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

[tara]

If you are still around ...

... really the worst thing that could happen is that it will knock your cycle off ...

Or knock you off your (bi)cycle.

A major progesterone overdose can be incapacitating (sedating). But it's easy to avoid by just dosing 3 drops at a time, with at least 10 mins in between to check for effects. Dosage seems to vary a lot from person to person.

An underdose can also make things temporarily worse for some women - enough to knock the estrogen out of the tissues and into circulation, but not enough to knock it out of action. Some recommendations suggest 3 drops 5x a day to start with, tapering to 3 doses a day or less after a few weeks as symptoms improve. You can do it in the second half of cycle only, or if it helps and the symptoms come back too badly when you stop, you can choose to take it continuously for a while.
I used about 5 doses a day for about a year, and I've recently dropped back to 2-3 doses a day. Hasn't stopped me menstruating yet (and I'm approaching typical menopause age).

Haidut mentioned salt - I think progesterone can waste salt, so it's possible you would want a bit more of it if you are using progesterone.

If you are biking 100 km day, I bet it's hard to get enough food in without starches. Getting enough food is important, so I don't recommend cutting starches unless yo can replace them adequately.
I too wonder whether you need to put this exercise stress on yourself every day? Even if the biking is important to you, you may find that your training would be just as effective if you did it every 2 or 3 or 4 days, instead of every day, so that your body gets a chance to rest and restore in between? After all, it's during the rest between stress that most of the adaptations - increased fitness, strength etc - happen.

Other ideas form others above may well be relevant, I just don't know so much about some of them.

 

[haidut]

If you are still around ...

... really the worst thing that could happen is that it will knock your cycle off ...

Or knock you off your (bi)cycle.

A major progesterone overdose can be incapacitating (sedating). But it's easy to avoid by just dosing 3 drops at a time, with at least 10 mins in between to check for effects. Dosage seems to vary a lot from person to person.

An underdose can also make things temporarily worse for some women - enough to knock the estrogen out of the tissues and into circulation, but not enough to knock it out of action. Some recommendations suggest 3 drops 5x a day to start with, tapering to 3 doses a day or less after a few weeks as symptoms improve. You can do it in the second half of cycle only, or if it helps and the symptoms come back too badly when you stop, you can choose to take it continuously for a while.
I used about 5 doses a day for about a year, and I've recently dropped back to 2-3 doses a day. Hasn't stopped me menstruating yet (and I'm approaching typical menopause age).

Haidut mentioned salt - I think progesterone can waste salt, so it's possible you would want a bit more of it if you are using progesterone.

If you are biking 100 km day, I bet it's hard to get enough food in without starches. Getting enough food is important, so I don't recommend cutting starches unless yo can replace them adequately.
I too wonder whether you need to put this exercise stress on yourself every day? Even if the biking is important to you, you may find that your training would be just as effective if you did it every 2 or 3 or 4 days, instead of every day, so that your body gets a chance to rest and restore in between? After all, it's during the rest between stress that most of the adaptations - increased fitness, strength etc - happen.

Other ideas form others above may well be relevant, I just don't know so much about some of them.

Vitamin E also increases salt excretion a lot. Since vitamin E is so closely related to progesterone in terms of function I am not really surprised. Other things that can cause sodium loss include taurine, and I think PUFAs as well.

 

[velo]

Hello thank you for the comments! I wouldn't really call it training, it's more of a lifestyle if that makes sense, I live in Berlin and bike through the city to get to wherever I'm going. It's a really large city so it usually ends up being at least 30 km daily. On weekends I do longer rides but mostly for fun. The pace ends up being quite fast most of the time. My dream is to be a bike messenger. I know its not the best to ride around all day, in all weather, winter, all times of the day but it's what I love. If I stop doing it I will have to make (another) total life change.

I don't know my cholesterol status unfortunately but will try to ask for a test on it when I have my appointment with the endocrinologist on the 12th. I eat liver twice a week and juices, sugar etc daily.

I tried a small piece of thyroid a few times preemptivley and post workout, it did warm me up after a long ride but when I took it on a normal day for fatigue I just got more tired and felt a bit nauseous. Didn't seem to make any real difference in the recovery either.

