Cortisol And HDL Too Low

alywest

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I recently had labs done and my morning fasting cortisol was below normal range. Estrogen was 44 which is high for the follicular phase of the month. Of course doctor didn't order progesterone labs and had I known that I would have asked him to include that, but oh well.

Anyway, I'm just confused because I thought high estrogen translated to high cortisol.

The low HDL (40) and high 'HDL to total cholesterol ratio' (4) hasn't changed much in the past few months. Before my HDL was right on the cusp of normal (46), but the ratio hardly changed since the last labs in October 2017 when it was 3.9 Overall cholesterol is only 160.

The doctor of course advised me to eat more salmon (5-6 times/week! lol) and to drink alcohol which i really don't do anymore. Apparently that will make me healthier. He also told me that my mild endometriosis is caused by eating sugar. The funny thing is, how would he know if the endometriosis is new or getting better? I used to have more pelvic pain during intercourse and now I really don't, so I suspect that has actually improved. Apparently the only reason they will do surgery for endometriosis is if the pain you experience is overwhelming. Otherwise they just leave it alone.

Other weird lab results were super high FSH, LH and low Vitamin D (which is nothing new.) I did see recently that low vitamin D can be associated with low cortisol which makes sense because I have taken Vitamin D supplements by the gallon and barely got it up over 32 over several months. I don't know if estrogen, FSH and LH are up from before since it wasn't tested in the past. I am not taking as much progesterone as I used to but I take between 125 and 200 mg/day.

Other weird things: I had stopped taking thiamine for sleep apnea because it seemed better but then it started to get bad again so I resumed 1,500 mg of thiamine, and my blood pressure which had been hovering around 140/100 went down to a respectable 120/80. Just from thiamine and a couple of nights of decent sleep! Perhaps with a long stretch of better sleep all of my labs will improve. I was honestly not even getting any deep sleep for a while because whenever I did get there I would start having nightmares which stemmed from not breathing, so I would wake up just completely suffocating.

Another suspicion with the really low HDL is that I've been taking too much thyroid, although I had similar labs in October and I am taking a completely different thyroid supplement now. Back then I was taking random doses of NDT that I was basing on how I felt. However, my TSH was like a 5.6 around that time. Recently I've been taking 88mcg of levothyroxine and 25 mg of cynomel/day. I was thinking about cutting down to a half pill of the levothyroxine and maintaining the cynomel because frankly if I don't take that amount I feel like crap. Soon after I started the 88mcg of levo I lowered my TSH to 2.4.

So if anyone has any expertise to share I would greatly appreciate it! I mean something more Peaty than eating more salmon and drinking alcohol.
 
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alywest

alywest

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Oh yeah, prolactin has also gone up from 6 to 10 in the few months since my last labs.
 
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lollipop

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Hi @alywest, I am not an expert and am not equipped to answer your questions. However, reading through your thread, I had the hit for you to continue to target estrogen and eat well balanced homemade Peat Friendly food, avoid PUFA’s, lower stress like walking, Yoga, meditation and as you yourself understood better sleep. I bet you will turn around your labs...
 
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alywest

alywest

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Hi @alywest, I am not an expert and am not equipped to answer your questions. However, reading through your thread, I had the hit for you to continue to target estrogen and eat well balanced homemade Peat Friendly food, avoid PUFA’s, lower stress like walking, Yoga, meditation and as you yourself understood better sleep. I bet you will turn around your labs...
Thanks, Lisa, I think exercise in those gentle forms would be good. I tend to push myself too hard when I exercise and I think that led me to being hypothyroid somewhat so I've avoided it, although I am constantly on my feet, usually running around or walking fast all day chasing young kids and two dogs. I rarely get to sit. Even now I am hurriedly typing this while standing in the kitchen. Anyway, I'm worried that meditation could lower my cortisol even more? I don't know. Maybe my adrenals are just so burned out that now my cortisol is low. The weird thing is my pulse will be over 100 first thing in the morning and almost all day. It usually lowers to around 90 after I've eaten a couple of meals, so I don't understand again how my cortisol is low.
 
