Determining "estrogen dominance?" Maybe PE is making me worse!

[freyasam]

So I've been Peating for nearly a year and taking large quantities of Progest-e for the past 8 months. I'm 35.

I only take it day 13 to the end of my cycle (which lasts 30-33 days). But I'm taking large quantities of PE during the luteal phase because it brings relief to pretty unbearable symptoms of insatiable appetite, anxiety, and insomnia. So I go through a bottle a week during the luteal phase, which I'm guessing is 400 mg / day.

But I've been looking at the sex hormone labs I've done over the past 1.5 years. The first lab was before ever starting progest-e, and the other two were after having started it. My progesterone is usually normal, or on the low-normal side. But estradiol is way below range.

For example, my most recent lab was drawn on day 2 of my cycle, so I wasn't taking progest-e at that time. Estradiol was 29 pg/ml (early follicular range is 46 - 143). Progesterone was 0.5 (follicular is under 1.35).

All this time I assumed my general symptoms were signs of estrogen dominance (depression, fatigue, weight gain, sore breasts post-ovulation, light/scanty menses, acne). But I appear to be LOW estrogen. Maybe even entering early menopause??

I've also gained 30 pounds of fat since Peating and have lost a lot of muscle strength. I wonder how much of that is from progesterone supplementation. There's this study showing female rats on progesterone gained fat:

http://joe.endocrinology-journals.org/c ... /361.short

Could I be overdosing on progesterone? Maybe I need ESTROGEN??

The thing is, though, that progesterone helps with symptoms around ovulation, so it's hard to just stop it and see how my body responds.

But I seem to be getting worse the longer I follow Peat's ideas. I'm at a loss.

 

[freyasam]

If estrogen is to blame for my worst symptom, depression, why is my estrogen far below range?

If we say that blood tests don't give an accurate picture of how much estrogen is in cells, then how can we ever determine someone to be "estrogen dominant?"

 

[purbec]

I'd like to know a lot of what you're asking too freyasam.

It's very confusing if lab tests are not fully accurate....then we can look at symptoms - yet many hormone imbalances can have similar symptoms - especially anxiety and depression, a whole host of deficiencies/toxicities of hormones aswell as nutrients generally cause anxiety/depression so it's very difficult to know the cause of the symptoms too in many cases.

When it's such a murky pool of unknowns - all one can do is try one angle/route - like you have with progesterone...see how labs and symptoms change...which, surprisingly despite your high dosing of Prog. it's amazing your level at day 2 being at the (ideal) low range and not higher considering all the dosing you do during luteal.

I'd like to know if RP has talked about instances where estrogen deficiency is problematic and should be supplemented, but so far i have read the opposite. It would be one question i'd love to have him address. He may have already but i'm a 'newb' to his philosophies so have not covered a great deal of his material.

I did research into aromatase deficiency - and although originally believed to be quite a rare disorder, when scientists tested women for estrogen deficiency for a study, and their aromatase, the conclusion to one particular study i remember them reporting the deficiency to be 'much more common than once thought'.

I do believe this angle needs to be taken into account - and might be something you could persue with further testing for clarification, rather than immediately opting for estrogen supplementation.

Do you know your Testosterone levels? Have you experienced hirsutism/virilisation?
Many women who have aromatase deficiency are diagnosed PCOS due to the excess androgens/ovarian cysts...as these are tested for more commonly than aromatase.
They get put on androgen blockers but rarely is the estrogen deficiency noticed or treated so a portion of PCOS women still suffer with symptoms post diagnosis with conventional treatment.

 

[freyasam]

Hi purbec,

The only time I tested testosterone was April 2013. Before progest-e and Peating.

This was day 2 of cycle:
Testosterone 21 (17-76)

No, I haven't experienced hirsutism.

Yes, it's all quite maddening to be told that lab values mean nothing, but so many contradictory conditions all have the same symptoms. That kind of leaves us stranded without knowing which direction to go in.

I don't think I mentioned it above, but I've developed mild hot flash symptoms the past two months. NOT COOL. It's absolutely devastating to think I may be starting menopause having just turned 35; I would maybe like to have a baby at some point. But more than that it's just disturbing that my body seems to be so out of balance. So is the progesterone bringing on hot flashes by lowering estrogen dangerously??

As far as I know, Peat does not recommend any estrogen therapy for anyone. But maybe he's wrong.

