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Do I raise my dose now....??

by Anon
(UK)

Prescribed nat prog cream in Oct 2012 (aged 37, still menstruating, ovulating?). I had been advised to start slow so 1st month I only used 20mg 3 days after ovulation and 3 days prior to period. I had such bad "est dom wakeup" reaction even on this small amount I nearly stopped. 2nd month took 20mg on days 14-28 = less "est dom wakeup" but still bad. After reading more info on web 3rd month doubled dose to 40mg daily days 14-28. Again less "est dom wakeup" symptoms and def more energy/more level emotionally and coping more with stress. Thought I'd cracked it however, last few days getting very anxious and low and today (4th month in, day 10 of my break from cream) I have totally crashed!! Really depressed and incapacitated again - pretty scared to be honest. Is this estrogen dominance symptoms??? Should I start the cream even though its only day 10 of my cycle?? Also I found your site today and after reading your info on starting prog cream and dosing my question is as I have missed the first three months high dosing and without breaks to make progesterone dominant can/should I do this now? Greatful for any help. Many thanks from the UK.

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Jan 01, 2013
 you have my sympathies...
by: Nadine

Hi there from the UK (me too!)
I dont know about the ins and outs of your situation and I know Wray will reply soon, but i wanted to offer you some support in the meantime....I started my cream on 19th Dec, straight in there at a teaspoon twice a day and I am wondering if I need to increase it still now as my bone aches are coming back. However, within days my mood was slowly lifting, my energy returning and my fear of going back to a responsible job is lessening. I am not there yet but I even missed some of my colleagues yesterday! I have had a period and kept going with the cream throughout and noticed a reduction in pain/PMT and NO breast soreness at all! Oh, the craving for chocolate/sweets is reduced a lot but not gone enough yet. On reading the oestrogen dominance stuff I realised I probably had this more than I knew and on taking Wrays advice and ordering a Vit D test I found out I am very deficient and so have begun supplements. I am in contact with Julienne, a friend of Wray's here in the UK and will be sourcing my cream etc through her in future rather than being sent from the US (although it wasnt too long a wait). I have a page on here too called sitting searching....(cant recall the rest)!! As you can see my memory and foggy headedness are taking a bit longer to resolve. :-)
Good luck, I am here if you want some moral support, Nadine
Jan 01, 2013
 Do I raise my dose now....??
by: Wray

Hi there I so wish people who sell progesterone, or who prescribe it, would actually take the time to read the studies, and there are thousands from every medical discipline. One thing which is apparent from many of them, oestrogen is needed to 'prime' progesterone, but the converse is also true. Ironically the oestrogen priming of progesterone leads to feeling better, although after time the oestrogen kicks in. I'm thinking in particular of HRT. Oestrogen is a mitogen, causing cells to proliferate, including fat cells. As these are a source of oestrogen a vicious cycle starts, and women put on weight. It's also an excitatory, inflammatory hormone, and causes water retention. So using a small amount of progesterone is only stimulating oestrogen and all the symptoms associated with the list above will increase. To explain the excitatory part, it stimulates glutamate, our most excitatory neurotransmitter, vital, but in excess the mind spins, it's overloaded, it's misfiring and any other term you can think of! See here. It increases free radicals, leading to inflammation, plus destroying beta-endorphin neurons in the brain. These produce beta-endorphins which promote a feeling of well being and relaxation. Beta-endorphins also appear to boost the immune system, protecting against cancer, see here. This paper says "Although it is widely accepted that exposure to estradiol throughout life contributes to reproductive aging.... Recent evidence ..... of chronic estradiol-mediated accelerated reproductive senescence now suggests such a hypothesis. It has been shown that chronic estradiol exposure results in the destruction of greater than 60% of all beta-endorphin neurons in the arcuate nucleus .....This loss of opioid neurons is prevented by treatment with antioxidants indicating that it results from estradiol-induced formation of free radicals", see here. Whereas progesterone protects against glutamate toxicity, it also increases BDNF (brain-derived neuroptrophic factor) in itself protective, see here and here. Ironic isn't it, that we've had oestrogen thrown at us to prevent ageing, and yet it's been known to cause it! Luckily progesterone is an excellent diuretic, so opposing oestrogen's water retention properties. Continued below
Jan 01, 2013
 Do I raise my dose now....?? Part 2
by: Wray