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alywest

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I should also say that the doctor told me as soon as I go into menopause, I should immediately start taking estrogen or my vagina will completely atrophy. He said when you go into menopause your estrogen levels become undetectable.
 
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lollipop

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I should also say that the doctor told me as soon as I go into menopause, I should immediately start taking estrogen or my vagina will completely atrophy. He said when you go into menopause your estrogen levels become undetectable.
Not true actually. Your progesterone levels become undectable. Actually you can read tons on this subject. It would be worth your while. Seriously stress is the problem. Whatever you can do to mitigate it under your current situation and your body will regulate. Sounds like your stress system itself seems exhausted from constantly being pulled upon.
 

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Wow, that sounds super frustrating. The elevated pulse could be from adrenaline. If it were me I definitely wouldn't follow the doctors advise on diet and alcohol.

I think you'd be much better off following @lisaferraro's suggestions. You're TSH by Peat standards is still a bit high but improving so that's positive. You could probably benefit from getting your Total cholesterol up closer to 200. I think that could possibly help your hormonal balance across the board.

I don't think I'd worry about the prolactin of 10 since it is in the 2-12 range Peat suggests is optimal for women. Prolactin fluctuates throughout the day so if you got this lab at a different time of day or time of the month that could account for the higher result.

I suppose if it were me I'd stay focused on the basics of good sleep especially with your sleep apnea, good food for cholesterol synthesis, sunlight and keeping stress in check and not get too worried about the numbers. If it was just morning cortisol that was checked it's possible your rhythm could be off and it is peaking later in the day and it might not really be low just appearing so based on that one reading. Sometimes I question their normal values anyway but that's a different conversation.
 
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alywest

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Wow, that sounds super frustrating. The elevated pulse could be from adrenaline. If it were me I definitely wouldn't follow the doctors advise on diet and alcohol.

I think you'd be much better off following @lisaferraro's suggestions. You're TSH by Peat standards is still a bit high but improving so that's positive. You could probably benefit from getting your Total cholesterol up closer to 200. I think that could possibly help your hormonal balance across the board.

I don't think I'd worry about the prolactin of 10 since it is in the 2-12 range Peat suggests is optimal for women. Prolactin fluctuates throughout the day so if you got this lab at a different time of day or time of the month that could account for the higher result.

I suppose if it were me I'd stay focused on the basics of good sleep especially with your sleep apnea, good food for cholesterol synthesis, sunlight and keeping stress in check and not get too worried about the numbers. If it was just morning cortisol that was checked it's possible your rhythm could be off and it is peaking later in the day and it might not really be low just appearing so based on that one reading. Sometimes I question their normal values anyway but that's a different conversation.
Thanks for the thoughtful response, Blossom. I almost always wake up really stiff and sore and achey, also feeling really groggy, and I always attributed that to not sleeping well, but having low cortisol in the AM was kind of an interesting way to explain that. I'm hoping that with continued good sleep for a while that will improve. Also, lactic acid builds up with CO2 is low, and thiamine increases CO2 so I'm hoping in the long run that will improve the achiness and soreness that I experience almost daily. Every day I feel as though I've been running a marathon recently and I don't ever run long distances. I do get achey I think from doing a lot of heavy lifting, but it's so bad and so continuous now that I believe that lactic acid is being built up by more than just exercise. CO2 has been low because of my sleeping issues. About a year ago I had really high cholesterol values (when I was only taking T4 and not T3). I also had a really low TSH (below normal range.) I was not eating Peat style at the time and I was pregnant, so my progesterone was likely very high. At the time my cortisol levels were normal as well but my DHEA was super low. Honestly, I'm just trying to find the connection between all of these things. Is it better to supplement MORE thyroid when cholesterol is low? Would that lower my cortisol even more? OR should I try to up my thyroid a bit (just the T4) and retest my thyroid in a couple of months? I don't want to get hyperthyroid but I'm pretty sure that's not going to happen. PRolactin is supposed to be a more accurate measure of tissue estrogen so I'm not super worried about the blood levels of estrogen. Perhaps there's a bit more in the blood because I'm excreting more out of my tissues. I think I need to double up on carrots to make sure it's getting out. Maybe if anything I need to cut down on progesterone because that lowers cortisol. Sorry I'm kind of thinking aloud here, but it really helps to do that. Thanks for letting me vent!
 

