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Dalmazio

by Dalmazio
(Calgary, Canada)

Greetings, and thanks for all the work you do.

I have a question regarding dosage and it's relationship to blood plasma levels of progesterone.

On your website I found the following:

==

"The typical 20-40mg/day that is recommended does not raise levels to that found in the luteal phase. One study found that using 40mg/day...

"...only low plasma progesterone levels were found (median 2.5 nmol/l)"

The ranges for the luteal phase are 15.9 - 63.6 nmol/L (5 to 20 ng/ml). Men secrete <3.18 nmol/L (<1 ng/ml). For more information see Hormone Testing."

==

However, I've come across some interesting research on the Virginia Hopkins site that states that blood serum levels are the wrong tests to use, with reference to scientific research that shows that they don't accurately show absorption of progesterone. That the progesterone is absorbed into the red blood cells rather than in the watery serum. And that saliva tests are a much more accurate test to use.

http://www.virginiahopkinstestkits.com/salivavsblood.html

For example:

==

"Direct Comparison of Plasma and Saliva Levels After Topical Progesterone Application Dollbaum CM, Duwe GF. Absorption of progesterone after topical application: plasma and saliva levels. Presented at the 7th Annual Meeting of the American Menopause Society, 1997.

The last reference is particularly revealing. Creams with varying concentrations of progesterone were applied to menopausal women after which both plasma and saliva levels were measure. The results are illustrated below.

...

When only 0.34 mg of progesterone was applied topically, the plasma level rose 39 percent, whereas saliva level rose 5-fold. This indicates that only a small portion of the added progesterone entered the plasma, whereas the saliva clearly showed a hefty increase of bioavailable progesterone. When an 88-fold larger dose was applied topically, the plasma level rose only 3.6-fold while the simultaneous saliva level rose 57-fold. This indicates that only the saliva reflected the great increase in absorbed bioavailable progesterone. The progesterone found in the saliva obviously was blood-borne, but it should be clear that the portion of the blood carrying the progesterone was not the plasma (serum) but, rather, was via red blood cells.

In all situations, however, it should be clear that plasma progesterone levels are not indicative of the true level of bioavailable progesterone such as is obtained from topical application. Saliva levels are far more appropriate for this purpose.

==

Could you comment on this? And specifically what Dr. John Lee stated, that most women should be using around 15-20mg per day (perhaps higher in the first few months to deal with side-effects of established estrogen dominance), but then reduce down to 15-20mg per day as a long-term supplement?

Best regards,
Dalmazio

Comments for Dalmazio

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Mar 21, 2013
 Progesterone
by: Letitia

I think this is an excellent question as I have also read John Lee & virigina Hopkins books.
What I have been told by my Compounding pharmacy is that a lot of Doctors use blood tests because the majority of insurance companies will pay for blood tests, but will not pay for saliva testing ????? go figure.

I found out via the virginia hopkins web sit that ZRT labs who is one of the bigger and better saliva testing labs for womans hormones is now offering a blood test that can measure the bio available progestone/estrogen just like the saliva and I am going to do this blood test with my doctor next week.
I will be greatly interested in what Wythe says about this great developement also for us woman.

Dalmazio, keep me posted please

Letitia
Mar 21, 2013
 Dalmazio
by: Wray

Hi Dalmazio Thanks for the kind words. Yes Saliva Tests are more accurate on the whole. We use them to test our cream, one way we know it does contain progesterone! And it tells us the carrier system we have works very well, a naturopath does them for us. You'll notice a before and after, she generally gives her patients 80-100mg/day progesterone. We do have a Hormone Testing page you could look through. We have more info on our site than you've given above too, see Progesterone Test. It's done by Dr Zava who runs ZRT Labs, one of the best there is. He gives all the pros and cons of both. I have found anomalies. For instance there are a number of women who write in saying their progesterone level is 10,000 or 20,000pg/ml and their doctor is freaking out. Or their ratio of P:E2 is over 2000:1. And yet they still have severe symptoms. They are often using only 100mg/day too, which is not much. I always tell them to increase the progesterone, and in every case it's helped. I don't put much store in tests, as they cannot tell how a woman is feeling, only what her level is. Another thing is low vitamin D, this affects progesterone. In fact I'm beginning to think I should tell people not to bother with using progesterone, unless they get their vitamin D levels up high, see here, here and here. Every time a woman has, even using very high amounts of 1000mg/day and over, persistent symptoms have gone. One of my arguments against the 20mg/day is if that amount is fine, then why do so many women have so many adverse side effects. As 5-20mg/day, up to 40mg/day, is the amount women make if they still have a cycle. If symptoms are severe very much more is needed to overcome them. As testified by the results of the studies done on Traumatic Brain Injury victims. They're given over 1200mg/day via IV transfusion. Another study to come out of the TBI studies is one on neuroblastoma, a brain tumour which kills more children under 1 years old than any other brain tumour. Continued below
Mar 21, 2013
 Dalmazio Part 2
by: Wray

Hi Dalmazio They found progesterone reverses the tumours, but only if exceptional high amounts were used, see here. One thing they did find was too low a level caused it to get worse. Which is exactly what is found if too little is used for any symptom, however minor. I was lucky enough to hear Dr Lee talk a number of times, most excellent. But I was also lucky enough to have met and talked to Dr Dalton, they didn't see eye to eye on the amount to use! If she had a problem on her hands, i.e. PND then she would use 800mg/day and more, see here. If her patient had post natal psychosis, then she would use up to 2400mg/day. It always worked, and they had no ill affects from it. It was from her work, and talking to her, that I realised she was right, large amounts are needed if symptoms are severe. In fact if you read that page I've given above, you'll see they also found no toxic affects on healthy cells, only good. The same with the TBI victims, only good. Take care Wray
Mar 21, 2013
 Progesterone Dosages
by: Dalmazio

Thanks Wray.

