Overdosing Progest-E To Simulate Epidural Effect

[Elvie]

Hi, everyone, I was wondering if anyone knows wether progest -e could be used for anesthetic effect during labor. If so what would be the dose to use? I know Ray mentioned somewhere that once he spilled the bottle of progest-e and couldn't feel his legs for some time. If this is the only side effect of using too much of progest - e I'd like to try it instead of the epidural.
Thank you,
Elvie

 

[tara]

I can't answer you question. I understand the wish to have safer anaesthetic. If you want to tell, is it a first baby?

Do you know you will be getting/needing an epidural? They do tend to hinder labour, I think. I know they are needed sometimes, but I was told by my midwife that I would likely have ended up with caesarian if I'd had the epidural that was eventually proposed. (I had a very long slow first labour). Sometimes that's needed too, but it's a longer road to recovery after.

I would be wondering what the effect would be on the baby of a very high progesterone dose - don't think I'd be keen without knowledgable reassurance and oversight. What if it affects her/his hormonal development? What if it over-anaesthetises her to a dangerous level?

I also don't know what effect it would have on the hormones/processes involved in labour itself - would it reduce your ability to do the work?

I expect the effective anaesthetic dose would be different for everyone. If using it, starting at a moderate dose and gradually adding more (10+min intervals) would be safer than a massive one off dose. Too much anaesthesia could be dangerous for mum, too.

Wouldn't surprise me if a more moderate dose would be OK, though, and might be somewhat helpful even if it doesn't do complete anaesthetic.
This just speculation on my part, not expertise.

 

[PakPik]

Elvie,
My undertsanding is that prostaglandins are key mediators for the induction and sustain of labor (they have to do with uterine contractions and so on). Progesterone is an antiprostaglandin agent: it both lowers production and destroys whatever has already been produced. So, I definitely believe progesterone shouldn't be administered for that stage of pregnancy, in fact labor starts when there's a sharp drop in progesterone as far as I know.

The role of prostaglandins in labor and delivery. - PubMed - NCBI
"It appears certain now that, at least in some cases, prostaglandins are important mediators of uterine activity. Indeed, a much stronger case can be made for the role of prostaglandins in labor than can be made for oxytocin."

 

[Elvie]

Tara, PakPik, thank you very much for your responses.
Tara, It is my first pregnancy, it has been so good so far no morning sickness in the first trimester. But now I'm 35 weeks and started experiencing things like: not sleeping well at all, I fall asleep by dawn, or if asleep wake up with desperate need for air and feeling hot.
PakPik, I'm taking 10 drops of progest-e every night before bed. I was under impression it has to be used till the end of term. Now you got me thinking if I should wean myself off, as you pointed out that labor starts at the drop of progesterone. I don't want to overdue. My estimated due date is June 26.
Once again, tons of thanks , your time and knowledge sharing is really appreciated.

 

[Elvie]

I also forgot to mention that I'm having issues with constipation that I believe is part of my sleep problem.

 

[PakPik]

Hi Elvier, I'm glad to hear you enjoyed many months without the bad symptoms.
10 drops of progesterone is not a big amount compared to what a pregnant woman should be producing in late pregnancy (10 drops=30-40 mg, and in pregnancy the amount of progesterone is around 400 mg daily). I was worrying you were planning to use a huge amount right before labor. I've read in a book by Katharina Dalton (one of the pioneers in progesterone therapy for pregnancy and PMS) about the success they had supporting pregnancies with natural progesterone, and that most women would stop the therapy after the fourth, fifth month, but there were a few women who needed to continue with progesterone till labor. She even mentions that the kids developed very healthy and intelligent into adulthood. So, I'm sharing this quote from the book (just information, don't take it as medical advice):

