At a loss with hormone imbalance, insulin resistance (lab work attached)

[velo]

Hello everyone, this is my first post and I would like to thank everyone in advance for taking the time to read through this!

I have for about two years tried to piece the puzzle of my health together but it seems to get getting more and more mysterious. The knowledge of the members on this forum is really amazing and I would be very glad if someone would have some advice for me.

I am a woman, 26 years old, about 80 kgs and eat a mostly Peatian diet. More grains than he recommends, but I find that my temperature goes down if I don't eat a proper carby meal at mealtime (oatmeal, rice, potatoes etc.) I do a fair amount of sports but with mixed results due to fatigue, cortisol surges, the weight that doesn't move etc.

My main problem as of now is fatigue, about 15 kgs excessive weight, insulin resistance (high blood sugar, have to eat frequently, wake up in the middle of the night and have to eat), all symptoms of hormonal imbalances including cysts, irregular periods, excessive hair growth, acne etc. I have poor digestion and fairly low temperatures (36.4 at waking, and 36.7 during the day). I just don't feel well in general, with very little energy. I sleep about 9 hours a day and don't feel refreshed after.

It seems my diet full of all organic quality fat, sugars, protein etc doesn't seem to make any particular difference and since a few weeks I developed a very painful cyst that led me to do a hormone test, attached in this post. Sadly it's in German but hopefully it is possible to make something out of it. It seems that my progesterone is very very low (didn't know a test could be minus..) and DHEA and testosterone are quite high which would explain the hair growth.

I have purchased both Prog-e and a Thyroid supplement but am wary to take it. In all the great research of Dr Peat and others this is what leaves me a bit confused, there seems there should be a reason for this imbalance and how can you determine what it is? The natural steps seems to test to supplement progesterone now, but what causes the imbalance in the first place? I feel a bit of at a loss and like I am going around in circles with my diet and (failing) health endeavors. Since I don't really know the problem, I fear I will make matters even worse trying to supplement with these quite strong supplements.

I know the description was quite brief, my story is long and I tried to keep it short, please ask if there are any other questions. Hope the question makes sense and someone could read something out of my results (better than my doctor who prescribed an anti-androgen usually prescribed for men with testicular cancer, thanks for that).

 

[tara]

velo

I'm not strong on interpreting labs, but my guess is the minus sign just indicates that the progesterone level is lower than they think it should be.
Your temps seem only slightly low - I wish mine were reliably in that range. Have you checked whether it goes up or down a while after eating breakfast? That can apparently help distinguish whether it is thyroid or stress hormones that are keeping you warm. What is your resting pulse like? Any noticable goiter?
TSH 1.26 is a bit on the high side, but not extreme, if I understand Peat correctly. He likes to see it below 1.0, and probably below 0.4.

My guess is that you are missing progesterone more than you are missing thyroid hormone at this stage. You could check a list of estrogen dominance symptoms and see how many of then seem to apply. Could do the same with a hypothyroid symptom list.
Some first remedies Peat has often recommended for hormone balancing are:
- minimise polyunsaturated fats (PUFAs), eg liquid vege oils, nuts, etc. A little coconut oil can be good.
- a daily raw carrot salad, preferably with vinegar and little coconut oil or olive oil, to help remove excess estrogen that is excreted in the bowel, before it gets reabsorbed from the gut.
- enough protein and carbs. Protein for hypothyroid folks, he suggests 80-100 g. For people who are not hypothyroid, he has said they probably do best on more - eg 130-150ish.
- figure out if anything in particular is irritating your gut, or slowing it down too much. Some people find they do better with low starch - starch tends to feed bacteria, which create endotoxins, which, when absorbed from the gut, put an extra load on the liver and make it harder for it to detoxify estrogen.

If you've had a go at those things, it would be interesting to know what difference it seemed to make.

Do you happen to have cholesterol numbers? You need cholesterol in your to produce the steroid hormones, including progesterone.

Next up, if you have history of lots of PUFAs, vitamin E supplementation may help while it is slowly making it's way out of your system.
And next up, progest-e could well be worth a try.

Others might suggest additional tactics or different priorities.

For figuring out what has caused the imbalance in the first place, a bit of history might help, if you want to.

 

[haidut]

Hello everyone, this is my first post and I would like to thank everyone in advance for taking the time to read through this!