Blossom

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I wouldn't be surprised if your cortisol pattern is off because of the sleep apnea. Basically it is *quite similar to running a marathon all night* when your body should be resting so it's no surprise you wake with aches due to struggling all night to breathe. That is how your body perceives the situation-literally fighting for your life. I don't mean to sound dramatic and I don't know the severity of your sleep apnea but when your blood gasses become unbalanced during sleep you never truly rest and it's perceived as a dire emergency. Your cortisol could be elevated while your sleeping to help keep you alive and then plummets up on waking because the emergency is over. I think fixing the sleep issue is probably the number one thing that will help you be able to find balance for your whole system. I have a real passion for breathing though so I might be a bit biased.
 
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alywest

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I wouldn't be surprised if your cortisol pattern is off because of the sleep apnea. Basically it is *quite similar to running a marathon all night* when your body should be resting so it's no surprise you wake with aches due to struggling all night to breathe. That is how your body perceives the situation-literally fighting for your life. I don't mean to sound dramatic and I don't know the severity of your sleep apnea but when your blood gasses become unbalanced during sleep you never truly rest and it's perceived as a dire emergency. Your cortisol could be elevated while your sleeping to help keep you alive and then plummets up on waking because the emergency is over. I think fixing the sleep issue is probably the number one thing that will help you be able to find balance for your whole system. I have a real passion for breathing though so I might be a bit biased.
Thanks for all that, it really encourages me that I'm on the right track at least. I seriously don't know how much more I can handle this physical pain and I know it's lactic acid, it's the same feeling. So that makes total sense that I would be high cortisol/adrenaline all night and then crashing by morning. When I got my blood work done I hadn't gotten on the thiamine yet. So fingers crossed. I agree, breathing is a passion of mine, too, probably because I have experience suffocation so much and felt the havoc it has wreaked on me. Thanks again!
 
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alywest

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Not true actually. Your progesterone levels become undectable. Actually you can read tons on this subject. It would be worth your while. Seriously stress is the problem. Whatever you can do to mitigate it under your current situation and your body will regulate. Sounds like your stress system itself seems exhausted from constantly being pulled upon.
I totally agree that progesterone is what is lacking in menopause, but it's interesting to be sitting with a doctor in a lab coat who is telling you if you don't take this hormone your vagina will for sure atrophy. It's no wonder so many women are taking estrogen, and it's really crazy! I mean, if I wasn't aware of Ray Peat I would have bought this advice hook line and sinker, I'm sure. Stress is definitely a problem and I really think I need to up my thyroid supplementation and focus on improving my diet as you mentioned. It's hard to stay on track when you have toddlers that want so desperately to eat starchy food and you are hungry so you eat it, too. I've not been eating eggs like I used to, and although I stay away from PUFA whenever possible it still makes its way into my diet, mainly if I eat out.
 

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Thanks for all that, it really encourages me that I'm on the right track at least. I seriously don't know how much more I can handle this physical pain and I know it's lactic acid, it's the same feeling. So that makes total sense that I would be high cortisol/adrenaline all night and then crashing by morning. When I got my blood work done I hadn't gotten on the thiamine yet. So fingers crossed. I agree, breathing is a passion of mine, too, probably because I have experience suffocation so much and felt the havoc it has wreaked on me. Thanks again!
I think you're definitely on the right track. It only makes sense to target the most basic things first like sleep and nutrition and then you can figure out what (if anything) is remaining that needs attention.
Please keep us updated!
 