"Alison (page 244) was discussed in the British Medical Journal in August 1957 in my paper "Toxemia of Pregnancy Treated with Progesterone During Symptomatic Stage." The paper discussed how when progesterone is given for the relief of pregnancy symptoms, usually "treatment can be discontinued after the fourth or fifth month, but where necessary treatment is maintained throughout pregnancy." Alison is an example of a woman who needed progesterone from the sixth week of pregnancy until labor, at thirty four weeks. She was thirty-one years old, working in the garment industry, and had had two previous miscarriages. She suffered from backaches, headaches, and exhaustion. These were eased with progesterone [clarification: the natural progesterone, not synthetic], taken daily or on alternate days. ... Attempts were made at twelve, sixteen, and twenty-two weeks of pregnancy to stop the progesterone, but her symptoms immediately returned.
Alison had an easy labor and gave birth to fraternal twins... she had no postnatal depression or PMS and had no further need for progesterone."

And yes, constipation can mess up hormones and nervous system. It would be important to fix the constipation issue. Are you getting enough light and rest? Eating enough calories and micronutrients? Enough macronutrients (carbs, protein, good fats/low PUFA)? All of these factors impact cellular respiration, which is so important for gut motility.

By the way, congratulations for your pregnancy and I pray and hope you'll deliver and healthy beautiful baby and be safe. :)

 

[Elvie]

PakPik, I can't thank you enough for your responses. I try to stay in the sun as much as I can but am a bit worried about what to consume after to make up the nutrients. Any suggestions? My appetite has decreased tremendously even tough they say I should be gaining a lb a week. I am worried that my baby - boy is not gaining because of that. I might be wrong and just paranoid. I am having a biophysical sonogram on Monday.

 

[Elvie]

Do you guys think that despite the low dose of peogest-e (10 drops at night), I should stop it completely as due date is approaching?

 

[PakPik]

I can't answer your question, but I personally would taper off gradually, say 2-3 drops less every week. I'd definitely would avoid lowering progesterone too much to soon, since Katharina Dalton mentioned certain women at risk for toxemia can have an exacerbation if progesterone is dropped too fast. In fact, I found the complete Katharina Dalton's paper she was referring to in my post above, and it mentions several things that I find relevant to this conversation, I suggest reading http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1962072/pdf/brmedj03116-0018.pdf

Finally, I'd do my best to get plenty of calcium and sodium, plenty of calories (incl. carbs), and at least 120 grams (or more for a taller person) of good quality protein. These are some of the most important factors according to Ray Peat to provide for pregnancy in order to avoid stress hormones rising too much. And well, last but not least, as much mental and physical rest and peace as can be afforded.

 

[Elvie]

Thank you, PakPik,
What would be an example of 120gr of protein intake? I have a hard time figuring out what foods to eat. I try four glasses of milk ,4 glasses of oj, some lamb, egg, cheese but still can't get to 80 grams. Do you think it's too much liquid that could slow the thyroid ?

 

[PakPik]

Elvie,
regarding liquids I understand your concern. You want to have a good balance of solutes (osmolarity), but providing enough liquids is very important. If that's your typical diet, what I get from it is that it contains only 2 litres of liquids? That's very low, in my humble opinion. Specially for a metabolic demanding situation like pregnancy, and not getting enough liquids leads to low blood volume, which is the crux of many of the metabolic difficulties seen in late pregnancy. Maybe worth trying to increase milk/OJ intake and see if that makes you feel better? When I myself have gotten dehydrated it was really hard to realize, but it turned out 2 litres were not enough, had to aim for at least 3.5 litres and many problems improved, specially adrenalin/restlesness (and I am definitely NOT a big woman :) ). I think the key is to provide enough minerals to balance the liquids -OJ and milk are balanced in that regard-, and not restricting liquids.

Your symptoms "not sleeping well at all, I fall asleep by dawn, or if asleep wake up with desperate need for air and feeling hot" are very similar to the adrenalin symptoms many people experience during sleep time. Low blood volume, low blood sodium and hypoglycemia are three of the things that cause an increase of adrenaline. Adrenaline can also cause constipation.

Check these quotes out:
"The pregnant woman's blood volume expands, to permit the supply of energy to match the needs of the embryo. If the blood volume doesn't increase, or if it decreases, as in pregnancy toxemia, her blood pressure will increase."When energy fails: Edema, heart failure, hypertension, sarcopenia, etc.

