Progest-E Dosing For Estrogen Dominance

[Vaness425]

I'll try to keep it short:

Diagnosed a few years ago (after childbirth) with Hashimoto's. Started NDT currently at 2.5 grains, this stopped me from being a walking zombie but still don't feel my best--after noticing my ups and downs seemed to follow hormonal cycle of my period I read more and have practically every symptom of estrogen dominance. I currently take Calcium D Glucarate and DIM and have recently begun a Peat diet including raw carrot a day to help with estrogen dominance.

My blood levels continue to show low levels of progesterone and too high levels of estrogen, and my symptoms have not improved much. I have ordered Progest-E. My understanding is to dose high to prevent a resurgence of estrogen dominance symptoms. This is from the website where I ordered: Long Natural Health

"It is recommended that nearly everyone should begin with the high dose directions for 10 days to avoid complications (as low thyroid, high estrogen situations require a high initial dose to avoid progesterone reverting to estrogen). For example, to relieve severe symptoms (hot flashes, menstrual pain, cramping, PMS, ovarian cysts, fibrocystic breast disease, high estrogen, etc.) take one dose (3 drops) five times daily for 10 days, then decrease to about 3 doses daily for 1-2 two weeks (can be longer as needed). Eventually, 1-2 doses for another few weeks or months as needed. Can continue using every day, or if you’re having a regular menses you can switch to a maintenance dose: one dose per day
from mid-cycle to start of menses (usually about 14 days)"

I will be day 14 of my period in a couple days (when progesterone is typically highest). If I start day 14, at a high dose (3 drops 5 times daily for 10 days), should I decrease to 3 doses daily for 1-2 weeks, thus likely skipping my next period due use of progesterone? Or stop progesterone completely to have my period, then start up again on day 14? I'm leaning towards skipping my period, as I'm thinking that will prevent a resurgence of estrogen dominance symptoms that many report when starting progesterone.

Interested to know how anyone here would start Progest E given the above situation.
Added: I am a 30 year old woman, on Paragard IUD (copper) and not trying or wanting to become pregnant. So if I skip a period for a month I'm not heartbroken.

 

[Mittir]

I do not have any idea about progesterone dosing for female.
You can check old threads on this and there are many threads.
I hope others who use progesterone will be able to help you.
Ray Peat recommends blood tests for hormones but he also
mentioned that one can have normal level of estrogen in blood
but higher level in tissues. Progesterone use can increase
estrogen level in blood by drawing out estrogen from tissues to
neutralize. RP put more emphasis on thyroid to fix most problems
as low thyroid function results in high estrogen and low progesterone.
High estrogen also lowers thyroid function. It would be a good idea
to test TSH, total T3, total T4 and reverse T3. Measuring temperature and pulse
1-2 hours after breakfast gives a good idea about metabolic state.
I remember one lady asking RP about IUD in an interview.
I vaguely remember that RP mentioned that these devices causes
irritation to wall and this results in hormonal imbalance.
He also mentioned it take some time to recover once this device is removed.
I believe there are old threads on IUD too.
You are already using thyroid supplements. RP thinks one should have
at least total cholesterol of 160 and preferably 200 before starting
thyroid supplement. Body needs active thyroid hormone and Vitamin A
to convert cholesterol into progesterone. Liver is a good source of vitamin A.
RP also thinks the way Hashimoto is diagnosed is not correct and
antibodies found in so called Hashimoto patients are result of clean up
process after inflammation. Excess Estrogen is a major cause of
thyroid problem in most females. Thyroid supplement also increases
need for nutrients by increasing metabolism. RP puts a lot of emphasis on
at least 80 grams of quality protein and B vitamins for liver to detoxify excess estrogen.
You also need to maintain a steady blood sugar level by eating small meals
of carb, protein and fat. Vitamin E is anti-estrogenic.
Niacinamide and or Aspirin helps with lowering PUFA and estrogen.
Diet is a big part of healing. You can use cronometer.com to track your nutrient intake.