Hi there For more info on this see our page on Traumatic Brain Injury. Judging by the reaction you had, I would suggest you try 400mg/day progesterone. If anxious about using such a high amount, please see this page here. I also suggest you use it daily, through any bleeding for at least 2-3 months until you feel stable enough to reduce it. Don't worry about only starting the high amounts now. Please have a vitamin D test done, it's low in most people living in the UK. 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. Not only does a lack of vitamin D reduce the benefits of progesterone, but they appear to work synergistically, see here, here, here, here and here. Birmingham Hospital send out test kits for £25, and the results back by email. But ignore their 'adequate' level, laughably low. If you'd like to chat to someone in the UK, please contact Julienne via her website here. She is also a registered EFT therapist, a wonderful therapy. Take care Wray
Jan 01, 2013
 Thanks...will keep you posted....
by: Anon

Thanks so much Wray and Nadine.

Nadine - bless ya....thanks for the support. Today is a little better and I look forward to putting the cream back in and at a higher dose as Wray suggests so I can feel less est. dom. again. So glad it seems to be helping you too.....fingers crossed we've found the answer to alot of our probs!!

Wray - you are a star, thanks for your help. Fab info to read tonight. Thankfully tested vit d (yes deficient!) a year ago so have been and am still taking 5,000iu daily, so hopefully higher levels now....Ta for Julienne's contact details. Will put cream back in right NOW......

Many thanks again x
Jan 02, 2013
 Thanks...will keep you posted....
by: Wray

Hi there It was so good of Nadine to lend support, considering she's very new to it too. If you were deficient according to the NHS 'adequate' level of 50nmol/L, then you are extremely deficient. I tell everyone to ignore those levels of theirs, far too low. Even the FDA have revised theirs to 75nmol/L, I believe the NHS is 'considering' doing this! 5000iu per day is only a maintenance dose, I feel you would need to take at least 10,000iu, if not 20,000iu to get yours up. Maybe you could have a another test done? Birmingham Hospital send out test kits for £25, the results come back by email about a week later. Far quicker than going to a doctor. And of course they use the NHS reference range. I have one done ever 6 months as recommended by the vitamin D specialists, mine is currently 230nmol/L, I never get ill. And do have a chat to Jules, she's very clued up on progesterone and of course vitamin D too. Do let us all know how you get on. Take care Wray
Jan 17, 2013
 Update & question
by: Anon

An update and a quick question.......despite the "blip" I posted about above I had at times started to feel more stable emotionally since starting prog (serenity - 3 months ago), despite feeling very "manic" and having insomnia. Since swapping to Natpro (100mg split 3 x's daily) and moving my last dose to 6pm my insomnia seems to have gone but have become alot more unstable emotionally again (low/aggrivated) & very sleepy.....any ideas? I am taking 100mg without breaks for the next 3 months as suggested to raise my prog levels. (As I am housebound and too ill to work at present sadly I am unable to afford to take more than 100mg). Is this just a coincidence or does this happen when swapping a cream? Taking too much? Should I go back to my old cream? Many thanks.
Jan 20, 2013
 Update & question
by: Wray

Hi there Using the recommended amount of Serenity, you were getting about 20mg/day. Then you said you increased it to 40mg/day. Going up to 100mg/day would initially cause oestrogen dominance to kick in. We have found that when swapping creams it can occur too. It depends on the thickness of the cream, if thicker than the Natpro the progesterone is not absorbed as well. We do know our cream is, as we run Saliva Tests periodically. They're done by a naturopath who lives in Somerset. You say you're too ill to work, but don't mention what illness in your previous posts. If you could let me know maybe we can help. Have you managed to have another vitamin D test done, as 5000iu is really a maintenance dose. Usually much higher is needed if ill. Please consider doing one. If cost is a factor please contact Julienne and we'll see what we can do to help. I do feel you need more progesterone too, so I'm going to speak to Jules and see if we can help there too. Take care Wray
Jan 28, 2013
 Thanks so much Wray.....
by: Anon