"So, Tom Brewer reviewed the evidence already in the 1950’s. He had a good collection of scientific studies showing that more salt was the cure to toxemia. Protein was the thing mostly emphasized. But protein and plenty of salt, and calcium. So, milk was the ideal protein, because drinking two quarts of milk, you get more than 2000mg of calcium. And the calcium is one of the things that helps to turn off aldosterone. And the sodium is very powerful at turning off the aldosterone. And the aldosterone is one of the immediate villains in producing many of the symptoms, such as leakiness of blood vessels (lets the water fall out of your blood, cause your feet and <inaudible> such to swell up). So, just drinking more water just causes more edema."CELLULAR REPAIR KMUD 2012

Your diet seems low in calories. Upping the milk and OJ can help in that regard, as well as helping increase your protein intake. I also think that things like honey and gelatin, if tolerated, can be excellent additions. Hope you find some relief!

 

[Elvie]

Thank you, PakPik, for such an informative reply. I will try doubling milk and oj. The only thing is it will make my trips to the bathroom at night very frequent, do you think I can try drinking before 6pm and then stop them for the night?
I'm not tall - 5'.1"( wich falsely made me think that 2L of milk & oj combined might be too much), hopefully things will improve as last night was really bad: constipated, couldn't sleep and had symptoms of panic attack. I tried breathing under the sheets to calm myself down as everyone around thinks I'm simply worried about upcoming due date and need to control my emotions.
You see how your advice is so timely and to the point. As I got your message in the AM , I was reading it while drinking 8oz glass of oj with 1/4 teaspoon of salt and then went for a glass of milk. ( will continue every hr)

Many, many thanks from my baby & me for taking time to evaluate my mistakes.

 

[leo]

Elvis your post reminded me of my pregnancy .........way back in 1980 when I had my first child, I developed horrific morning sickness which was actually all day sickness and lasted the entire 9 months. I could barely go into my kitchen as food smells triggered it. ,,,I would vomit up to ten times a day. Drs did nothing as then there were no meds to take for it that would be safe for baby.

The only things I could eat, and actually craved were whole fat milk, watermelons, and highly salted tomatoes. I feared I would have sickly children (it happened with both my pregnancies). I ate no meats, vegetables starches or anything...but drank gallons upon gallons of milk. I would freeze the carton, then when defrosting drink the heavier cream that would be liquid first and leave the tube of watery ice milk that remained. These three things were ALL I ate for nine months.

I ended up having a very healthy 9 lb boy and 3 yrs later an 8 lb girl.

I was 28 then. No internet. No idea of thyroid or anything. But my body got exactly what it needed with those three foods because my children were very healthy and breastfed for nine months afterwards, as I was a milk making machine. LOL

I now live in a country where the poorer populations survive on rice beans and plantains and have seemingly healthy children. I've thus learned not to worry so much about food. So much more is at play and best wishes for a beautiful healthy baby!

 

[Elvie]

Wow, Thank you Leo. Birth weight of 9& 8 lbs , well done!!! As per Dr.Brewer's theory, your kids must be very intelligent and academically successful!
Was the delivery uneventful?

 

[schultz]

Liver once a week would be prudent, especially if you're getting lots of sun.

I made sure my wife ate a bowl of ice cream before bed when she was pregnant.

Gelatin for extra protein could be helpful. It may also help you sleep if you take some before bed.

Daily carrots may help the constipation.

Below are some Ray Peat quotes from his book "From PMS to Menopause"

"At least in the case of progesterone, an excess tends to balance or neutralize an excess of the specialized hormones, so it has been described as having anti-androgenic, anti-estrogen, anti-aldosterone, and anti-cortisol functions."

I'm not sure if this is a stretch but, the progesterone you're taking at night may be having an anti-cortisol action and therefore keeping your blood sugar a bit low. This may account for your sleep troubles, at least partially. You need to back-up the progesterone with ample nutrition. High progesterone and good nutrition should prevent stretch marks as well (stretch marks during pregnancy are likely caused by cortisol).