My hands and feet are never cold, except after long bike rides. Even not when my temperature is very cold. This is one of the many mysteries of my body.. I usually wake up with a decent temperature (can have a waking temperature of 36.9 when ovulating), it goes up a bit after breakfast but whatever I am doing, it just crashes at random during the day. I remember once I came back from a café job, and my temperature was 35.3. I slept normally, ate as usual, worked only 4 hours, no stress at work, I really loved this job.. also temperature drops like crazy after exercise. But it drops all the time even doing almost nothing so it makes no sense to me, and which us why I just train anyway because I feel as tired and cold when training, then not training. At least training I get some joy from it and become a bit more fit. It's so strange to me that my temperatures during the day are colder than my temperature waking up.

Thank you again for your time, hope any of this makes sense.

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?

 

[velo]

Hey, sorry, no, I wasn't clear enough. I bike every day, but only sometimes try to do longer ride with a bike group or so. I wish I could do 100 km a day.. I am totally dead after these long rides for two days straight.

Thanks for your thoughtful advice. I have followed it and taken progesterone three weeks with one week off, but just three drops a day. Sadly my PCOS seems to have become worse, I have even more hair and now the cysts are there all the time, instead of only ovulation -> period. Also the acne is substantially more and I have for some reason developed dandruff, but this could be unrelated.

I will try to take a larger dose and see what happens before I give up.

Thanks again for your time!

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 :).

 

[velo]

Hello, thank you very much for asking. I took some savings and escaped to Vietnam for a month. It was just a bit too much for me, I just felt so horribly sick, tired, unattractive and above all totally discouraged so some kind of rest and refeeding vacation seemed like the only option. No training for a month and just fresh food and no computer exposure etc. This health aspect took over my whole life in the sense that I felt that I couldn't pursue my purpose in life and do what I really love, don't look very well and felt unattractive, inferior and incapable in general.. I just felt totally trapped in my present life situation and had to somehow break free from it.

I do feel a lot better! In such warm climate everything is easier. I had good temperatures almost the whole time and lost some weight. My PCOS got worse but probably due to incorrect dosing of progesterone. Mostly I feel more positive again.

I developed some low thyroid symptoms though, dandruff, dry lower legs etc but we'll see how everything goes now that I'm back home.

Thanks again for taking the time to ask.

How are you doing, Velo?

 

[velo]

Hello, thanks for the great comments.

I think exactly what you described about the dose being a bit low happened to me. After three months on progesterone (three drops per day, three weeks with one week off) my symptoms got worse, the cysts are now present all the time, the hair is worse, acne worse etc.. also developed some low thyroid symptoms like dandruff and dry lower legs. I will try to take this larger dose in the second half of my cycle. Will report back.

The cycling isn't really training per se, only sometimes.. I mostly just ride around in the city and my dream is to be a bike messenger. So the good news is that it's not always crazy strong and fast competitve riding (even though I would love that), the bad news is that it's still a ton of riding all the time, all hours of the day.. It's more of a lifestyle choice. I used to work at a nightclub with a lot of drinking, drugs, being awake for a long time.. and changed this and moved to a new city where I found biking. Being sedentary just doesn't work for me, I need to be active somehow.

Thanks again for your time.

If you are still around ...

... really the worst thing that could happen is that it will knock your cycle off ...

Or knock you off your (bi)cycle.

A major progesterone overdose can be incapacitating (sedating). But it's easy to avoid by just dosing 3 drops at a time, with at least 10 mins in between to check for effects. Dosage seems to vary a lot from person to person.

An underdose can also make things temporarily worse for some women - enough to knock the estrogen out of the tissues and into circulation, but not enough to knock it out of action. Some recommendations suggest 3 drops 5x a day to start with, tapering to 3 doses a day or less after a few weeks as symptoms improve. You can do it in the second half of cycle only, or if it helps and the symptoms come back too badly when you stop, you can choose to take it continuously for a while.
I used about 5 doses a day for about a year, and I've recently dropped back to 2-3 doses a day. Hasn't stopped me menstruating yet (and I'm approaching typical menopause age).

Haidut mentioned salt - I think progesterone can waste salt, so it's possible you would want a bit more of it if you are using progesterone.

If you are biking 100 km day, I bet it's hard to get enough food in without starches. Getting enough food is important, so I don't recommend cutting starches unless yo can replace them adequately.
I too wonder whether you need to put this exercise stress on yourself every day? Even if the biking is important to you, you may find that your training would be just as effective if you did it every 2 or 3 or 4 days, instead of every day, so that your body gets a chance to rest and restore in between? After all, it's during the rest between stress that most of the adaptations - increased fitness, strength etc - happen.

