one fell swoop! You can also get an app that connects with a basal thermometer on Amazon, so that you can track the temps that way and it will also give you a better idea of where she's at in the cycle. I have found that the tracking and recording has been the most important step for me in getting some control of my situation with menstrual migraines. Also get a topical vitamin D supplement if you haven't yet. I have heard RP say on KMUD that you can do about 12,000IU/ day which would be about the equivalent of sitting in the bright sun for a half an hour. Low D is going to mess everything up. Ok hope this helps!
 

Runenight201

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Im naive on all this hormone, bloodwork, stuff, but if you’re looking for a simple dietary way to sky rocket temperature, fatty mashed potatoes with coffee works like a damn charm.
 
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Hi j2mugs...Unfortunately your absolutely darling wife has OVERT hypothyroidism, pure and simple. Whatever preparation she's currently taking is NOT doing the job. She desperately needs real (oral) T3 and maybe lots of it.

I wrote to Dr. Peat asking why some folks (women in particular) seem to need what he would refer to as "unphysiological doses" of T3. He acknowledged that there are SOME women who do need very high doses. I also mentioned to him that my dose changes seasonally, I personally need a lot more T3 in Winter and next to nothing in the Summer. Thank goodness I finally found an MD that would actually listen to me and I got a prescription for high dose T3 only. My doc trusts me to titrate according to pulse, temperature and seasonal need.

I emailed a photo of my prescription bottle to Dr. Peat so he could see for himself the (unphysiological) dose my doctor has prescribed (and to note that I'm under the care of a physician). He asked me for several labs. I showed him labs that were taken with NO thyroid hormone and labs taken with high dose T3 and MAN WHAT A DIFFERENCE!!! As a side note, the time of day and time of year when blood gets drawn also makes a difference.

Anywho, Dr. Peat gave me some pointers to be on lookout for in case I get too much. I'll post his direct quote here for you and your wife should you decide to take the bull by the horns:

"If the T3 were too much, it would cause you to overheat, with a fast pounding heart, a tendency to lose weight even while eating a lot, to need to drink a lot of fluids, and you would have a high oxygen requirement, getting out of breath easily. Sensitivity to T3 sometimes increases in the spring and summer. Your cholesterol would probably go below normal." Ray Peat

My cholesterol is 185 and I don't have any of those symptoms described by Peat on my wintertime Unphysiological Dose Regime.

As you noted, your wife's vitamin D is waaaaay too low (it's no wonder she's getting cold sores), please consider a dose higher than 2,000 IU, at least for a week or two.

Especially PLEASE get your beautiful wife some real T3.... I'm guessing she's miserable being freezing cold and swollen and bleeding constantly. I also bleed too much if I don't get enough T3.

Anecdotal tidbit: I personally purchased three bottles of Tyronene back in the Fall of 2016. Maybe it was a bad batch, who knows, but it didn't do anything for me. I was on a cross country road trip at the time and by Christmas I was a non-stop bleeding hormonal wreck!!!

I was determined to enjoy my vacation so I lobbed a Hail Mary email to the Mexican Underground and guess what happened? A perfect stranger sent me six bottles of glorious Cynomel. I was in South Carolina by then and this perfect stranger had mailed the goods IN ONE DAY from Columbia, SC. OMG, the Guardian Angels are everywhere, they truly have a network. They may charge more than $13 bucks a bottle (she charged me exactly $20.00 USD plus 5.00 to mail it), but I'm sure you're all familiar with that nagging desperation to feel normal. Twenty dollars a bottle was a real deal. Especially compared to greed-driven "deals" that were offered privately on this forum.

I'm not one to cry over wasted time, money (or spilt goat milk), so I chose to view this set-back as yet another fabulous unintended experiment. Tyronene DOES NOT WORK for me. Mexican made Cynomel does work and so does American made SigmaPharm, which is a generic Cytomel.

Feeling really good on my way back across the country I decided that I never ever EVER wanted to be without real T3 again, so I made a run for the border. I parked my bus in Del Rio Texas and walked across to Acuna Mexico where I found True Salvation in Jesus Calvillo De Leon at the Farmacia del Nino. But you folks don't hafta drive there ya know, they mail Cynomel to your home. Promptly. Courteously...and for dirt cheap.

Results for: "cynomel" - Farmacia Del Niño - PHARMACY ONLINE IN MEXICO OF BRAND NAME & GENERIC MEDICATIONS, DRUG STORE IN MEXICO, MEDICINES ONLINE, PHARMACY IN MEXICO / Anointed By God

TRUE STORY WARNING!!! I was stopped at the border and refused entry back in to my own country for having found My Salvation and attempting to bring ALL of it back home with me.

Lesson Learned: Don't attempt to bring Salvation to the Masses...Know when to say WHEN.

Our ever efficient Gubment knows how much T3 is necessary to save a middle-aged menopausal hypothyroid woman and apparently there's a limit. Who knew?

I'll probably be banned for saying this, but your wife needs REAL oral T3 in tablet form Cytomel/Cynomel...AND she might very well need a higher dose than the peeps here are willing to admit.