All very interesting.

It seems vitamin D is behaving as a powerful absorptive activator. I think you are onto something when you say that you are beginning to think you should tell people not to bother with using progesterone, unless they get their vitamin D levels up high. It seems there is something of an epidemic of vitamin D deficiency all over the world.

Natural news: Vit. D deficiency.

Does your progesterone product include a strong recommendation to supplement with sufficient vitamin D? What would you recommend as a supplemental dose of vitamin D for women with moderate to severe symptoms? 5000 IUs? 10,000 IUs? I’m thinking this might help a lot of women, as it’s really easy to miss.

I’m also wondering if those 20-40mg / day doses of progesterone might become tenable again as a longterm supplement if there was sufficient vitamin D. Your scientific publication links seem to suggest this.

Curious if Dr. Lee was using vitamin D supplementation in his patients, without really realizing the powerful effect it had on progesterone absorption. That could explain the lower vs. higher progesterone dosage discrepancy between his and Dr. Dalton’s work.

The other thing I’m really curious about is why too low an amount of progesterone often has the side-effect of making symptoms worse? Very odd this. Perhaps some sort of sudden "immuno-estro retaliatory" response?

I would be interested to know if anyone has tried approaching this from the other side - i.e., instead of blitzing with large amounts of progesterone upfront, perhaps sneaking the extra progesterone in the back-door undetected, by adding small amounts and increasing very gradually, say a few mg / day?

Finally, what’s the barrier to producing a product with higher concentrations approaching 10% or even 20% -> 100mg - 200mg progesterone / mL? I mean - for more severe cases specifically?

Anyway, thanks for all the very useful info.
Mar 21, 2013
 Progesterone Dosages
by: Dalmazio

Letitia,

Thanks for the info.

I take it that real testing of progesterone levels then is not viable within the existing medical establishment/environment? How unfortunate.

I'd be interested to know if these new-and-improved blood tests show the same levels as in the saliva test.

Definitely keep us posted.

All the best.
Mar 22, 2013
 Progesterone
by: Wray

Hi Letitia Your pharmacist is right, blood tests are the norm, Saliva Tests are a much more recent development. Which leaves me puzzled as ZRT have been doing blood tests for years. You might also be interested in reading Dr Dalton's books too, to get another perspective on progesterone. Take care Wray
Mar 22, 2013
 Progesterone Dosages
by: Wray

Hi Dalmazio There is a huge worldwide deficiency in vitamin D, Holick believes 2 billion are deficient. That's nearly 30% of the world's population. Luckily there is now a huge amount of research coming out, over 3600 studies were published last year. In fact it's overtaken vitamin C as the most studied vitamin. But when it will filter through is another matter. The FDA raised their daily recommended amount last year from 400iu to 600iu, laughable! Their 'adequate' level is 30ng/ml, also laughable. Considering a study done last year on rural communitites in Africa found an average of 46ng/ml, one pregnant woman having 105ng/ml. 5ng/ml over the highest limit of 100ng/ml, which some regard as toxic! When will they wake up, meanwhile all our diseases escalate due to a lack of it. We don't suggest on the product itself to take vitamin D, but in almost all the answers I give people I do. I've just finished a page on vitamin D, but it's not on the website yet. But this is what I paste in most answers..... For more info on vitamin D levels, test kits etc see the Vitamin D Council, GrassrootsHealth and Birmingham Hospital. Blood levels should be 70-100ng/ml (175-250nmol/L) and not the 30ng/ml (75nmol/L) most labs and doctors regard as adequate. The minimum daily dose should be 5000iu's per day, although recent research indicates it should be 10,000iu's per day, see here. But I have suggested they take far more, if they have really dangerously low levels. I've found most women seem to reduce down to 120mg/day progesterone. But others stay on the higher amounts for months. It depends on the severity of the symptoms, how much oestrogen and testosterone is present, and what age they are. I doubt Dr Lee had his patients on vitamin D, his first book was published in 1993, the next in 1999, and the next in 2002. It's only in the last 10 years that knowledge of it's essential nature has filtered down to the public, and some in the medical profession. It's not so much an absorption issue, but far more fundamental, working at the molecular level. Both Progesterone and Vitamin D influence our genes and how they express themselves. In fact a lack of vitamin D has lead to a number of epigenetic diseases. Probably progesterone too, if they looked! Continued below
Mar 22, 2013
 Progesterone Dosages Part 2
by: Wray

Hi Dalmazio Dr Lee first discovered progesterone in about 1978, and was prescribing it to his menopausal patients. Dr Dalton started using it on her patients in 1948, and was treating women with far more serious problems. She would appear in court on the behalf of a woman who had committed infanticide without knowing it. I think this is where the 'discrepancy' lies. When first starting progesterone, or increasing it, it stimulates oestrogen, the reverse also occurs. It's explained on our Oestrogen Dominance page. There is a feedback system within the body between all hormones. The only time this does not occur is in the corpus luteum, when progesterone stimulates it's own production. Yes many women have tried increasing it slowly, usually under the guidance of their doctors, and it's disastrous! Each increase just stimulates oestrogen, so they're in constant a state of oestrogen dominance. And as you saw on that Emory paper, too little is detrimental. Some compounding pharmacists do make a 10% cream, 20% and you'll find the progesterone won't dissolve, and you'd end up with an exfoliant! Take care Wray

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