 

[tara]

I don't think I've got this sorted for myself yet, but I can report that even the higher dose described above (3 drops x 5/day) was not enough to stop me menstruating. When I started, I was palanning to reduce day 26, but my period started day 25, and I liked the effects of the progesterone, so I keep using it continuously.

You could do the 3x5 from day 14, then either stop or reduce when you expect menstruation. Or if the symptoms are too horrible, just keep going with the 3x5 till it improves, then reduce for first half of cycle, and eventually reduce further when it no longer seems necessary.

Others will have more experience with this.

 

[aguilaroja]

I'll try to keep it short:

Diagnosed a few years ago (after childbirth) with Hashimoto's. Started NDT currently at 2.5 grains, this stopped me from being a walking zombie but still don't feel my best--after noticing my ups and downs seemed to follow hormonal cycle of my period I... have practically every symptom of estrogen dominance. I currently take Calcium D Glucarate and DIM

This comment is for discussion only. See the general forum advisement.

Every situation is specific, while the forum discussions are general, since Dr. Peat provides the context for individual decision making, in contrast to fixed procedures. Some information has been reported, while it is expected that there is more to the story.

What symptoms attributed to estrogen dominance are there, and how serve have they been?
Is the NDT being divided into spaced dosing throughout the day? It is better to keep the T3 element of NDT delivered in small amounts throughout the day. Is it being chewed before swallowing? Some people do better with crushed NDT absorption, due to some binders in the pills. Mittir has given important guidance about factors that will maximize augmentation of metabolism and thyroid function. Maybe some of them have been pursued in your study so far.

(AFAIK Dr. Peat continues to prefer the bio-identical "synthetic" T4 & T3.
http://raypeat.com/articles/articles/thyroid.shtml)

If choosing to go with the protocol described, it would seem that response during the two weeks after mid-cycle would give indications about further adjustment. In some situations where thyroid augmentation is underway, Progest-E & bio-identical progesterone will strongly boost thyroid function. If thyroid function becomes over-active, it may be necessary be scale back thyroid support.

There are open questions about how IUD's affect metabolism. It seems that in the recent generation of devices, there is some effect on minerals. I am not lobbying against their use, only describing that there is an additional factor here:

DIM/diindolylmethane according to various research articles has both anti-estrogenic and estrogenic properties. Though there have been some intriguing reports, I plead ignorance about to what extant DIM is safe or helpful.
--
http://www.ncbi.nlm.nih.gov/pubmed/24304153
Eur J Contracept Reprod Health Care. 2014 Feb;19(1):45-50. doi: 10.3109/13625187.2013.856404. Epub 2013 Dec 5.
Changes in copper and zinc serum levels in women wearing a copper TCu-380A intrauterine device.Imani S1, Moghaddam-Banaem L, Roudbar-Mohammadi S, Asghari-Jafarabadi M.

http://www.ncbi.nlm.nih.gov/pubmed/20160136
Endocrinology. 2010 Apr;151(4):1662-7. doi: 10.1210/en.2009-1028. Epub 2010 Feb 16.
Selective activation of estrogen receptor-beta target genes by 3,3'-diindolylmethane.Vivar OI1, Saunier EF, Leitman DC, Firestone GL, Bjeldanes LF.

http://www.ncbi.nlm.nih.gov/pubmed/21267453
PLoS One. 2011 Jan 18;6(1):e15879. doi: 10.1371/journal.pone.0015879.
Estrogen induced metastatic modulators MMP-2 and MMP-9 are targets of 3,3'-diindolylmethane in thyroid cancer.Rajoria S1, Suriano R, George A, Shanmugam A, Schantz SP, Geliebter J, Tiwari RK.

 

[4peatssake]

If it were me I'd not be concerned about missing a period or two.

Dosing high as recommended for several weeks knocked down my symptoms of estrogen dominance. And when I first used Progest E, within 3 days my menses were normalized and since then I no longer have heavy bleeding and clotting. I was amazed.

I don't need to use it a lot any more. it worked wonders for me.

I will also say that I did not at first follow the recommendations for high dosing and my symptoms did worsen as a result. Once I began to dose as directed things improved swiftly.