I have for about two years tried to piece the puzzle of my health together but it seems to get getting more and more mysterious. The knowledge of the members on this forum is really amazing and I would be very glad if someone would have some advice for me.

I am a woman, 26 years old, about 80 kgs and eat a mostly Peatian diet. More grains than he recommends, but I find that my temperature goes down if I don't eat a proper carby meal at mealtime (oatmeal, rice, potatoes etc.) I do a fair amount of sports but with mixed results due to fatigue, cortisol surges, the weight that doesn't move etc.

My main problem as of now is fatigue, about 15 kgs excessive weight, insulin resistance (high blood sugar, have to eat frequently, wake up in the middle of the night and have to eat), all symptoms of hormonal imbalances including cysts, irregular periods, excessive hair growth, acne etc. I have poor digestion and fairly low temperatures (36.4 at waking, and 36.7 during the day). I just don't feel well in general, with very little energy. I sleep about 9 hours a day and don't feel refreshed after.

It seems my diet full of all organic quality fat, sugars, protein etc doesn't seem to make any particular difference and since a few weeks I developed a very painful cyst that led me to do a hormone test, attached in this post. Sadly it's in German but hopefully it is possible to make something out of it. It seems that my progesterone is very very low (didn't know a test could be minus..) and DHEA and testosterone are quite high which would explain the hair growth.

I have purchased both Prog-e and a Thyroid supplement but am wary to take it. In all the great research of Dr Peat and others this is what leaves me a bit confused, there seems there should be a reason for this imbalance and how can you determine what it is? The natural steps seems to test to supplement progesterone now, but what causes the imbalance in the first place? I feel a bit of at a loss and like I am going around in circles with my diet and (failing) health endeavors. Since I don't really know the problem, I fear I will make matters even worse trying to supplement with these quite strong supplements.

I know the description was quite brief, my story is long and I tried to keep it short, please ask if there are any other questions. Hope the question makes sense and someone could read something out of my results (better than my doctor who prescribed an anti-androgen usually prescribed for men with testicular cancer, thanks for that).

As Peat says, and you have noticed, health problems are usually systemic and involve the whole body. But in your case, having high DHEA, high testosterone and low progesterone suggests some sort of adrenal dysfunction - likely overactive adrenals caused by excess estrogen, which is supported by the low progesterone. Are you under a lot of stress? Have you talked to your doctor about maybe doing some kidney/adrenal tests? Have you heard of a drug called clonidine? Your doctor should be able to tell you more about it.

 

[velo]

velo

I'm not strong on interpreting labs, but my guess is the minus sign just indicates that the progesterone level is lower than they think it should be.
Your temps seem only slightly low - I wish mine were reliably in that range. Have you checked whether it goes up or down a while after eating breakfast? That can apparently help distinguish whether it is thyroid or stress hormones that are keeping you warm. What is your resting pulse like? Any noticable goiter?
TSH 1.26 is a bit on the high side, but not extreme, if I understand Peat correctly. He likes to see it below 1.0, and probably below 0.4.

My guess is that you are missing progesterone more than you are missing thyroid hormone at this stage. You could check a list of estrogen dominance symptoms and see how many of then seem to apply. Could do the same with a hypothyroid symptom list.
Some first remedies Peat has often recommended for hormone balancing are:
- minimise polyunsaturated fats (PUFAs), eg liquid vege oils, nuts, etc. A little coconut oil can be good.
- a daily raw carrot salad, preferably with vinegar and little coconut oil or olive oil, to help remove excess estrogen that is excreted in the bowel, before it gets reabsorbed from the gut.
- enough protein and carbs. Protein for hypothyroid folks, he suggests 80-100 g. For people who are not hypothyroid, he has said they probably do best on more - eg 130-150ish.
- figure out if anything in particular is irritating your gut, or slowing it down too much. Some people find they do better with low starch - starch tends to feed bacteria, which create endotoxins, which, when absorbed from the gut, put an extra load on the liver and make it harder for it to detoxify estrogen.

If you've had a go at those things, it would be interesting to know what difference it seemed to make.

Do you happen to have cholesterol numbers? You need cholesterol in your to produce the steroid hormones, including progesterone.

Next up, if you have history of lots of PUFAs, vitamin E supplementation may help while it is slowly making it's way out of your system.
And next up, progest-e could well be worth a try.