I've been trying to dig through some studies on estrogen therapy for younger women, but it's all so confusing. It seems to me that the subject of women's health is especially gnarly due to various political and religious elements; that these issues make it hard to find the truth. Which really just pisses me off.

I did find one study showing favorable outcomes for estrogen therapy for younger "hypoestrogenic" women, which I guess you and I would be. I wonder what Peat would say about that study.

 

[tara]

I haven't got answers the questions, and I'm interested, but if you haven't read this article, I recommend it to help fill out the picture.
http://raypeat.com/articles/articles/ti ... ogen.shtml

 

[freyasam]

Thanks for the article, Tara! That's helpful.

So it seems like mid-luteal phase is the time to test E because plasma estrogen is closest to tissue estrogen.

Another question this article raises for me is why do many women, including me, feel best during the follicular stage (after menses but prior to ovulation) if this is the time of highest estrogen concentration in the tissue? This to me suggests that estrogen is a GOOD thing.

 

[purbec]

Well i must admit i would be open to tissue biopsy for hormone testing if all the hormones get stuck in the tissues!!

I agree mid-luteal is the most ideal phase to test freyasam...helps to show if you're ovulating too.

I will have to refamiliarise myself why RP does not think saliva is accurate, as before i got my labs - i had limited funds so was undecided whether to go for serum or for saliva...i couldn't afford both.
Online advice from other hormonally-ill folk was useless...no-one knew scientifically which was more accurate. Doctors said blood, ALL ND's and some online doctors said saliva...but when these folks have affiliations with labs i don't tend to trust their advice 100%.
I researched like mad for weeks on the validity of serum/saliva testing. Studies were done to determine this. Various studies. I was particularly interested in cortisol at the time, and one study showed saliva cortisol to be more accurate than serum. The sex hormones tested also showed both serum correlated to lab values. Also the hormones remained stable in the saliva over many weeks verses degradation of serum.

I cannot quote intricate details of these studies at this moment as it was 18 months ago i researched this, and all links buried in a long list of favourites yet to be sorted ( i might do a separate post about this in the debate section - i don't want to cause a debate about this in this thread!) but the overall impression was that certainly cortisol saliva was more accurate and salivary sex hormones were valid too - the military and other organisations use saliva testing verses serum as it's easier, less invasive etc.
So i went for saliva testing. I will admit that the results correlated with my symptoms.

Like i said, i need to know the details of RP's preference for serum over saliva. I recall he doesn't buy into the 'free' hormone verses 'protein-bound' hormone models others do and studies show.
Maybe this is the only angle i will end up disagreeing with him on!

it's good you don't have high androgens - yet if you do get mid-luteal testing - it would be wise to have T tested at the same time. If you do have low Est. at that time it could be going on to produce T.
Day 2 verses Day 20 are hugely different hormone levels (normally).

It's strange you're now only just getting hot flashes, especially after prolonged Prog use.
Are you applying the prog to the same areas and possibly not getting the absorption you were once getting?
Mercola recommends using it vaginally for more natural absorption - also it will absorb into the portal vein area where progesterone from the ovaries would naturally find it's way into...according to him.
Maybe try this method to see if it helps with the flashes?

I'm getting continued hot flashes despite now being on day 7 - 4 days after a short 3 day bleed, and i've been using prog. to help me feel 'better'...just 3 drops of progest-e....but i've had headaches, hot flashes and really severe pelvic pains! I never get pelvic pains post-bleed. I do think i need to up the dose as i'm super low and not ovulating so have a huge deficit of Prog to catch up on. I was waiting for day 14 to really rev up the dose, but might start that sooner...just to get beyond these symptoms.

My 'prime' time in my cycle is certainly after ovulation - i have more energy - i have more T ...more aggression hahaaa...but i feel more 'awake'. Just after menstruation like now, im filled with brain fog, low body temps, tired all the time, sweating, anxious...lalalalalaa! ;-/

If your symptoms don't abait and your mid-luteal labs show low levels of both like your day 2 results - i really think it would be valid to continue on for aromatase deficiency testing.
As Pete said in the article, excess estrogen can only be estrogen through aromatase enzyme conversion...which increases as we age...or should. There ARE people with enzyme dysfunctions and in those cases, supplementing with estrogen would be essential.
Estrogen has a use in the body, as RP recognises, it's excessive levels that are damaging, if unopposed by progesterone. I'm sure if anyone asked him if someone had low aromatase and therefore low estrogen compared to prog. he would recommend Est. supplementation, coupled with prog.
Unfortunately it's 95% of people with hormone issues that have estrogen dominance - so therefore treating that has dominated hormone supplementation circles...and therefore info online.
When i tried to garner more info on true estrogen deficiency i couldn't find much online!