It is a safe and very protective supplement when used properly.

 

[Clara226]

Hi Vaness425,

Your situation sounds very familiar with what I went though. How are you feeling lately?
Any new news? Have you started the Progest-E ?

 

[tara]

Hi,
Just found this that I thought might be relevant to your use of an IUD:

The effect of an intra-uterine irritant is to signal the ovary to suppress progesterone production, to prevent pregnancy while there is a problem in the uterus.

Menopause and its causes:
http://raypeat.com/articles/articles/menopause.shtml
or here:
viewtopic.php?f=19&t=308

I interpret that as implying that using an IUD for effective contraception may be incompatible with having enough progesterone in the system to support good health. Is that how others read it? If so, it might be a choice about which is more important. May be worth considering other prophylaxis that doesn't rely on raising estrogen or lowering progesterone.

 

[Debz]

Hi ,
After reading that the IUD increases estrogen on Monday .Today I had it taken out .My Doctor couldn't understand my reasoning ,she says its definately not hormonal. Can anyone give me literature to prove she's wrong. I have been fighting Estrogen dominance for so long I'm glad its out .
The other thing ,is she found a big cyst ,anything I can do besides the Progest- E which I will do ,to make sure its not there when she scans again in a months time.

 

[Debz]

Hi to continue on about my newly discovered cyst , I found these Peat Quotes and yes I still have not been able to increase my temperatures on Thyroid-S after almost one year ,should I try something else

Animal experiments show that lack of thyroid hormone can cause cystic ovaries.” -Ray Peat, PhD in “Nutrition for Women”

“Animals which are artificially made hypothyroid develop cystic ovaries, so it is reasonable to consider hypothyroidism as an important factor when women have cystic ovaries.” -Ray Peat, PhD

 

[sweetpeat]

Hi to continue on about my newly discovered cyst , I found these Peat Quotes and yes I still have not been able to increase my temperatures on Thyroid-S after almost one year ,should I try something else

Animal experiments show that lack of thyroid hormone can cause cystic ovaries.” -Ray Peat, PhD in “Nutrition for Women”

“Animals which are artificially made hypothyroid develop cystic ovaries, so it is reasonable to consider hypothyroidism as an important factor when women have cystic ovaries.” -Ray Peat, PhD

How much Thyroid-S are you taking? Are you taking it all in one dose or splitting it into several doses throughout the day?

 

[lindsay]

My experience has been that high doses of progesterone were the ONLY thing that brought on a period for me (the opposite of what one would expect). When I was taking about 400 mg per day, I started menstruating again after a year of being without a period (I was told I was post menopausal at the time). This lasted two months and then I got sloppy with my dosing and haven't menstruated again since - that was last April. So it didn't stop me from getting a period.

On a side note Debz, did your doctor know what kind of cyst it was? I had an ovarian tumor removed almost 2 years ago (I was 30 at the time). They thought it was a dermoid cyst. If I had known then what I know now, I would have asked for a thyroid panel and I would have taken high doses of progesterone, some thyroid (currently taking Cynoplus - works much better than NDT did for me) and laid on my butt until the thing went away. Instead, I didn't do anything and I let them take out an ovary and screw up my hormonal health. Whatever you do, don't let your doctor's scare you into anything and get a second opinion. But progesterone and thyroid are likely going to be very important for you at this point.

 

[Debz]

Hi
I take 4 split into half eight times a day ,I feel warmer but I still have 35C temp in the afternoons

 

[Debz]

Thanks Lindsey ,not sure what kind it was 5,3cm Looked fluid filled on the scan. Hoping that lots of progest -e will get rid of it ,but I must sort out my thyroid . I'm wondering if I should wait longer than a month ,maybe 6 weeks to do the next scan to give me time to get rid off it .I know my Doctor will try and bully me into doing something I dont want if its still there .

 

[lindsay]

Thanks Lindsey ,not sure what kind it was 5,3cm Looked fluid filled on the scan. Hoping that lots of progest -e will get rid of it ,but I must sort out my thyroid . I'm wondering if I should wait longer than a month ,maybe 6 weeks to do the next scan to give me time to get rid off it .I know my Doctor will try and bully me into doing something I dont want if its still there .