Others might suggest additional tactics or different priorities.

For figuring out what has caused the imbalance in the first place, a bit of history might help, if you want to.

Hello, thank you for the the long detailed response! I was away for a few days, sorry for the slow replies.

Thanks for your advice. I eat no PUFAS since about a year, and eat two raw carrots every day. I eat about 100 grams of protein a day. It seems to me different things irritate my gut. Sometimes it's milk, sometimes even plain rice. It's more like food in general seems to irritate my gut, nomatter what the food is if that makes sense. I don't eat gluten since about a year but without other grains and especially potatoes my temperatures drop and I feel awful. I also cycle about 30 km/day and do other sports on top of this.

As for the history it's a long one, but I was doing pretty well until last year when I tried Great Lakes Gelatin, it really did a number on my stomach and I couldn't eat at all for a few days and only liquids for about three weeks. After this I developed bad insulin resistance.

After a few months of this and other symptoms I consulted with a nutritional coach (who himself is a fan of Peat) who said I seem to have thyroid and adrenal issues and recommended I try a adrenal glandular. I took a small dose for three months but felt progressively weirder and worse on it and started noticed I developed hair in places I shouldn't have any. At the end of quitting I also foolishly took "day after pill" against my own judgement (I panicked). It was a superdose of progesterone I think. After this it was basically downhill hormone-wise. After this i I got the irregular periods, hirutism, bad fatigue, acne and everything else.

I asked the doctor who did the hormone tests about the adrenal glands causing the problem and she said if they did the results would be much "worse" or more off so it is not them causing it. Which doesn't really make sense but I can understand she doesn't want to do more expensive tests.

Looking at this text it seems quite obvious what the problem is, or at least how it started.. but still at a loss at what to do about it. Do I just give up on healing through food? I started taking two drops of progesterone now in the 15th day of my cycle. Feel a bit worse after it with nausea and cold hands and feed. Will do just one drop tomorrow and see how it goes. Thank you again for your time.

 

[velo]

As Peat says, and you have noticed, health problems are usually systemic and involve the whole body. But in your case, having high DHEA, high testosterone and low progesterone suggests some sort of adrenal dysfunction - likely overactive adrenals caused by excess estrogen, which is supported by the low progesterone. Are you under a lot of stress? Have you talked to your doctor about maybe doing some kidney/adrenal tests? Have you heard of a drug called clonidine? Your doctor should be able to tell you more about it.

Thank you very much for your response, no I didn't know of this medication. I'm not sure I understand the function, it seems it stimulates the adrenal glands further, shouldn't I want to avoid that?

It is very interesting you mention this, since my problems started in large part after taking an adrenal glandular. I talked to the doctor that did these tests about the adrenal glands causing the problem and she said that it is not possible since the hormones are not "so" out of balance. I will try to get a second opinion.

If my adrenal glands are over active after taking this grandular (I stopped more than 6 months ago), what can be done about it? Would a bit of extra prog. help? It seems the problems get worse and not better and don't particularly respond to diet.

 

[velo]

..and regarding stress, I'm quite stressed about the situation of my health I guess but otherwise no. I made some large changes in my life, stopped working nights/changed career, moved country, changed circle of friends that were all for the better, but it's an adjustment period. Mostly I think I'm stressed about the health stuff, which is not very productive of course.

 

[haidut]

As Peat says, and you have noticed, health problems are usually systemic and involve the whole body. But in your case, having high DHEA, high testosterone and low progesterone suggests some sort of adrenal dysfunction - likely overactive adrenals caused by excess estrogen, which is supported by the low progesterone. Are you under a lot of stress? Have you talked to your doctor about maybe doing some kidney/adrenal tests? Have you heard of a drug called clonidine? Your doctor should be able to tell you more about it.

Thank you very much for your response, no I didn't know of this medication. I'm not sure I understand the function, it seems it stimulates the adrenal glands further, shouldn't I want to avoid that?

It is very interesting you mention this, since my problems started in large part after taking an adrenal glandular. I talked to the doctor that did these tests about the adrenal glands causing the problem and she said that it is not possible since the hormones are not "so" out of balance. I will try to get a second opinion.

If my adrenal glands are over active after taking this grandular (I stopped more than 6 months ago), what can be done about it? Would a bit of extra prog. help? It seems the problems get worse and not better and don't particularly respond to diet.