"During pregnancy, very large amounts of progesterone are made. It protects and stabilizes practically all functions of both the mother and the fetus. Progesterone, glucose and the thyroid hormones powerfully influence the brain development and intelligence of the baby, probably by influencing both the number and the size of brain cells, and the quality of their functioning."

"Part of progesterone's protective effect is a result of its quieting effect on cells. For example, it tends to prevent seizure activity in brain cells. During childbirth, its normal function is to act as an anesthetic. When the level of estrogen is too high, progesterone can't achieve this effect."

 

[Elvie]

Shultz, thank you very much for your reply. Unfortunately, I do not get lots of sun but get it in the amount of 1 hr- 1.5 hrs when it's out. I live in NY. So we had a sunny day yesterday, I walked and sat in the sun for 2 hrs. My Vit.D came back low 27.5, so I'm making sure to come out on a sunny day. I noticed that when there is no sunlight, like today, I feel so fatigued and sluggish. My thyroid starts acting up, im taking 112mcg of Synthroid and TSH goes up when there is more sun. My endocrinologist does not believe that, just keeps upping the dose. I got myself 300 watt incandescent bulb that I use on cloudy days but it doesn't have the same effect for some reason.
I eat my baby carrots every afternoon.
I will try gelatin before bed. What form are you consuming it in? I make jello.
Ice cream before bed, what a great husband!!!
As far as progest-e, I thought tapering off gradually as progesterone production is shut down by the body before delivery. PakPik kindly provided the link:

Elvie,
My undertsanding is that prostaglandins are key mediators for the induction and sustain of labor (they have to do with uterine contractions and so on). Progesterone is an antiprostaglandin agent: it both lowers production and destroys whatever has already been produced. So, I definitely believe progesterone shouldn't be administered for that stage of pregnancy, in fact labor starts when there's a sharp drop in progesterone as far as I know.

The role of prostaglandins in labor and delivery. - PubMed - NCBI
"It appears certain now that, at least in some cases, prostaglandins are important mediators of uterine activity. Indeed, a much stronger case can be made for the role of prostaglandins in labor than can be made for oxytocin."

I thought of using a large dose of Progest-e instead of epidural but it doesn't seem like a prudent thing to do from the replies I got.

 

[PakPik]

I thought this image might be informative. Looks like progesterone remains high well until the very last 2 weeks, when it starts to go a little down while estrogen keeps rising.

 

[leo]

Elvi perfect deliveries although my firstborn had a very large head (caput) and was extremely painful to deliver as I was very skinny with hardly no hips then (those were the days!). Second delivery almost happened without my knowing about it LOL.

Very good students, one an engineer and the other an architect. So yeah, no visible brain damage from mom's very restrictive(according to mainstream then) diet. The very minute I gave birth, my appetite returned to normal and I had no nausea. Of course I gained the pregnancy weight AFTER their births. I've always been known to do everything backwards.

Funny now that I have found Peat's perspectives on food, I see that the milk, salt, fruit was very ample in keeping me healthy. But I did have everyone very very worried for nine months just eating that. I just listened to my body and it paid of thank God.

My very best to you!

 

[Elvie]

Thank you, all intelligent peaterians, for all your valuable input.
PakPik hugs to you for resolving my constipation issue , I am amazed at how quickly you can see the results, I kept on drinking milk and oj throughout the day , I don't think I got to 3.5L but will get there. I had a BM by the evening and today in the AM. Apologies for TMI, I just thought it might be helpful for smb else having the same problem.
I still had some fear of falling a sleep, with my nose clogging and heavy pattern of breathing. Still I had a better night - some sleep. Shultz, thank you for the ice cream tip. I got up at 6 am had and ice cream w/glass of milk and was able to sleep another 2hrs.
I am so greatful to all of you for not leaving my questions unanswered.
Love, kisses and hugs from my baby and me!

 

[Elvie]

Leo:
Such a positive story ! Thank you for sharing it. Really encouraging!
Elvie