Other ideas form others above may well be relevant, I just don't know so much about some of them.

 

[velo]

Thanks for your comments. I use a lot of salt and put it in everything, coffee, milk, juice, fruits etc. I salt my food to the point that other people can't eat it (I always did this so I don't do it just for the sake of it, it's just like there is something missing with the food if there is not enough salt on it for me).

If you are still around ...

... really the worst thing that could happen is that it will knock your cycle off ...

Or knock you off your (bi)cycle.

A major progesterone overdose can be incapacitating (sedating). But it's easy to avoid by just dosing 3 drops at a time, with at least 10 mins in between to check for effects. Dosage seems to vary a lot from person to person.

An underdose can also make things temporarily worse for some women - enough to knock the estrogen out of the tissues and into circulation, but not enough to knock it out of action. Some recommendations suggest 3 drops 5x a day to start with, tapering to 3 doses a day or less after a few weeks as symptoms improve. You can do it in the second half of cycle only, or if it helps and the symptoms come back too badly when you stop, you can choose to take it continuously for a while.
I used about 5 doses a day for about a year, and I've recently dropped back to 2-3 doses a day. Hasn't stopped me menstruating yet (and I'm approaching typical menopause age).

Haidut mentioned salt - I think progesterone can waste salt, so it's possible you would want a bit more of it if you are using progesterone.

If you are biking 100 km day, I bet it's hard to get enough food in without starches. Getting enough food is important, so I don't recommend cutting starches unless yo can replace them adequately.
I too wonder whether you need to put this exercise stress on yourself every day? Even if the biking is important to you, you may find that your training would be just as effective if you did it every 2 or 3 or 4 days, instead of every day, so that your body gets a chance to rest and restore in between? After all, it's during the rest between stress that most of the adaptations - increased fitness, strength etc - happen.

Other ideas form others above may well be relevant, I just don't know so much about some of them.

Vitamin E also increases salt excretion a lot. Since vitamin E is so closely related to progesterone in terms of function I am not really surprised. Other things that can cause sodium loss include taurine, and I think PUFAs as well.

 

[aquaman]

Now I do long rides of 100+ km on the bike and bike almost every day.

If you're sick, these are just going to make you worse worse worse.

You may need to go back to basic, non-damaging exercise for a while. Like low intensity weight sessions, walks in nature etc.

Get yourself better first, 100km is a serious distance!

 

[velo]

Hello, thanks for your comments! I totally agree with you an some of the training I did before I left for my trip was pushing it for someone in a not so good physiological state.

I think I gave the wrong impression, I only do long rides like this on occaison. It's not something I can do often, or try to. Mostly I just ride in the city, at my own pace, so it is no so bad as it sounds. But since I have aspirations to be better, I do try to train more.

I have on several occasions tried with long brakes in training, this past month for a full month, and previously 3 weeks, 2.5 months etc. with just light exercise, yoga etc. Sadly it doesn't help to be sedentary in this way, my bloodsugar issues get much worse as do my hormones. Plus it makes me depressed. So eventually I start with some training again since it doesn't seem to matter anyway.

This is the problem in a nutshell, I don't really know what exactly is wrong, and it doesn't really respond to anything except getting worse.

Now I do long rides of 100+ km on the bike and bike almost every day.

If you're sick, these are just going to make you worse worse worse.

You may need to go back to basic, non-damaging exercise for a while. Like low intensity weight sessions, walks in nature etc.

Get yourself better first, 100km is a serious distance!

 

[marsaday]

http://www.progesteronetherapy.com/faq- ... z3WFxPGLeG

This website is very good and explains a lot on how to use progesterone.

 

[oxidation_is_normal]

Is there a time in your life when most symptoms appeared?
Do you take birth control?
When do you usually feel best?
When do you usually feel worst?

 

[velo]

Hello!

Yes they mostly appeared after I started eating "normally" again after a fairly restrictive diet.
Not since four years, but before this I took it for five years and had no periods at all during this time.

Usually when I wake up in the morning! I am warm, strong and fast heartbeat and some energy with a clear mind. But after breakfast I feel very tired again and mostly want to go back to sleep and spend the rest of the day in this haze.

After any kind of stress, like training or emotional stress, not sleeping, not eating. I can easily cry from hunger.