Typically, salt and magnesium help with overactive adrenals. Have you been tested for some sort of latent infection? Chronically overactive adrenals, but not into the zone of Cushing disease, are sometimes the result of the body trying to get rid of some type of virus/bacteria. But take that with a grain of salt, most of the studies I have seen were just case studies.

 

[mujuro]

I agree with haidut, I think having some adrenal examinations will be extremely helpful in your puzzle. AM/PM cortisol, ACTH and CRH ideally.

Just something I've been thinking about and it may apply here. When an acute stressor is present for long enough and does not abate (unknown illness got you worried, upcoming deadline, breakup, etc.) it becomes a chronic stressor and may potentially break the feedback mechanism in those biologically inclined through densensitization, resulting in poor glucocorticoid signaling and thus hypersecretion of cortisol due to a faulty feedback. Dysfunction of the HPA axis/feedback is implicit in almost all mood disorders, depression specifically, being more or less unresponsive to suppression tests but it is opined by the authors from whom I got this information to be the root cause of all stress disorders. In such an instance, lowering cortisol won't do you as good as restoring glucocorticoid signaling.

 

[Katty]

I agree with haidut, I think having some adrenal examinations will be extremely helpful in your puzzle. AM/PM cortisol, ACTH and CRH ideally.

Just something I've been thinking about and it may apply here. When an acute stressor is present for long enough and does not abate (unknown illness got you worried, upcoming deadline, breakup, etc.) it becomes a chronic stressor and may potentially break the feedback mechanism in those biologically inclined through densensitization, resulting in poor glucocorticoid signaling and thus hypersecretion of cortisol due to a faulty feedback. Dysfunction of the HPA axis/feedback is implicit in almost all mood disorders, depression specifically, being more or less unresponsive to suppression tests but it is opined by the authors from whom I got this information to be the root cause of all stress disorders. In such an instance, lowering cortisol won't do you as good as restoring glucocorticoid signaling.

So how do you restore glucocorticoid signaling? I thought the steps to reduce cortisol would also restore glucocorticoid signaling, but perhaps I am wrong...

 

[mujuro]

Antidepressants, for the most part. The tricyclic amitriptyline definitely achieves this, but it is old and carries a host of side effects. From my reading, fluoxetine is a first line treatment and as it happens, SSRIs seem to work more favorably in females. Atypicals neuroleptics like quetiapine and ziprasidone lower cortisol secretion, the former also lowers ACTH levels. So I don't think the corrective mechanism is exclusive to the antidepressants, but I wouldn't recommend the neuroleptics to anyone unless they were backed into a corner. If you search pubmed for terms like "antidepressant glucocorticoid crh acth" you will find a plethora of papers dealing with the interaction between antidepressants and the hypothalamic-pituitary-adrenal axis.

The hypothetical elevated cortisol may explain the low progesterone. Didn't Peat say that stress acted as a progesterone thief, or something along those lines? I don't know the optimal levels for SHBG for females either, but from memory T3 increases SHBG levels, and thus decreases free androgens.

But alas this is all fruitless if you have normal stress hormones.

EDIT - wanted to link to haidut's thread about clonidine's anti-stress effects in case you miss it. http://www.raypeatforum.com/forum/viewtopic.php?f=75&t=5223

 

[haidut]

Antidepressants, for the most part. The tricyclic amitriptyline definitely achieves this, but it is old and carries a host of side effects. From my reading, fluoxetine is a first line treatment and as it happens, SSRIs seem to work more favorably in females. Atypicals neuroleptics like quetiapine and ziprasidone lower cortisol secretion, the former also lowers ACTH levels. So I don't think the corrective mechanism is exclusive to the antidepressants, but I wouldn't recommend the neuroleptics to anyone unless they were backed into a corner. If you search pubmed for terms like "antidepressant glucocorticoid crh acth" you will find a plethora of papers dealing with the interaction between antidepressants and the hypothalamic-pituitary-adrenal axis.

The hypothetical elevated cortisol may explain the low progesterone. Didn't Peat say that stress acted as a progesterone thief, or something along those lines? I don't know the optimal levels for SHBG for females either, but from memory T3 increases SHBG levels, and thus decreases free androgens.

But alas this is all fruitless if you have normal stress hormones.