Else with a TSH such as your wife's, find a good doctor.
 

alywest

Member
Joined
Apr 19, 2017
Messages
1,028
Hi j2mugs...Unfortunately your absolutely darling wife has OVERT hypothyroidism, pure and simple. Whatever preparation she's currently taking is NOT doing the job. She desperately needs real (oral) T3 and maybe lots of it.

I wrote to Dr. Peat asking why some folks (women in particular) seem to need what he would refer to as "unphysiological doses" of T3. He acknowledged that there are SOME women who do need very high doses. I also mentioned to him that my dose changes seasonally, I personally need a lot more T3 in Winter and next to nothing in the Summer. Thank goodness I finally found an MD that would actually listen to me and I got a prescription for high dose T3 only. My doc trusts me to titrate according to pulse, temperature and seasonal need.

I emailed a photo of my prescription bottle to Dr. Peat so he could see for himself the (unphysiological) dose my doctor has prescribed (and to note that I'm under the care of a physician). He asked me for several labs. I showed him labs that were taken with NO thyroid hormone and labs taken with high dose T3 and MAN WHAT A DIFFERENCE!!! As a side note, the time of day and time of year when blood gets drawn also makes a difference.

Anywho, Dr. Peat gave me some pointers to be on lookout for in case I get too much. I'll post his direct quote here for you and your wife should you decide to take the bull by the horns:

"If the T3 were too much, it would cause you to overheat, with a fast pounding heart, a tendency to lose weight even while eating a lot, to need to drink a lot of fluids, and you would have a high oxygen requirement, getting out of breath easily. Sensitivity to T3 sometimes increases in the spring and summer. Your cholesterol would probably go below normal." Ray Peat

My cholesterol is 185 and I don't have any of those symptoms described by Peat on my wintertime Unphysiological Dose Regime.

As you noted, your wife's vitamin D is waaaaay too low (it's no wonder she's getting cold sores), please consider a dose higher than 2,000 IU, at least for a week or two.

Especially PLEASE get your beautiful wife some real T3.... I'm guessing she's miserable being freezing cold and swollen and bleeding constantly. I also bleed too much if I don't get enough T3.

Anecdotal tidbit: I personally purchased three bottles of Tyronene back in the Fall of 2016. Maybe it was a bad batch, who knows, but it didn't do anything for me. I was on a cross country road trip at the time and by Christmas I was a non-stop bleeding hormonal wreck!!!

I was determined to enjoy my vacation so I lobbed a Hail Mary email to the Mexican Underground and guess what happened? A perfect stranger sent me six bottles of glorious Cynomel. I was in South Carolina by then and this perfect stranger had mailed the goods IN ONE DAY from Columbia, SC. OMG, the Guardian Angels are everywhere, they truly have a network. They may charge more than $13 bucks a bottle (she charged me exactly $20.00 USD plus 5.00 to mail it), but I'm sure you're all familiar with that nagging desperation to feel normal. Twenty dollars a bottle was a real deal. Especially compared to greed-driven "deals" that were offered privately on this forum.

I'm not one to cry over wasted time, money (or spilt goat milk), so I chose to view this set-back as yet another fabulous unintended experiment. Tyronene DOES NOT WORK for me. Mexican made Cynomel does work and so does American made SigmaPharm, which is a generic Cytomel.

Feeling really good on my way back across the country I decided that I never ever EVER wanted to be without real T3 again, so I made a run for the border. I parked my bus in Del Rio Texas and walked across to Acuna Mexico where I found True Salvation in Jesus Calvillo De Leon at the Farmacia del Nino. But you folks don't hafta drive there ya know, they mail Cynomel to your home. Promptly. Courteously...and for dirt cheap.

Results for: "cynomel" - Farmacia Del Niño - PHARMACY ONLINE IN MEXICO OF BRAND NAME & GENERIC MEDICATIONS, DRUG STORE IN MEXICO, MEDICINES ONLINE, PHARMACY IN MEXICO / Anointed By God

TRUE STORY WARNING!!! I was stopped at the border and refused entry back in to my own country for having found My Salvation and attempting to bring ALL of it back home with me.

Lesson Learned: Don't attempt to bring Salvation to the Masses...Know when to say WHEN.

Our ever efficient Gubment knows how much T3 is necessary to save a middle-aged menopausal hypothyroid woman and apparently there's a limit. Who knew?

I'll probably be banned for saying this, but your wife needs REAL oral T3 in tablet form Cytomel/Cynomel...AND she might very well need a higher dose than the peeps here are willing to admit.

Else with a TSH such as your wife's, find a good doctor.
I agree, at times I have taken about 75mcg of t3 per day when I was also only taking 88 mcg of levothyroxine. So clearly there is a higher need for some. I have been able to cut back after a few weeks of that but sure enough that was in the dead of winter when the days were shortest and coldest. Go figure. I have been using triyotek from mymexicanpharmacy and it works pretty well. Thanks for the direct information from Peat stating what signs to look for in taking too much. I have had a naturopath in Oregon who did prescribe me genuine cytomel, and if I were willing to pay $100 out of pocket to have regular phone consultations with him I'm sure he would keep the prescription going. The prescription itself would be covered by insurance so it's really the cost of the appointment that isn't covered by my insurance, but he did take insurance so it's possible someone else might be able to get that covered by him as well. I'd be happy to share his info to anyone who wants to PM me.
 

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