Oh good! Fluid filled cysts USUALLY dissipate, drain or rupture (note - the latter is very painful and can be brought on by physical exertion). I had one large cyst rupture when I was a teenager - happened while I was mowing the lawn with a push mower. It was SO painful, I would really advise against any intense exercise.

I think you are right about waiting 6 weeks - that was the timeframe I waited before checking my tumor. It didn't go away, but then I was stupid and kept up intense swimming and I was eating so little from the pain of it interfering with digestion (It had caused ovarian torsion and pretty much killed my left ovary, which I found out after the surgery).

If you can, just take it easy, relax and keep up a good diet and the progesterone (lots of progesterone). Thyroid may or may not be necessary, but take it easy and I'm sure it will go away - so long as it is fluid filled. If it is a dermoid, it might take longer to go away. Also, if you can, I would opt for a ultrasound over a cat scan (because of the radiation). I think MRI's are okay, but they are just flat out miserable to go through.

The likelihood is the cyst will drain when you have your next period, so you might have some pain. Aspirin should also help, but I would take that while eating some liver or taking a K2 supplement.

 

[sweetpeat]

Hi
I take 4 split into half eight times a day ,I feel warmer but I still have 35C temp in the afternoons

A couple of things come to mind. Each tablet of Thyroid-S contains 9mcg of t3, I believe. Splitting the pill in half like you’re doing gives you 4.5mcg of t3 per dose. It’s possible the dose is still too high to be effective. Ray Peat has said that the body normally produces about 4 mcg of t3 per hour and anything over that could be made inactive. I’m still trying to figure out my best overall thyroid dosage too, but I experienced significant (for me) temperature increases when I took smaller doses, keeping the t3 at 2 or 3mcg per dose. So, you could try splitting the pills into 4, 6 or even 8 pieces for some of your doses. They do start getting tiny and crumbly at that point, but sometimes less is more, if you know what I mean. You could still take a larger dose maybe first thing in the morning and/or at the end of the day. It’s really a matter of experimentation.

Another thought is that since you are so strongly estrogen dominant, your body isn’t converting the t4 in the pills into the active t3 and it’s just building up in your system. Peat has also said that thyroxine (or t4) can act as a “thyroid anti-hormone” especially in women because of estrogen issues. Several women on this board, including myself, use additional t3 (Cynomel) with a product like Thyroid-S because of conversion issues like that. I’m not saying you need to do that, but it’s something to keep in mind. Especially if you haven’t seen much improvement after a year. There are several logs in the testimonials section you could read through to get an idea of how people have added in the extra t3.

Splitting the pills into smaller pieces is the easiest thing to try first, while you continue hammering away at the progesterone. Let us know how things turn out!

 

[Debz]

Thanks for all the great advice ,will send an update next year .

 

[athena7]

Hey guys, this topic is very interesting to me. I have been trying to take lugols iodine to help sort out whatever thyroid issue I must have (I get very hot and then cold, mostly hot and sweat all the time with racing heart). It is very hard for me to handle iodine, obviously, but I have not heard of these kinds you ladies are taking(cynomel)? Maybe I should try something else. The progest-e(mega dosing at first then backing down) on its own has been amazing and brought my endometriosis pain wayyy down and shortened my horrendous periods. Also, my adult acne I was suffering with is finally gone, yay! I also take DIM(an active form) and calcium d-glucurate and I think the combination of all these things has helped all aspects. Also I take vitamin A(retinyl palmitate) every other day along with a beta carotene rich diet and I take zinc and vitamin D. Lots of good fat and protein, healthy carbs. My main concern now is trying to get in a source of iodine.....and figuring out if I even have a thyroid problem. My blood work says all is normal but I question that because I sweat and have a racing heart with just a few drops of iodine in the morning. In turn it causes severe anxiety!!! I got put on beta blockers and they work but not perfectly. Plus, I would rather not be on any medication. Would seaweed be enough iodine to add into my diet. Like, nori with dinner? Any thoughts would be appreciated. Thanks!