EDIT - wanted to link to haidut's thread about clonidine's anti-stress effects in case you miss it. http://www.raypeatforum.com/forum/viewtopic.php?f=75&t=5223

And I would add theanine to the options. A human dose of <200mg blocked cortisol increase caused by 200mg of caffeine and a human dose of 600mg+ lowered cortisol to the point of having noticeable effect on blood pressure. Btw, taurine is effective in lowering adrenalin. I don't know if it would lower cortisol as well, but the theanine + taurine combo has enough studies behind it showing it should lower both cortisol and adrenalin in dosages of 600mg+ for theanine and 3,000mg+ for taurine. Note that the studies were about each substance taken separately. When combined, they probably have synergistic effects and if you take a hefty dose of each at the same time you may have an unpleasant drop in blood pessure, which is something I experienced years ago when I took 10g of taurine in a single dose. So, mind what you are doing
Anyways, just wanted to give an alternative to people who do not have access to clonidine and want to lower both cortisol and adrenalin.

 

[velo]

As Peat says, and you have noticed, health problems are usually systemic and involve the whole body. But in your case, having high DHEA, high testosterone and low progesterone suggests some sort of adrenal dysfunction - likely overactive adrenals caused by excess estrogen, which is supported by the low progesterone. Are you under a lot of stress? Have you talked to your doctor about maybe doing some kidney/adrenal tests? Have you heard of a drug called clonidine? Your doctor should be able to tell you more about it.

Thank you very much for your response, no I didn't know of this medication. I'm not sure I understand the function, it seems it stimulates the adrenal glands further, shouldn't I want to avoid that?

It is very interesting you mention this, since my problems started in large part after taking an adrenal glandular. I talked to the doctor that did these tests about the adrenal glands causing the problem and she said that it is not possible since the hormones are not "so" out of balance. I will try to get a second opinion.

If my adrenal glands are over active after taking this grandular (I stopped more than 6 months ago), what can be done about it? Would a bit of extra prog. help? It seems the problems get worse and not better and don't particularly respond to diet.

Typically, salt and magnesium help with overactive adrenals. Have you been tested for some sort of latent infection? Chronically overactive adrenals, but not into the zone of Cushing disease, are sometimes the result of the body trying to get rid of some type of virus/bacteria. But take that with a grain of salt, most of the studies I have seen were just case studies.

Thanks for the ideas and your time. I started supplementing with magnesium hopefully it will help a bit.

I have been sick for the past 7 months or so, with flu like symptoms. I have a more or less constant tightness in my throat, thought at first it was a goiter but don't have the other symptoms, then just concluded is stress or this "mystery" illness whatever it is.

I have had checks for infections but I guess these were more standard tests. Is there some other type of infection you had in mind? My test were negative for infections.

 

[haidut]

As Peat says, and you have noticed, health problems are usually systemic and involve the whole body. But in your case, having high DHEA, high testosterone and low progesterone suggests some sort of adrenal dysfunction - likely overactive adrenals caused by excess estrogen, which is supported by the low progesterone. Are you under a lot of stress? Have you talked to your doctor about maybe doing some kidney/adrenal tests? Have you heard of a drug called clonidine? Your doctor should be able to tell you more about it.

Thank you very much for your response, no I didn't know of this medication. I'm not sure I understand the function, it seems it stimulates the adrenal glands further, shouldn't I want to avoid that?

It is very interesting you mention this, since my problems started in large part after taking an adrenal glandular. I talked to the doctor that did these tests about the adrenal glands causing the problem and she said that it is not possible since the hormones are not "so" out of balance. I will try to get a second opinion.

If my adrenal glands are over active after taking this grandular (I stopped more than 6 months ago), what can be done about it? Would a bit of extra prog. help? It seems the problems get worse and not better and don't particularly respond to diet.

Typically, salt and magnesium help with overactive adrenals. Have you been tested for some sort of latent infection? Chronically overactive adrenals, but not into the zone of Cushing disease, are sometimes the result of the body trying to get rid of some type of virus/bacteria. But take that with a grain of salt, most of the studies I have seen were just case studies.

Thanks for the ideas and your time. I started supplementing with magnesium hopefully it will help a bit.

I have been sick for the past 7 months or so, with flu like symptoms. I have a more or less constant tightness in my throat, thought at first it was a goiter but don't have the other symptoms, then just concluded is stress or this "mystery" illness whatever it is.