Oh Wray, thank you SO much for your kindness......I have been in contact with Jules and have received the cream......SOOOoo kind of you to help me......is there a way to email/PM you or is this the only way to contact you? What should I put the cream up to? Have kept at 100mg Natpro till I hear from you/Jules what to go up to. Thankfully since last posted emotionally have settled a bit again but am more than happy to raise cream to get better quicker. As to my illness - I have suffered with M.E./Fibromyalgia since age 15 (now 37). Very up and down with severity of illness over the years until about age 35 when everything got ALOT worse = have been either bed/house bound since then (now wonder how much of illness is hormone related, ie start of problems at puberty, worsening at 35, evidence of family history of hormone problems??!!). I can/have learnt cope with the physical/pain etc side of things its the emotional/anxiety/depression that is my main concern. Until I was more stabilised on my adrenal medication I was experiencing suicidal moods swings for 2 years!! (even anti-dep & other psych drugs did nothing to ease it!!). I now take steroids for adrenal insufficiency (Prednisolone) and should be on thyroid medication (for hypothyroidism/hashimotos) but due to how ill I still am at present cannot tolerate the medication for this. It is thought I may have had both these problems at age 15 when I fell ill (if not before) but they were not picked up at the time. Ok, I will ask my Doc for a Vit D retest. Thanks again from the bottom of my heart for all your help with this. Regards.
Jan 29, 2013
 Thanks so much Wray
by: Wray

Hi there Oh I'm so pleased the cream has arrived already, amazing postal service! This is the best way to contact me, I tend to leave emails until I really have to answer them! I've also found that if others can read about our own troubles, it makes them feel not so alone. Please try 200mg/day, that will mean the 3 tubes will last 30 days. Let me know if it helps at all, or improves things. Well it all appears you have a vitamin D deficiency since childhood. This doesn't surprise me, as nearly everyone in the UK has too low a level, not enough sun. Plus you're to ill to go outside, which only compounds the problem. If you have problems with the testing, I know how reluctant doctors are there to do the test, specially if it's on NHS, and how long it takes too, let either Jules or I know. And most probably your progesterone level was too low too, and still is. ME at 15 speaks volumes. You could try D-ribose, it has been successful in one study, see here, this is the actual paper here. I know I sent some to Jules, I'm not sure if she has any left, but you could ask her. Pity about the Prednisolone, I would hope with enough progesterone it will help the adrenals. It's so calming, it lessens the stress response, plus supplying much needed progesterone for the adrenals. These normally secrete it, before they convert it to cortisol, but if very stressed they can't secrete enough, so rob other sources. Which of course means progesterone levels drop throughout the body. It doesn't surprise me you have Hashi's either, this is most probably because of a lack of vitamin D, see here, here, here and here. Plus a lack of vitamin D reduces the benefits of progesterone, see here, here and here. Let us know how you get on. Take care Wray
Jan 29, 2013
 All at once or gradually?
by: Anon

Thanks for advice Wray. Funnily enough tried D-ribose earlier this year and think almost gave cells too much energy or something as adrenals crashed big time and had to stop - shame as I too had read good results from it. Maybe when/if I get stronger I could try again. Ok will raise Natpro to 200mg. Knowing my responses so far do you advise to raise from 100mg all in one go to 200mg or gradually? Ta,
Jan 30, 2013
 All at once or gradually?
by: Wray

Hi there What a pity about the D-ribose, maybe later. I don't advise increasing progesterone slowly, as it can stimulate oestrogen and adverse side effects are felt. There might be a few increasing by 100mg, but it generally doesn't last as long. Let me know how you get on. Take care Wray
Jan 30, 2013
 ok....ta..
by: Anon

Ta Wray, you're a star!! Will raise today and keep you posted. Kind regards. x
Feb 26, 2013
 An update and question...
by: Anon

Hi Wray, been using cream religiously as advised. Just starting third month now of taking cream daily for 3 months without a break - am Day 4 of month 3. (Days 1-34 we tried 100mg daily = not enough so since then now on 200mg daily).

I do seem to be more stable/physically stronger than was but STILL est dom symptoms!!

I know stress causes extra problems with controlling est dom and as since last week we are now nursing my mum at home(rushed to hospital Wed, confirmed her cancer has returned and has only 3 months to live now!) my dose may be especially difficult to gauge/sort (ie - I have just used 1 tube in the last week!!). Poor darling she is only 57!! :o(

But here is the general gist of whats been going on:

Still had my last two periods even though on cream continually - is this normal??

My family especially feel cream seems to be helping me, so pray to God we are on the right track. But still getting est dom symps - even new ones like "peeing" loads, palpitations worse again, gaining weight and blood sugar alot more unbalanced (even prior to mum).

