Low energy, low pressure, low P/E2 ratio. How to help?

[hewau]

I've got my blood work done recently and trying to heal/ find the cause for my low energy issues.

I'm relatively new to Ray Peat's teachings and I am currently wondering if I should be taking a thyroid supplement or Progest-E, or both.

My GP told me that the reason for my low energy is my low blood pressure, lack of iron and that my thyroid is working properly but I suspect that the reason for my low energy is low thyroid.

I think that because
1. From analysing my blood tests, I have found that my progesterone - estrogen ratio in the luteal phase (day 21) would be described as low: 45.2 (P: 8.22 nmol/ E2: 210 pmol/L) which would mean I have estrogen dominance
2. Very low blood pressure
3. Moderate painful periods and PMS (only since a year or so)
4. Predominant feeling of numbness, sometimes mood swings
5. Low energy - in the morning I always need to drink coffee before being able to do anything, recently the energy levels were so low I wasn't able to leave the house. I feel like I'm living in the preservation of energy mode, and that is why life events don't excite me anymore
6. Dry skin
7. TSH of 1.59 mUI/L, according to Peat the best is below 1


However, I am not sure if I am right, since my T3:T4 ratio seems to be within the norm: 1:2.5; LH and TSH are also within conventional norms

I am wondering if taking progesterone would help to improve the problem with estrogen dominance or if should I approach it differently. I am also thinking about taking thyroid, however, I am wary of supplementing T3 because it seems within the norm...

I'm eating according to Ray's principles for a few months and avoiding PUFAs for 9 months or so. I can see that the right diet has improved my nails, hair growth, and even face skin a bit, don't understand why I still deal with the low-energy problem

I would highly appreciate any insights or advice you might share on how to approach this problem.

 

[sweetpeat]

It would be helpful for folks to know more about your lifestyle. It's possible making some lifestyle adjustments will help your situation. At the very least, you don't want to be adding metabolic stimulants if you're in a state of deprivation.
What is your diet like, approximate number of calories, workout routine (if any), any other source of stress. Also your age.

Edited for spelling.

 

[youngsinatra]

I've got my blood work done recently and trying to heal/ find the cause for my low energy issues.

I'm relatively new to Ray Peat's teachings and I am currently wondering if I should be taking a thyroid supplement or Progest-E, or both.

My GP told me that the reason for my low energy is my low blood pressure, lack of iron and that my thyroid is working properly but I believe that the reason for my low energy is my low thyroid.

I think that because
1. From analysing my blood tests, I have found that my progesterone - estrogen ratio in the luteal phase (day 21) would be described as low: 45.2 (P: 8.22 nmol/ E2: 210 pmol/L) which would mean I have estrogen dominance
2. Very low blood pressure
3. Moderate painful periods and PMS (only since a year or so)
4. Predominant feeling of numbness, sometimes mood swings
5. Low energy - in the morning I always need to drink coffee before being able to do anything, recently the energy levels were so low I wasn't able to leave the house. I feel like I'm living in the preservation of energy mode, and that is why life events don't excite me anymore
6. Dry skin
7. TSH of 1.59 mUI/L, according to Peat the best is below 1


However, I am not sure if I am right, since my T3:T4 ratio seems to be within the norm: 1:2.5; LH and TSH are also within conventional norms

I am wondering if taking progesterone would help to improve the problem with estrogen dominance or if should I approach it differently. I am also thinking about taking thyroid, however, I am wary of supplementing T3 because it seems within the norm...

I'm eating according to Ray's principles for a few months and avoiding PUFAs for 9 months or so. I can see that the right diet has improved my nails, hair growth, and even face skin a bit, don't understand why I still deal with the low-energy problem

I would highly appreciate any insights or advice you might share on how to approach this problem.

Your thyroid is most likely fine.

You mentioned iron deficiency — have you had any recent iron blood work?

I‘d investigate iron status (possibly B12/folate aswell) and the adrenals. (low cortisol and low aldosterone can cause major issues with low energy, not feeling refreshed in the morning, being dependent on caffeine just to be awake, low blood pressure, not retaining electrolytes properly, dizziness etc.)

 

[hewau]

It would be helpful for folks to know more about your lifestyle. It's possible making some lifestyle adjustments will help your situation. At the very least, you don't want to be adding metabolic stimulants if you're in a state of depravation.
What is your diet like, approximate number of calories, workout routine (if any), any other source of stress. Also your age.

I eat a lot of eggs, cheese, yoghurts, fruits often steaks (once or twice a week), and liver (maybe once, or twice a week) with potatoes or rice. Sometimes starches, like gluten-free pasta, and ice cream. When it comes to fats, I use coconut oil or butter.
I don't count my calories but I would say around 1900
My work is sedentary, and I work from home, so I don't have a lot of social contact
I often exercise 5 times a week for 40 min, usually bodyweight exercises, sometimes yoga, used to run but now I don't because of the heat
I am 26. When it comes to stress, my past month was pretty stressful because of work changes, maybe this explains why I feel worse now
Also, I live by the Mediterranean sea and the heat and humidity in the summer are hard to bear

 

[hewau]

Your thyroid is most likely fine.