I have had checks for infections but I guess these were more standard tests. Is there some other type of infection you had in mind? My test were negative for infections.

Tightness in the throat can be produced by allergic reaction or endotoxin, especially in people with liver issues since that would allow higher levels of endotoxin to persist for longer in the bloodstream. Try some charcoal and see if the tightness clears up. If it does then it is likely allergy or endotoxin.

 

[velo]

I agree with haidut, I think having some adrenal examinations will be extremely helpful in your puzzle. AM/PM cortisol, ACTH and CRH ideally.

Just something I've been thinking about and it may apply here. When an acute stressor is present for long enough and does not abate (unknown illness got you worried, upcoming deadline, breakup, etc.) it becomes a chronic stressor and may potentially break the feedback mechanism in those biologically inclined through densensitization, resulting in poor glucocorticoid signaling and thus hypersecretion of cortisol due to a faulty feedback. Dysfunction of the HPA axis/feedback is implicit in almost all mood disorders, depression specifically, being more or less unresponsive to suppression tests but it is opined by the authors from whom I got this information to be the root cause of all stress disorders. In such an instance, lowering cortisol won't do you as good as restoring glucocorticoid signaling.

Thank you for your input. I have a meeting with an internal medicine doctor and will thanks to you have a case to present (will pretend that the other doctor suggested these tests so there is a slight chance she will actually do it).

I did a morning cortisol test (could sadly not afford to do a whole day panel at the time) and it was fairly normal, 9438 out of a reference range of 2300 - 12 700. So as you said, it didn't really give me a direction to go.

I think you are right about adrenals being chronically stressed. I have some signs from already early teenagehood of very high stress (I was extremely addicted to sugar and would drink 10 cans of cola a day, got bags under my eyes when I was 13 etc). I also believe there is something wrong in the signaling or in some very intricate part.. this because of the fact that diet/supplements/strategies don't really produce any effect (except feeling worse when I don't eat my livers/smoothies etc). Like I allude to in my first post.. I feel like I do everything right but can't figure out what the problem is or what helps.

I tried progesterone for 14 days into my cycle. I got a panic attach the second day after starting and anxiety lasted for a few days but went away and the rest of the days I felt quite calm. No other noticeable differences. I took two-three drops of prog-e. My period is now a day late so maybe I took it in the wrong time or in the wrong dose somehow.

If you don't mind me asking, could there be another way except anti depressants to "restart" or help this system that seems to be out of balance?

Thank you again for your time.

 

[velo]

As Peat says, and you have noticed, health problems are usually systemic and involve the whole body. But in your case, having high DHEA, high testosterone and low progesterone suggests some sort of adrenal dysfunction - likely overactive adrenals caused by excess estrogen, which is supported by the low progesterone. Are you under a lot of stress? Have you talked to your doctor about maybe doing some kidney/adrenal tests? Have you heard of a drug called clonidine? Your doctor should be able to tell you more about it.

Thank you very much for your response, no I didn't know of this medication. I'm not sure I understand the function, it seems it stimulates the adrenal glands further, shouldn't I want to avoid that?

It is very interesting you mention this, since my problems started in large part after taking an adrenal glandular. I talked to the doctor that did these tests about the adrenal glands causing the problem and she said that it is not possible since the hormones are not "so" out of balance. I will try to get a second opinion.

If my adrenal glands are over active after taking this grandular (I stopped more than 6 months ago), what can be done about it? Would a bit of extra prog. help? It seems the problems get worse and not better and don't particularly respond to diet.

Typically, salt and magnesium help with overactive adrenals. Have you been tested for some sort of latent infection? Chronically overactive adrenals, but not into the zone of Cushing disease, are sometimes the result of the body trying to get rid of some type of virus/bacteria. But take that with a grain of salt, most of the studies I have seen were just case studies.

Thanks for the ideas and your time. I started supplementing with magnesium hopefully it will help a bit.

I have been sick for the past 7 months or so, with flu like symptoms. I have a more or less constant tightness in my throat, thought at first it was a goiter but don't have the other symptoms, then just concluded is stress or this "mystery" illness whatever it is.

I have had checks for infections but I guess these were more standard tests. Is there some other type of infection you had in mind? My test were negative for infections.