 

[Peata]

My symptoms are better up to ovulation and gets worse as my period gets closer. What I think is happening, is that in the follicular phase, estrogen is low and progesterone may be too, but they are more even/balanced. Then, at ovulation and beyond, estrogen rises. Normally, progesterone would too, but in my case, it must stay at a lower level and the estrogen is dominant. Just guessing.

 

[HDD]

From "PMS to Menopause"
"Only a blood test can tell for sure whether your estrogen is higher than it should be, and it is necessary to measure your progesterone at the same time, since it is best to have .five or ten times as much progesterone as estrogen. If your progesterone level is low, even an average estrogen level can cause serious symptoms, because it's effects are not balanced and opposed by progesterone.

Generally, people whose temperature (measured by an oral thermometer) is below normal or whose thyroid function is low are likely to have high estrogen and low progesterone. (Low temperature stimulates the ovaries to produce excess estrogen, and retards the liver's ability to excrete it.) A deficiency of protein and B vitamins can make it impossible for your liver to excrete estrogen, leading to chronically high estrogen level."

 

[HDD]

From "PMS to Menopause"

Progesterone can relieve disabilities with great speed and safety. Since it is a protective substance that stabilizes structures and functions at many levels, it can be useful in almost any situation. It even helps the body regain its ability to produce more progesterone. But if there is a progesterone deficiency, something has caused that deficiency, and it us important to find out what the basic problem is. A diet that is deficient in high quality protein, or that contains natural food toxicants, often is responsible for a progesterone deficiency. If your diet is killing you, supplementing progesterone is of limited value.

If progesterone is used as part of an appropriate physiological program, it isn't necessary to keep using it once it has helped to restore a balanced hormone metabolism."

 

[HDD]

I have experienced first- and second hand that progesterone is just as potent in lowering testosterone as it is in lowering estrogen. As I wrote earlier I have been using a lot (sometimes a bottle in 3 days) and it took a few months until I noticed that my muscles disappeared. It was always easy for me to build muscles in my arms and legs -- there was hardly anything left after about 4 months of progesterone. Which is not dramatic for me. I am using less now (1 bottle in 2 weeks) and slowly the muscles come back. But it takes effort and time. I also noticed some other changes. Behavioral most of all. I lack ambition which I never did. I avoid confrontation which I never did. I lack motivation which is new, too. Things usually connected to testosterone seem to have gone missing.

A friend of mine (male) had a car accident with brain injury. He has been using progesterone for 4 months. His brain is fine now but his muscles vanished during that time (1 bottle in 1 week) and he had no libido at all.

A 70 year old man was heavily injured during an accident and used 1 bottle of progest-e-complex in 2 weeks. His body healed but his muscles were gone.

A friend of mine (female) is a sports swimmer. She has been using progest-e-complex to get pregnant. Sports will do a lot of harm to a the system and it took a while until the progesterone started to decrease the estrogen. At the same time her hair became thicker and her skin better and her luteal phase longer -- her muscles became less and less. In the end she couldn't swim for more than 20 minutes when before that there was no limit or at least she never experienced it.

viewtopic.php?f=3&t=227&p=2511&hilit=Muscles#p2511

 

[freyasam]

HDD, thanks for the quotes!

From "PMS to Menopause"

But if there is a progesterone deficiency, something has caused that deficiency, and it us important to find out what the basic problem is. A diet that is deficient in high quality protein, or that contains natural food toxicants, often is responsible for a progesterone deficiency. If your diet is killing you, supplementing progesterone is of limited value.

If progesterone is used as part of an appropriate physiological program, it isn't necessary to keep using it once it has helped to restore a balanced hormone metabolism."

So how does one find out what's causing a progesterone deficiency? I'm eating 90-100 gm of quality protein and a good diet overall based on Peat's ideas for nearly a year. So I don't see how my diet could be causing a progesterone deficiency.

Also, how long should it take for progesterone to restore a "balanced hormone metabolism?" Especially in light of the fact that progesterone apparently wastes muscles, based on people's experiences?

I would like to stop taking Progest-e, but it makes my luteal phase so much more bearable.