You mentioned iron deficiency — have you had any recent iron blood work?

I‘d investigate iron status (possibly B12/folate aswell) and the adrenals. (low cortisol and low aldosterone can cause major issues with low energy, not feeling refreshed in the morning, being dependent on caffeine just to be awake, low blood pressure, not retaining electrolytes properly, dizziness etc.)

Yes, I did, and my doctor prescribed me an iron supplement and B9 for that. Wondering if I should take it to feel better, cause it might have helped me in the past, but I know that it also can be toxic so I'm confused. Ferritin - 60 ng/mL and serum folate 29.7 nmol/L
Cortisol seems to be in the norm (311.4 nmol/L)

 

[youngsinatra]

Ferritin and folate seem to be well within the reference range to me.

 

[sweetpeat]

Cortisol seems to be in the norm (311.4 nmol/L)

What is the reference range for cortisol?
Do you know your cholesterol level? High cholesterol is a marker for hypothyroidism.

 

[youngsinatra]

What is the reference range for cortisol?
Do you know your cholesterol level? High cholesterol is a marker for hypothyroidism.

It‘s 140 to 690 nmol/L from the medical textbooks I‘ve access to.

Below 100 indicates adrenal insufficiency.

 

[hewau]

What is the reference range for cortisol?
Do you know your cholesterol level? High cholesterol is a marker for hypothyroidism.

The reference by the test is 102 to 535

Cholesterol seems within the norm
Total - 1,90 g/L norm <2
HDL - 0.68 g/L norm >0.4
LDL - 1.10 g/L (maybe too high according to Google)

 

[LizRey86]

Id check more into low cortisol it can be in the normal ranges, meaning your adrenals could be making enough. But you’re body can’t use it, I think its called cortisol resistance.

Low cortisol symptoms and causes | General center | SteadyHealth.com

Low cortisol levels can cause extreme exhaustion and many other symptoms that can sometimes be life-threatening.

ic.steadyhealth.com

Just a different viewpoint, can’t hurt to look into it.

 

[hewau]

thank you! I'll look into it

do you think it would be helpful to try supplementing progest-E since it looks like my progesterone-estrogen ratio is low?
I heard about many "Peating" people using it, however, I do wonder if they do so because of hormonal imbalances or just as a support
what's your take on this? :)

 

[LizRey86]

thank you! I'll look into it

do you think it would be helpful to try supplementing progest-E since it looks like my progesterone-estrogen ratio is low?
I heard about many "Peating" people using it, however, I do wonder if they do so because of hormonal imbalances or just as a support
what's your take on this? :)

Ive tried all brands of bioidentical progesterone and it makes my symptoms worse, it does this to alot of women and my guess is that because my adrenals are very weak. And the pressure to produce cortisol by the progesterone supplements is too much and it makes me crash- insomnia, diarrhea, no appetite, nausea, horrible pms. Pregnenalone, vitex and Delta 8 cbd (if its legal in your state) has been more beneficial for me hormone wise.

 

[hewau]

Ive tried all brands of bioidentical progesterone and it makes my symptoms worse, it does this to alot of women and my guess is that because my adrenals are very weak. And the pressure to produce cortisol by the progesterone supplements is too much and it makes me crash- insomnia, diarrhea, no appetite, nausea, horrible pms. Pregnenalone, vitex and Delta 8 cbd (if its legal in your state) has been more beneficial for me hormone wise.

Interesting, if I might ask, what makes you think your adrenals are very weak? I had adrenal fatigue last autumn, maybe that's why I'm tired now too

 

[LizRey86]

Interesting, if I might ask, what makes you think your adrenals are very weak? I had adrenal fatigue last autumn, maybe that's why I'm tired now too

I have a lot of trouble with sleep, shaking and sweating when I overextend myself, low blood pressure, hypoglycemia, having to lay down down after small tasks like washing dishes, stomach pain, bad histamine issues and other allergies.so all the symptoms of low cortisol, adrenal insufficiency. Ive been dealing with it for 3 years and its taken me this long to figure it out but Im much better than I was a year ago, thanks to this forum and some ladies that have helped me out.

 

[hewau]

I suspect that the reason for my low energy is low thyroid.