Is there a time in your life when most symptoms appeared?
Do you take birth control?
When do you usually feel best?
When do you usually feel worst?

 

[oxidation_is_normal]

Sounds like you need to continue eating normally and it is taking a while to re-adjust after the restricted diet pattern. One way to decrease the stress and increase the adaptation rate is to do absolutely nothing (lay down) after you eat, as often as you can for a while. If you have to, then wake up earlier so you can eat breakfast and then chill for a bit before doing anything. Try this for every meal. It sounds like a waste of time, but the difference might surprise you.

I'm not sure if you answered the question of when you feel your best...
Also, how much do you end up eating per day? (People often end up eating less when they have lots of side effects from food, unfortunately.)

 

[LandofMilkandHoney]

Sounds like you need to continue eating normally and it is taking a while to re-adjust after the restricted diet pattern. One way to decrease the stress and increase the adaptation rate is to do absolutely nothing (lay down) after you eat, as often as you can for a while. If you have to, then wake up earlier so you can eat breakfast and then chill for a bit before doing anything. Try this for every meal. It sounds like a waste of time, but the difference might surprise you.

I'm not sure if you answered the question of when you feel your best...
Also, how much do you end up eating per day? (People often end up eating less when they have lots of side effects from food, unfortunately.)

Does your gut absorb nutrients at the same rate when you lie down immediately after eating?

 

[oxidation_is_normal]

I don't know, but the rest of your systems are less stressed. More adaptive energy to the rest.

 

[velo]

Thanks for the suggestion, I try to do it when I can but it is hard with my bit hectic freelance lifestyle of eating on the road most of the time.

When I was 12-15 I was extremely sporty and my body seemed to work quite well, but already then I had stress symptoms (extreme sugar cravings, bags under eyes etc). Then when I followed a very restricted diet about 4 years ago (around age 23-24) I also felt good and my body worked well. It was a kind of mix of peat and gaps but now I don't know how I survived eating like that, like 1 800 calories a day mostly from meat, butter and juice..

So this diet was like 4 years ago, it's quite some time I think already.

I eat about 2500-3000 calories/day now. I stopped gluten and milk so most are from sugars of different kinds and about 80-100 g protein. It's a lot of calories for a woman I think. I've tried to eat less but then I feel like I am starving. I am a bit overweight, but also not extremely so. Mostly it's "cortisol fat" around my stomach and general unleanness. I have alot of musclemass though.

Sounds like you need to continue eating normally and it is taking a while to re-adjust after the restricted diet pattern. One way to decrease the stress and increase the adaptation rate is to do absolutely nothing (lay down) after you eat, as often as you can for a while. If you have to, then wake up earlier so you can eat breakfast and then chill for a bit before doing anything. Try this for every meal. It sounds like a waste of time, but the difference might surprise you.

I'm not sure if you answered the question of when you feel your best...
Also, how much do you end up eating per day? (People often end up eating less when they have lots of side effects from food, unfortunately.)

 

[tara]

I eat about 2500-3000 calories/day now. I stopped gluten and milk so most are from sugars of different kinds and about 80-100 g protein. It's a lot of calories for a woman I think. I've tried to eat less but then I feel like I am starving.

Hi velo,
This does not seem excessive to me. Apparently weight-stable women eat on average about 2500 (more before 25yrs while still growing). More could well be needed if extra physically active and/or recovering.
Feeling starving is too stressful. Appetite may be guiding you well. :)

 

[Westside PUFAs]

velo
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.

Here are 116 quotes by Ray Peat on endotoxin:

http://www.functionalps.com/blog/2012/1 ... endotoxin/

Out of 116 quotes, only 2 mention starch. Two.

“Bacteria thrive on starches that aren’t quickly digested, and the bacteria convert the energy into bulk, and stimulate the intestine. (But at the same time, they are making the toxins that affect the hormones.)”

"Bacterial endotoxin increases serotonin release from the intestine, and increases its synthesis in the brain (Nolan, et al., 2000) and liver (Endo, 1983). It also stimulates its release from platelets, and reduces the lungs’ ability to destroy it. The formation of serotonin in the intestine is also stimulated by the lactate, propionate and butyrate that are formed by bacteria fermenting fiber and starch, but these bacteria also produce endotoxin. The inflammation-producing effects of lactate, serotonin, and endotoxin are overlapping, additive, and sometimes synergistic, along with histamine, nitric oxide, bradykinin, and the cytokines."