 

[freyasam]

Like i said, i need to know the details of RP's preference for serum over saliva. I recall he doesn't buy into the 'free' hormone verses 'protein-bound' hormone models others do and studies show.
Maybe this is the only angle i will end up disagreeing with him on!

it's good you don't have high androgens - yet if you do get mid-luteal testing - it would be wise to have T tested at the same time. If you do have low Est. at that time it could be going on to produce T.
Day 2 verses Day 20 are hugely different hormone levels (normally).

It's strange you're now only just getting hot flashes, especially after prolonged Prog use.
Are you applying the prog to the same areas and possibly not getting the absorption you were once getting?
Mercola recommends using it vaginally for more natural absorption - also it will absorb into the portal vein area where progesterone from the ovaries would naturally find it's way into...according to him.
Maybe try this method to see if it helps with the flashes?



If your symptoms don't abait and your mid-luteal labs show low levels of both like your day 2 results - i really think it would be valid to continue on for aromatase deficiency testing.
As Pete said in the article, excess estrogen can only be estrogen through aromatase enzyme conversion...which increases as we age...or should. There ARE people with enzyme dysfunctions and in those cases, supplementing with estrogen would be essential.
Estrogen has a use in the body, as RP recognises, it's excessive levels that are damaging, if unopposed by progesterone. I'm sure if anyone asked him if someone had low aromatase and therefore low estrogen compared to prog. he would recommend Est. supplementation, coupled with prog.

Thanks purbec for your thoughts. I will test testosterone along with P and E mid-luteal and keep in mind the aromatase issue.

I've been using progest-e orally all this time. I could try using it vaginally and see if that makes a difference.

I don't have any source to give you for Peat claiming serum tests are more valuable than saliva. Maybe start a new topic asking this question to see if others know. :)

 

[HDD]

Are you hypothyroid? Temps., pulse, other symptoms? Are you supplementing thyroid?

 

[freyasam]

Yes, I'm hypothyroid but I cannot tolerate thyroid meds at all. I've tried four different kinds and I have extreme reactions of tachycardia, anxiety, and insomnia to microscopic doses (like just scraping off dust from a tablet with my fingernail).

My symptoms of hypothyroidism are: depression, fatigue, weight gain, cold extremities, acne, anxiety, insomnia, insatiable appetite, super light and short periods. Temps are low and pulse is high. I'm running on adrenaline.

 

[freyasam]

I posted recently about how I can't tolerate thyroid meds ever since I took iodine a year ago. I've asked Peat about this and he has suggested magnesium, which didn't work to lessen the reaction at all. I react very violently to thyroid and I'm giving up on trying to take it.

viewtopic.php?f=56&t=5518&p=65206#p65206

 

[HDD]

Are you using salt, sugar, caffeine, magnesium, aspirin?

Haidut's combo works well. Surrogate thyroid I think was the thread but I can find it if you want.

The salt and sugar amounts I would get from maybe Peatarian's posts.

 

[freyasam]

I use liberal amounts of salt, sugar, and magnesium. I drink about a cup of coffee a day as I'm sensitive to caffeine and it's stressful to me at higher amounts.

I read that thread and want to experiment with that combo, but I quit aspirin because I couldn't find enough info to assure me that it is safe with my hemoglobin disorder, thalassemia, which alters the functioning of platelets. I don't know if aspirin would be harmful in this case.

 

[HDD]

"Iam trying to get my thyroid running on coconut oil, lots of salt (3 table spoons a day) and sugar, Coca-Cola (hardly ever mentioned in the forum but so very important for the Peat-diet), milk and coffee." - Peatarian

In another post she asks someone if they use enough sugar to lower cortisol. I remember a poster (possibly on peatarian.com)saying they used a cup a day.

I believe not being able to drink coffee is a liver issue. The active thread now discusses using higher amounts of k2 and ?

I was also going to suggest chicken neck or fish head broth but just saw you posted that you don't tolerate that either.

Maybe you could email Ray Peat again and ask him about thalassemia? And for any other insight.

 

[freyasam]

I believe not being able to drink coffee is a liver issue. The active thread now discusses using higher amounts of k2 and ?

Is that on the thyroid surrogate thread?

I can't imagine eating that much sugar. I've seen a huge increase in tooth sensitivity the past year since eating this way. And I always rinse in water or baking soda/water after sugar or juice. But still. Going to the dentist soon and pretty sure I'll need a couple fillings; hopefully not more.

Thanks again for your help, HDD