 

[tara]

athena7

The progest-e(mega dosing at first then backing down) on its own has been amazing and brought my endometriosis pain wayyy down and shortened my horrendous periods.

Excellent!

Also, my adult acne I was suffering with is finally gone, yay! I also take DIM(an active form) and calcium d-glucurate and I think the combination of all these things has helped all aspects. Also I take vitamin A(retinyl palmitate) every other day along with a beta carotene rich diet and I take zinc and vitamin D. Lots of good fat and protein, healthy carbs. My main concern now is trying to get in a source of iodine.....and figuring out if I even have a thyroid problem. My blood work says all is normal but I question that because I sweat and have a racing heart with just a few drops of iodine in the morning. In turn it causes severe anxiety!!! I got put on beta blockers and they work but not perfectly. Plus, I would rather not be on any medication. Would seaweed be enough iodine to add into my diet. Like, nori with dinner? Any thoughts would be appreciated. Thanks!

Peat generally recommend not supplementing iodine. My understanding (someone correct me if I'm wrong) is that too much iodine causes as many problems as too little.
Some people ho have low thyroid function have troule converting much beta-carotene into the active form of Vit-A, in which case they are better off not getting too much of it. One way you can tell is if you see aa yellow/orange tinge to skin/callouses. I don't eat cooked carrots for this reason (and I'm averse to them, which I guess may be related).

To get more of an idea of what's going on with your thyroid function, you could try tracking your temperature over a few days - eg. at first waking (before rising), a bit after breakfast, afternoon. Also measuring resting heart rate a few times could give more info. If you have any related lab results, you can post thyroid numbers here if you want to. We, and Peat, don't always interpret them the same way as the endocrinologists.
Cynomel is synthetic T3 (active thyroid hormone). It should only be used if you need it, and with caution and very small doses.

I'd recommend reading up on raypeat.com/articles about thyroid, and also read quite a few other threads on it here, to get more of an idea of how people use them, and the avoidable risks.

 

[Debz]

Had my ultra sound today and my ovarian cyst is still there and growing after two months of pumping in progest-e .It is now 5.5cm and the doctor thinks its a chocolate cyst, that is I have endmetriosis .I also received my blood test back and my CA125 is high 42.7 so she wants to operate.
My Estrogen was even higher than last year even after a year on progest-e and daily carrot salad.
Estrogen - 4494
Progesterone - 15.1
SHBG -176

Then my Thyroid was strange, Ive been on Thyroid-S for a year and my Cynomel has just arrived ,not sure I should take it now or take it with T4 ,any ideas
TSH - 0.001
T4 free 11.3
T3free 5.8

So not a good day at the Doctors . I told her I wouldn't go for a hysterectomy as she suggested , but then she said the second option would be to take the ovary but then she would put me on Lupron for 6 months which I also do not want. I was thinking of finding a Doctor to do Laser Surgery on the inside of the ovary and who will give me an Aromatase inhibitor instead of Lupron.

 

[Debz]

Had my ultra sound today and my ovarian cyst is still there and growing after two months of pumping in progest-e .It is now 5.5cm and the doctor thinks its a chocolate cyst, that is I have endmetriosis .I also received my blood test back and my CA125 is high 42.7 so she wants to operate.
My Estrogen was even higher than last year even after a year on progest-e and daily carrot salad.
Estrogen - 4494
Progesterone - 15.1
SHBG -176

Then my Thyroid was strange, Ive been on Thyroid-S for a year and my Cynomel has just arrived ,not sure I should take it now or take it with T4 ,any ideas
TSH - 0.001
T4 free 11.3
T3free 5.8

So not a good day at the Doctors . I told her I wouldn't go for a hysterectomy as she suggested , but then she said the second option would be to take the ovary but then she would put me on Lupron for 6 months which I also do not want. I was thinking of finding a Doctor to do Laser Surgery on the inside of the ovary and who will give me an Aromatase inhibitor instead of Lupron.