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but it's interesting to be sitting with a doctor in a lab coat who is telling you if you don't take this hormone your vagina will for sure atrophy. It's no wonder so many women are taking estrogen, and it's really crazy! I mean, if I wasn't aware of Ray Peat I would have bought this advice hook line and sinker,
Totally crazy! A person in my family was put on a low dose SSRI for her perimenopausal hot flashes!!! :-/ Grrrgh...I was so angry (and I rarely get angry tbt) and made her get off them after one month and throw them in the trash. She had UGLY withdrawals from only one month. Just imagine. That gynecologist would have had her addicted. Of course I spent my good will points so if the MD tries to put her on estrogen, I might not have an open ear.

I am sooooooo glad for you and agree with @Blossom that you are on the right track...
 
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alywest

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Totally crazy! A person in my family was put on a low dose SSRI for her perimenopausal hot flashes!!! :-/ Grrrgh...I was so angry (and I rarely get angry tbt) and made her get off them after one month and throw them in the trash. She had UGLY withdrawals from only one month. Just imagine. That gynecologist would have had her addicted. Of course I spent my good will points so if the MD tries to put her on estrogen, I might not have an open ear.

I am sooooooo glad for you and agree with @Blossom that you are on the right track...
I know, it's crazy because even if you show someone the research and all that, they still are confused because there is so much on the internet, etc. saying the opposite, that estrogen or lack thereof causes all these symptoms. At least recently I have seen some magazine actually blame estrogen for the fact that women can have knee issues in older age, and serotonin causing people to eat more because of the fact that it makes people feel good so they want to eat more and then get fat. I think that's true to an extent, I think we get addicted to things that are not really good for us because we either get a serotonin boost or a rush of endorphins that make us feel "good," just like with any addiction. Even if it makes you feel horrible in the long run, the quick chemical rush outweighs all the negatives in the short run and that's why people justify indulging them. Just my 2c.
 

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it's interesting to be sitting with a doctor in a lab coat who is telling you if you don't take this hormone your vagina will for sure atrophy.
I just thought of this since you mentioned vaginal atrophy (which can actually start sometimes in peri menopause).
My experience has led me to believe that if a woman begins to have even a hint of vaginal dryness it's time to consider using progesterone and dhea vaginally. It's much better to be proactive because it's hard to turn the situation around if ignored for too long. I'm certain many women go the estrogen route because it seems preferable to leaking urine and it's normally one of the few choices they're given. You can read about it at length on menopause and prolapse forums. The doctor probably means well and he has seen the horrible consequences of atrophy like urinary incontinence and the increased possibility of prolapse and estrogen is the only option he is probably aware of to offer. Big pharma even makes a vaginal dhea product for atrophy though so he wouldn't have to do too much research to figure that out. With your history of endometriosis I'm not sure estrogen would be the best choice from even a mainstream medical perspective but maybe they believe it stays solely in the vagina?!?!
Several women have posted about improvements with the dhea/progesterone combo so I wanted to mention that here in case it comes down to you feeling there is no other choice.
 

Lejeboca

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I think I need to double up on carrots to make sure it's getting out.

Could result in too much beta-carotene with many carrots... I've read on this forum somewhere that @haidut takes charcoal 2-3 times per week instead of carrots. Maybe switching (increasing) charcoal is a better option for you?

I do get achey I think from doing a lot of heavy lifting, but it's so bad and so continuous now that I believe that lactic acid is being built up

I avoid the aches and pains after physical activity by taking aspirin (or arnica 9c or 30c) before and after the activity. Recently, I've started taking aspirin (well, willow bark actually) before going to bed, and it helps me sleep like a baby :):. I recall that @lisaferraro said she takes aspirin for better sleep.
Hence, I wonder whether aspirin may too kill two birds for you: better sleep and less aches/pains?
 