I think that because
1. From analysing my blood tests, I have found that my progesterone - estrogen ratio in the luteal phase (day 21) would be described as low: 45.2 (P: 8.22 nmol/ E2: 210 pmol/L) which would mean I have estrogen dominance
2. Very low blood pressure
3. Moderate painful periods and PMS (only since a year or so)
4. Predominant feeling of numbness, sometimes mood swings
5. Low energy - in the morning I always need to drink coffee before being able to do anything, recently the energy levels were so low I wasn't able to leave the house. I feel like I'm living in the preservation of energy mode, and that is why life events don't excite me anymore
6. Dry skin
7. TSH of 1.59 mUI/L, according to Peat the best is below 1

However, I am not sure if I am right, since my T3:T4 ratio seems to be within the norm: 1:2.5; LH and TSH are also within conventional norms

Wondering if there still can be problems with the thyroid if tests are within norms?...
I started to check my axillary temperature and is as low as 35.6 C and my feet and hands are usually cold
do something else come to your mind which may be causing it?

 

[youngsinatra]

Wondering if there still can be problems with the thyroid if tests are within norms?...
I started to check my axillary temperature and is as low as 35.6 C and my feet and hands are usually cold
do something else come to your mind which may be causing it?

Iron deficiency, B9/B12 deficiency, anemia, low adrenal function (low cortisol/aldosterone)…

 

[mostlylurking]

7. TSH of 1.59 mUI/L, according to Peat the best is below 1


However, I am not sure if I am right, since my T3:T4 ratio seems to be within the norm: 1:2.5; LH and TSH are also within conventional norms

Can you please share the test results for T3 and T4? Before I got my thyroid medication straightened out, when I was severely hypothyroid, my TSH was .02 so the TSH test really isn't very helpful because other things can affect it.

Interesting, if I might ask, what makes you think your adrenals are very weak? I had adrenal fatigue last autumn, maybe that's why I'm tired now too

For your consideration:

Hiding in Plain Sight: Modern Thiamine Deficiency

Thiamine or vitamin B1 is an essential, water-soluble vitamin required for mitochondrial energetics—the production of adenosine triphosphate (ATP). It is a critical and rate-limiting cofactor to multiple enzymes involved in this process, including ...

www.ncbi.nlm.nih.gov

Thiamine, Fibromyalgia and Chronic Fatigue- Hormones Matter

Could thiamine deficiency be linked to fibromyalgia and chronic fatigue syndrome? Perhaps.

www.hormonesmatter.com

Every organ in the body need thiamine to function because the mitochondria (that make energy - ATP) require thiamine (and T3) for oxidative metabolism.

Wondering if there still can be problems with the thyroid if tests are within norms?...
I started to check my axillary temperature and is as low as 35.6 C and my feet and hands are usually cold
do something else come to your mind which may be causing it?

Yes, because the thyroid test isn't calibrated correctly. In order to be symptom free, my T3 needs to be at the high point in the "normal" range of the blood test.

Thyroid: Therapies, Confusion, and Fraud

Ray Peat

raypeat.com

Thiamine deficiency/functional blockage and hypothyroidism share many symptoms. This is because they both are required for oxidative metabolism (makes energy). In addition, the thyroid gland needs thiamine to work properly.

It may also be very helpful to take progesterone to help get your estrogen normalized. Progesterone can make you feel worse in the beginning, Ray Peat said it pushes the estrogen out of the cells which briefly increases the amount in the blood stream. The liver needs to be operating well in order to do its job, which includes detoxing the body of estrogen. The liver needs thiamine to function.

• Politics & Science: Progesterone Part 1
• Politics & Science: Progesterone Part 2
• Politics & Science: Progesterone Part 3

 

[sweetpeat]

Do you get much salt in your diet? Salt is important for adrenal function.

I'm not sure I agree that you're estrogen dominant. But maybe I'm missing something. If anything, both estradiol and progesterone look low to me, but the ratio is good. But like I said, maybe I'm missing something.
Have you seen this thread? Progesterone To Estradiol Ratio (P:E2)

I'm not saying progesterone can't help you. Because of it's relationship to cortisol, I personally find it helpful for adrenal issues. Pregnenolone too. But if it were me I'd start low.

 

[hewau]

@mostlylurking Thank you so much for sharing the useful info; I have to say taking a lot of thiamine has helped me in the autumn for the adrenal fatigue (as well as sleep and eating more red meat)

my free T3 is at 3,98 pmol/L (2,59 pg/mL) and free T4 at 10,02 pmol/L (0,77ng/DL)

 

[hewau]

Do you get much salt in your diet? Salt is important for adrenal function.

I'm not sure I agree that you're estrogen dominant. But maybe I'm missing something. If anything, both estradiol and progesterone look low to me, but the ratio is good. But like I said, maybe I'm missing something.
Have you seen this thread? Progesterone To Estradiol Ratio (P:E2)

I'm not saying progesterone can't help you. Because of it's relationship to cortisol, I personally find it helpful for adrenal issues. Pregnenolone too. But if it were me I'd start low.

I have calculated according to the thread and my ratio stands at 1:1,46 (so low compared to 1:10 that I start to doubt my mathematical abilities haha)
and before I used this calculator: Progesterone to Estrogen Ratio Calculator

I'll think about it... I started to take Vitex which should increase progesterone and I think about supplementing vit E; do you recommend any brand for pregnenolone?