Def. think there seems to be a flare up of symptoms mid cycle, PMT but worst seems especially week 1 of cycle!!??

So my questions are:

What are my next steps.....Dosage?.....Should I be starting to lower/put in break from cream etc?

Thanks again for all your kindness and help. x
Mar 03, 2013
 An update and question...
by: Wray

Hi there I'm so sorry to hear about your mother, it's no wonder you have oestrogen dominance symptoms. You didn't mention before she had cancer, that would have affected you. Stress does cause havoc with us. Peeing loads is actually a sign progesterone is working, it's an excellent diuretic. Now given via IV transfusion to Traumatic Brain Injury victims to prevent oedema forming. 200mg/day will not stop bleeding, it needs to be 400mg/day and higher to do that. We do have a page on Anxiety, I can't think why I didn't give it to you before. But it does have a list of nutrients which help. Speak to Jules too, as we have a Calming Complex which she stocks, it combines all the calming nutrients. It contains a high dose of taurine too, this helps to calm the heart down. It's also a calming neurotransmitter. Have you had a vitamin D test done yet? I do go on about this, but it's so important to find out your level. A lack of this reduces the benefits of progesterone, and getting it high helps greatly. Please have it done. While on this subject please get one done for your mother. A low level of vitamin D increases the risk for over 20 different cancers. She should get her level up very high, about 375ng/ml, and very quickly too. Speak to Jules about this. And she needs progesterone, at least 1000-2000mg/day if not more. It does reduce tumours, see here. She should also take high doses of all the antioxidant amino acids. I feel it's criminal to tell a person they have 3 months to live. this increases adrenaline levels, adrenaline keeps cancer cells alive, see here and here. She ail need a high amount of progesterone to suppress the adrenaline. Keep her off all sugars, even those found in 'healthy' foods like all grains, legumes and sweet starchy fruits and root veggies. I suggest you increase the amount of progesterone you use a few days prior to mid-cycle, the few days prior to bleeding and the week after. Doesn't leave much time to lower it again! Which really shows you do need more. But before doing this please get your vitamin D level up high, please. Take care Wray
Apr 13, 2013
 Adjustment in dosage???
by: Anon

Hi Wray, thanks for your last comments. Sadly we lost Mum two weeks ago - she did not last 3 months but sadly only a month with us.

I am still taking 200mg Natpro daily. I have had no breaks, as advised, for 3 months now (1 month @ 100mg & 2 @ months 200mg).

I have steadily been gaining more weight since on the cream - is this because dose too high? (not water retention as peeing loads!!).

I also take Prednisolone for adrenal insufficiency and have now been put on Pregabalin for Fibromyalgia.

Since starting the Pregabalin I have noticed as the cream starts working I get v bad palpitations and adrenaline rush and feel my face is v bloated (moonface??).

Could the Pregabalin be meaning i need to lower my cream?

So my questions are:

What are my next steps.....Dosage?.....Should I be starting to lower/put in break from cream etc?

Many thanks
Apr 15, 2013
 Adjustment in dosage???
by: Wray

Hi there I'm very sorry to hear about your mother. I'm at a loss what to tell you, as I don't like working with drugs. Prednisolone being a corticosteroid causes water retention and therefore weight gain, it also causes thirst, which could account for peeing loads. I hope you haven't taken it for longer than 2 weeks, as it then makes the body dependant on it, and the adrenals shut down. It also causes Osteoporosis. And did you try the D-ribose for the fibro? And your vitamin D level, do you know what it is, as this is a potent anti-inflammatory, so is the progesterone of course. Please have a vitamin D test done. Evidently the 200mg/day is not sufficient, particularly if you are gaining weight, and it's not from the drugs. Pregabalin causes weight gain too plus oedema, but why give you an anti-convulsant for pain, there are plenty of other safer options. It also causes dependance too. Plus tachycardia. I feel you should stop the progesterone gradually until you are no longer using it. It doesn't normally react with any drug, but I can't advise you further if you are going to continue with them. Take care Wray
Apr 17, 2013
 Drugs & progestone......
by: Anonymous

Thanks Wray for your comment.