Tightness in the throat can be produced by allergic reaction or endotoxin, especially in people with liver issues since that would allow higher levels of endotoxin to persist for longer in the bloodstream. Try some charcoal and see if the tightness clears up. If it does then it is likely allergy or endotoxin.

Thank you for your quick response! Also how much you know is amazing, my utmost respect for this level of knowledge on this forum.

I ordered the supplements you mentioned, even though supplements and actions to lower cortisol haven't really helped much I think it is a good idea to have these supplements to stressdose for difficults days or events. Looking forward to trying them.

I mentioned in another answer that I did a morning cortisol test (could sadly not afford to do a whole day panel at the time) taken at 9 AM, and it was fairly normal: 9438 out of a reference range of 2300 - 12 700. I kind of expected it to be low or high (who knows at this point...) but it didn't really show anything in any direction.

I have an appointment with a internal medicine specialist and will present this case discussed in the thread, overactive adrenals causing overproduction of androgens and possibly insulin resistance. The first doctor said this is not possible since my results are not "so" out of balance, but since the correlation seems so strong I think it is a viable option. Is there something I could be missing?

And thank you I will try the charcoal. If it does not make any difference and it is an allergy, is going down the route of eliminating foods again to find out what it is the best option?

 

[messtafarian]

Hi there:

The reason women have low progesterone usually has to do with anovulatory ( not ovulating) cycles due to stress. You are pretty young -- but you might recall ten years ago perhaps in your life when your cycles were not dependable or were too heavy or painful or missing-- this all has to do with supersensitive signaling and it's never exactly the same for every woman.

But if you do not ovulate or do not ovulate on time, or stress keeps you from ovulating, or bad diet...anything - your cycle runs off the rails eventually and then you get a hormone imbalance. I think that natural progesterone should be safe for you and I would not worry about taking it.

I would be careful though with thyroid. Your TSH levels are not very high at all and it might not be necessary and may complicate things. Not everyone has a bad thyroid and really at your age your thyroid function would statistically be excellent.

Also -- this is just my opinion but I would not worry so much either about high DHEA. Please remember that your DHEA level now is probably the highest it will ever be in your life because its production starts to fade away in the very late 20s. It is probably a response to anovulatory cycles ( the most common initiator of PCOS) that's gone on a long time; and also probably a STRONG response because your body really wants to have babies!!!

I would also try to stop all starches and if you can't do that -- at least stop all gluten. If you are a coeliac type even just the *slightest* touch of gluten can send your metabolism into a spiral and begin to effect your hormones. Ray Peat thinks endotoxin, from unsafe starches -- *is* stress. Many women with PCOS also are very strongly allergic to gluten. Anything you can do to detoxify the gut while adding progesterone should bring improvement.

If you try this, give a it a little time. Give the progesterone some time and a gluten free diet a little time. And just see. Sometimes things take a while to respond.

 

[velo]

Hi there:

The reason women have low progesterone usually has to do with anovulatory ( not ovulating) cycles due to stress. You are pretty young -- but you might recall ten years ago perhaps in your life when your cycles were not dependable or were too heavy or painful or missing-- this all has to do with supersensitive signaling and it's never exactly the same for every woman.

But if you do not ovulate or do not ovulate on time, or stress keeps you from ovulating, or bad diet...anything - your cycle runs off the rails eventually and then you get a hormone imbalance. I think that natural progesterone should be safe for you and I would not worry about taking it.

I would be careful though with thyroid. Your TSH levels are not very high at all and it might not be necessary and may complicate things. Not everyone has a bad thyroid and really at your age your thyroid function would statistically be excellent.

Also -- this is just my opinion but I would not worry so much either about high DHEA. Please remember that your DHEA level now is probably the highest it will ever be in your life because its production starts to fade away in the very late 20s. It is probably a response to anovulatory cycles ( the most common initiator of PCOS) that's gone on a long time; and also probably a STRONG response because your body really wants to have babies!!!

I would also try to stop all starches and if you can't do that -- at least stop all gluten. If you are a coeliac type even just the *slightest* touch of gluten can send your metabolism into a spiral and begin to effect your hormones. Ray Peat thinks endotoxin, from unsafe starches -- *is* stress. Many women with PCOS also are very strongly allergic to gluten. Anything you can do to detoxify the gut while adding progesterone should bring improvement.

If you try this, give a it a little time. Give the progesterone some time and a gluten free diet a little time. And just see. Sometimes things take a while to respond.