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alywest

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I just thought of this since you mentioned vaginal atrophy (which can actually start sometimes in peri menopause).
My experience has led me to believe that if a woman begins to have even a hint of vaginal dryness it's time to consider using progesterone and dhea vaginally. It's much better to be proactive because it's hard to turn the situation around if ignored for too long. I'm certain many women go the estrogen route because it seems preferable to leaking urine and it's normally one of the few choices they're given. You can read about it at length on menopause and prolapse forums. The doctor probably means well and he has seen the horrible consequences of atrophy like urinary incontinence and the increased possibility of prolapse and estrogen is the only option he is probably aware of to offer. Big pharma even makes a vaginal dhea product for atrophy though so he wouldn't have to do too much research to figure that out. With your history of endometriosis I'm not sure estrogen would be the best choice from even a mainstream medical perspective but maybe they believe it stays solely in the vagina?!?!
Several women have posted about improvements with the dhea/progesterone combo so I wanted to mention that here in case it comes down to you feeling there is no other choice.
I have been using pansterone and it's awesome. I just started using it again so it may take a while for the results to show. The thing that confuses me is how is it possible that a doctor could be so totally wrong about estrogen. Is it just that they are going by blood values so they assume that estrogen is practically non-existent when it could be just sitting in the tissue? I agree they must be confused if they think the estrogen stays in the vagina with a ring or taking it orally. Or else they believe that estrogen is fine for the rest of the body as well. This doc assured me that the risk of breast cancer is incredibly low. And although he told me that since I get migraines with aura I shouldn't take birth control pills because neurologists warn against it (because of risk of stroke and heart attack), it's somehow ok to take it after menopause. I guess since they assume that the estrogen levels drop so completely that a small amount of estrogen in the whole body is advisable. He also told me they have lasers to correct atrophy once it happens but treatment costs upwards of $2,000 because it's such an expensive machine.
 
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alywest

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Could result in too much beta-carotene with many carrots... I've read on this forum somewhere that @haidut takes charcoal 2-3 times per week instead of carrots. Maybe switching (increasing) charcoal is a better option for you?



I avoid the aches and pains after physical activity by taking aspirin (or arnica 9c or 30c) before and after the activity. Recently, I've started taking aspirin (well, willow bark actually) before going to bed, and it helps me sleep like a baby :):. I recall that @lisaferraro said she takes aspirin for better sleep.
Hence, I wonder whether aspirin may too kill two birds for you: better sleep and less aches/pains?
Thanks for the idea about charcoal. I honestly hate eating carrots so charcoal would be nice. I think I need to buy some empty capsules to take it in because the large granules really bother me because they get stuck in my throat.

I love aspirin and do take it regularly. I will try taking it at night for a few nights in a row to see if it helps with aches and better sleep. I'll report back!
 

Blossom

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I have been using pansterone and it's awesome. I just started using it again so it may take a while for the results to show. The thing that confuses me is how is it possible that a doctor could be so totally wrong about estrogen. Is it just that they are going by blood values so they assume that estrogen is practically non-existent when it could be just sitting in the tissue? I agree they must be confused if they think the estrogen stays in the vagina with a ring or taking it orally. Or else they believe that estrogen is fine for the rest of the body as well. This doc assured me that the risk of breast cancer is incredibly low. And although he told me that since I get migraines with aura I shouldn't take birth control pills because neurologists warn against it (because of risk of stroke and heart attack), it's somehow ok to take it after menopause. I guess since they assume that the estrogen levels drop so completely that a small amount of estrogen in the whole body is advisable. He also told me they have lasers to correct atrophy once it happens but treatment costs upwards of $2,000 because it's such an expensive machine.
Ironically to add to the confusion there is an active thread right now that's males discussing the downsides of too low estrogen.:confused:
I've heard of the laser you mentioned. One retired nurse I know called it a cold laser but from what I gather it sounds a lot like red light! I've thought about buying the red laser pointers for self experimentation just to see if they'd work.
 

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