Like you I am not happy to be on such drugs. But sadly due to the severe nature of my health I have no alternative. I am prescribed prednisolone for adrenal failure and have recently been put on pregabalin for the extreme anxiety which is part of my fibromyalgia/CFS. This anxiety, for which I have tried everything to alleviate (vits & min, natural and pharmas etc)to no avail, has been so extreme I was hospitalised 6 years ago and have spent the last 3.5 years housebound as so crippled by this symptom. I have in the past def. had my Vitamin D levels at the high level you state and still feel symptoms. And yes I have tried D-ribose as advised by Dr Myhill to me. But as she says it doesnt always help and it sadly didnt for me personally.

Im sorry you feel you cannot help me any more if I remain on medication. Did I not tell you I was on steroids and antid's in the beginning? I was hoping that I could continue to use the progesterone in conjunction with these meds, is this not the case then?

Am I right to understand that you are advising me to slowly wean down and come off all progesterone?

Where will that leave my hormones at!!??

Many thanks.

Apr 18, 2013
 Drugs & progestone......
by: Wray

Hi there Sorry if I sounded defeated, but I don't know what's causing what. I gave a list above of possible reasons for the symptoms you have. Which could be caused by the drugs, and could be caused by oestrogen dominance. So how to advise you. I don't want you to stop the progesterone, as I know how beneficial it is. For instance the weight gain, is it the drugs or is it you're not using enough progesterone and oestrogen is causing water retention, which you say you don't have. I seem to be going round in circles! You say you have problems around your period which indicates oestrogen has risen in ratio to progesterone. I know you need about 1000mg/day but I remember somewhere you said you can't afford much. So we compromised on the 200mg/day. Progesterone is a potent anxiolytic, so calming that in fact it can be used as an anaesthetic. It's metabolite allopregnanolone is even more potent, but you need a great deal of progesterone to make it, see here, here, here and here. So where to from here? Can you afford 1000mg/day? I don't know if you're getting the cream from Julienne, but we do give a 30% discount on 20 tubes, it works out to £225.50. Would you consider taking NAC (N-acetyl cysteine)? They're finding it excellent for what they term neuropsychiatric problems, see here. You'd need at least 2000mg/day. And your vitamin D levels, you say you've had it high in the past, but don't forget the UK use nmol/L which is 2.5 times smaller than a ng/ml, so you might have misunderstood the figures for a 'high' level. I wish I knew your level, but you haven't had a test since writing in. I'm happy to help where I can, but as I said I don't know which symptoms are doing what, which makes me concerned I could be misleading you. Take care Wray
May 29, 2013
 Thanks and Cyclogest....
by: Anon

Hi Wray, posted this message a while back but has not been posted yet so thought would send again…….thanks for sticking with me despite the other drugs confusing matters....as you say I do feel the progesterone has helped so would like to stick with it. I am going to ask my Doctor for a Vitamin D retest (will post results asap for you). In the meantime I wonder if you have any thoughts.....Sadly even with Jules discount I could not afford 1000mg per day but realise I need to get this progesterone up so was wondering your thoughts this……and have found out on the NHS in UK I may be able to get a vaginal pessary “Cyclogest” prescribed (400mg 2 x daily). I have researched this and it contains:

What Cyclogest contains
• The active substance (the ingredient that makes the medicine work) is progesterone. Each pessary contains either 200mg or 400mg of the active ingredient.
• The other ingredients are vegetable fat.

If I could get this obviously this would be free and I could then top up my dosage of Natpro. Sorry to ask this as I know Natpro is your business but really would like to get weller than I am and dont think I can without raising the progesterone as you advise. What do you think??? Many thanks
May 30, 2013
 Thanks and Cyclogest....
by: Wray

Hi there Strange you say you posted the message a while ago, as I do all the publishing and it's not on our server site, maybe some glitch in the ether! So pleased you can get the Cyclogest on the NHS, this the pessary Dr Dalton prescribed to her patients. It does come in 400mgs. But can you find a doctor willing to prescribe that much? If he/she needs convincing, you could go to the British Library in Euston Road and do what I did, which was copy as many of her papers as I could in the day I spent there! Climbing up and down ladders, lugging heavy tomes to the copy machine. Some date back to the 50's and I haven't found them on the internet. You might like to read this comment here from a patient of hers. It's safety is without question, so this is another study you could give here. I don't mind what brand people use, the aim is to help the person get well. Did you try the NAC as I suggested? And I look forward to getting your vitamin D test results. Take care Wray

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