Thank you, that is very great and comforting advice that makes a lot of sense. I had extremely heavy and horrible periods when they started, I had to quit all sports because two weeks of the month I was out of business. I would faint the first two days of my period if I stood up etc.

It seems crazy that the hormonal imbalance makes me feel so awful, it seems like there should be another reason. But maybe there isn't one.

I tried progesterone for the 15-28th day, is there some other time frame that would be good to take it? Also read about women that take it every day, or just a few days.

I think you are right about starches, I am already glutenfree but starches is hard for me to give up due to my training. I ate a starchfree diet for a few months a few years ago and it was no problem and made me feel good, but I was completely sedetary. Now I do long rides of 100+ km on the bike and bike almost every day. I tried to eat less starch, but I crash horribly if I don't eat a proper meal with rice/potatoes after a training. I tried to eat bananas, other vegetables and drink a lot of juice and so but it doesn't seem to work, these things are only good whilst riding as a snack. Would you have a suggestion for me regarding that?

Thank you kindly for your advice and great input.

 

[Stilgar]

Is your training totally necessary? I know it can be hard to kick in the beginning because you can become quite reliant on it to feel good, but it may be adding to your stress level.

Two markers that haven't been mentioned yet (from a brief skim) would be vitamin A status and cholesterol. Without Progest-E, these along with sugar are necessary for endogenous production of progesterone.

Do you get liver/vitamin A supplement? Any idea on your cholesterol level? Sugar can used to raise it if it is too low. High may indicate inflammation and viral activity.

I agree that thyroid dosing may complicate things. However, it may be the key to allowing your liver to effectively store sugar and ablate the problems you are having with blood sugar regulation, which is probably causing the stress hormone problems. If thyroid is your problem (which is hard to tell from purely TSH alone), microdosing T3 post workout would warm your hands up. You may be experiencing a post-exercise latency period in which your body can't quite get the T3 back up to where it should be. However, T3 alone is difficult to use. I would get NDT or cynomel (pure T3) and have just an 1/8 after a workout or even less if you are taking pure T3 and see if it helps. You could try a tiny dose in the morning for fatigue. Or, how about chicken neck soup?

Do your extremities feel cold only after workouts or all times of the day?

 

[messtafarian]

Ohhhh wait a minute, I didn't realize this -- did you say up there somewhere you were cycling 100 KM a day?

No wonder your DHEA is so high!!!

That's a lot of exercise and heavy exercise can totally contribute to anovulatory cycles. This is because the body just doesn't have enough nutrients -- especially protein and especially sugar before and after training. Vitamin A is a good idea -- in fact more of all the fat solubles - -A, E, D, and K. A really good multiple vitamin is also probably a good idea. If you are training like that the starch issue actually is a problem because you really need the calories. However, just because you need the calories does not mean it isn't creating endotoxin.

So this is what I suggest:

Stay with the progesterone, time it to your cycle for three weeks with one week off. Don't be afraid of using "too much" -- really the worst thing that could happen is that it will knock your cycle off and that's about all. I know pregnant women are said to get morning sickness from the extra progesterone but I have never had any kind of gastrointestinal problem from supplemental progesterone and I have rarely ever heard of that happening with women who use *a lot* of it.
Add more saturated fat -- more butter, coconut oil, full fat ice cream without additives is a great "supplement." :)
If you add more fat, you might need less starch. Don't cut starch if you need it, just add more fats and see how it goes. You might, in fact, just need more calories overall.
There is a product Haidut created called Estroban that contains all the fat-soluble vitamins. Something to look into if you're interested -- otherwise there are A,D,E,K supplements on the market. But go slow in adding these, especially if you are adding more fat to your diet and a multiple vitamin.
Stress increases serotonin in the gut. Serotonin is part of a negative feedback loop that can affect the reproductive cycle. Dr. Peat advises eating a carrot salad once a day to sweep the intestine clean ( of endotoxin but also serotonin); or activated charcoal maybe once a week.

I would just stick with that for now. The thyroid issue -- especially T3 as Stilgar suggested, is probably worth looking into but your labs plus your training schedule are saying it's just a plain hormone imbalance with no real extra complications. Progesterone is essentially nontoxic and food usually is, too -- so start there :).

 

[Peata]

How are you doing, Velo?