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Latest labs--conversion help, seems high progesterone

by colleen
(staten island)

My last labs for progesterone: 0.6 ng/ml, estradiol: 36 pg/ml

I have been on and off varying doses of all three hormones for the past 5 years. Before this test, I stopped my compounded RX of 200mg of progesterone and 2mg of bi-est and went on OTC progesterone 20mg for about two months with no estrogen, I felt about the same, no improvement, but nothing worse. Then I used some OTC estrogen, 1mg of bi-est for about a month.

The day before the test, I had another migraine, so I put on 25mg of a compounded progesterone, and 1.5mg of bi-est and the above were the results the next day.

It seems to me, if I convert the estradiol 36pg/ml to ng/ml it is 0.036 which is much lower than the progesterone.

When I look at symptoms i have many low estrogen, and some low progesterone, and low cortisol.

I have one ovary and the other is barely visible on sonogram. I have had only 1 cycle every 10, 11, 9 months in the last three years, even when I cycled in the progesterone for 14 days, while on low doses of estradiol. I didn't seem to get cycles no matter what doses I was on.

So it seems by these serum labs, I'm progesterone dominant?

When I check my labs on 200mg of progesterone and 2mb of bi-est for several weeks my labs were:

progesterone 1.4 ng/dl, estradiol 82.7 pg/ml, And again if I convert the estradiol to ng/dl, it's much lower than the progesterone.

I know there is the other formula used, but that is only for saliva, correct? I only have serum results and it appears i must be progesterone dominant?

Corky

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Apr 21, 2013
 Latest labs--conversion help, seems high progesterone
by: Wray

Hi Corky It's the ratio of the two which is critical and not the amount. You are correct in converting the pg/ml to ng/ml, but to find the ratio you divide this figure into the progesterone. So taking your first results, progesterone 0.6 ng/ml and oestradiol 36 pg/ml, your ratio is 17:1, extremely low. Your second results of progesterone 1.4 ng/dl and oestradiol 82.7 pg/ml also gives 17:1. Please have a look at our Saliva Test results, the ratios are all over 600:1. So you have oestrogen as the dominant hormone. This is understandable as you have been using it. When you say 'compounded RX of 200mg of progesterone' is that oral or a cream? And presumably the 'OTC progesterone 20mg' is a cream? I do normally recommend 100-200mg/day progesterone, but in a form which is absorbed well, i.e. creams, suppositories or injections. We do have a page on Migraines you could look through. Next time you feel one coming, rub progesterone cream only under you ears and all over your neck and face. Repeat this as often as needed. Oestrogen is an excitatory, inflammatory hormone. You might like to read more about it's affects on us on our HRT page. It matters not what form it comes in, it's still has the same effect. As you have virtually no cycle, I suggest using the progesterone daily. We have more info on our page How to use progesterone cream. As you have high oestrogen, please read our page on Oestrogen Dominance, particularly if you do use 200mg/day progesterone. Take care Wray
Apr 21, 2013
 Thank you for your input
by: Corky

Yes the 200mg cream is a compounded progesterone cream. The OTC was also a cream. When I post on hyster sisters, I get comments from women saying it's the progesterone causing the problem, and that we need our estradiol to at least 100pg ml. A few women told me they didn't feel balanced and great until their serum estradiol was 200pg/ml. Of course, I have my uterus, so I do need to take some progesterone, but they say I should do only bi-est for a month with out progesterone, then cycle it in every three months for uterine protection.

On this site, I see women having issues on the progesterone as well, but being told to raise it even higher and wait it out. I see issues of weight gain also. I'm struggling with my weight for 5 years and I've been on progesterone pretty much all that time except for some breaks here and there.

So I see so much differing information I do not know what to do at this point. I have the 200mg progesterone, but it has 2mg of bi-est, 1mg of estriol, 1mg of estrdiol 80/20.

I've read most of your research info, and I also sort of agree that I'm not making much progesterone, but when I was young and cycling, there was only 20mg or 30mg a day being made, so why do I need to take 200mg a day?

I do agree that progesterone is good for cortisol and thyroid, which I have low thyroid and take natural thyroid hormone as well, but I still can't understand taking high doses, yet my doctor wanted to put me on 400mg a few months back and I said no.

I also somewhat agree with the estrogen to progesterone ratio. But why do I see many women on other hormones boards saying progesterone was awful, and many only take estrogen, and cycle the progesterone in 3x a year and they say they feel wonderful.

At this point, I have the dual cream, and I suppose I can finish that and re-asses. If I feel no different, maybe next month I can try estrogen only.

Thank you for all your advice. But there is so much information on both sides of this issue, thus my anxiety and confusion.
Apr 22, 2013
 Thank you for your input
by: Wray

Hi Corky I don't read any blogs at all, they supply no studies, only women's opinions. The majority of whom have not read a single study on progesterone. But I do gather from comments made by women on this site, that many women condemn progesterone. Understandable as they are all using very low amounts. I for one would never touch oestrogen, in spite of those blogs you've read saying how wonderful they feel. There are over 100 oestrogen mimics in our environment now, see Our Stolen Future. All the food we eat has phytoestrogens too. Drinking water contains oestrogen from the HRT and Contraceptives women wee out, very rarely is this removed. Finally oestrogen is a mitogen, and an excitatory, inflammatory hormone. It stimulates glutamate, our most excitatory neurotransmitter, see here. It increases free radicals, plus destroying beta-endorphin neurons in the brain, these produce endorphins which promote a feeling of well being and relaxation. It contributes to reproductive ageing too, see here. Progesterone protects against glutamate toxicity, it also increases BDNF (brain-derived neuroptrophic factor) in itself protective, see here and here. Excess glutamate increases levels of calcium, an excitatory mineral. Progesterone also protects against calcium induced excitotoxicity, see here. Being a mitogen oestrogen stimulates cells to proliferate, hence it's involvement in Cancer. Yes it is needed, but in tiny amounts. When we're young most of us do produce 20-40mg/day and it's sufficient. But there are many women in their 20's who write in saying how awful they feel. The youngest to write in was 16. There are copious reasons for this, one being a lack of vitamin D, so essential for the full benefit of progesterone. Stress drops levels, dark days, winter, large meals, alcohol, sugar, PCOS, the list goes on. Some women have defective luteal phases when they don't produce enough progesterone. The worse the symptom the more is needed, simple as that. Take care Wray
Apr 22, 2013
 Latest labs--conversion help, seems high progesterone
by: JL

Hi Corky

I can see where the confusion comes in - BLOGS. They so very often provide incorrect information about progesterone causing progesterone to get a bad name. You need to look for websites that provide study research papers. Those papers need to be read otherwise people will be running around in square circles!

One huge mis-conception about progesterone is the amount used. Most websites and doctors say to use 20 to 40mg per day. This is wrong and merely means that progesterone is always in the stimulation mode which leaves one in a permanent state of estrogen dominance. So the people who are saying that progesterone does not work and makes the situation worse are the ones who are not using the correct amount of progesterone.

A minimum of 100mg/3ml per day should be used but this would also depend on how severe one's symptoms are i.e. 400mg/12ml per day is needed for about 5 days to help with hot flushes, once they clear the amount can be reduced to a level that suits the individual but NEVER less than 100mg/3ml per day.

Hope this helps.
Apr 24, 2013
 Thank you--SHBG help now
by: Corky

I am interest in all that I see here. I have another question. I asked for an SHBG test the last two draws, and the level was high and over the range. The doctor was not concerned. I tried to find info and one link said it could be hyperthyroidism. I am on natural thyroid treatment, yet i still have hypo symptoms and also have high Reverse T3. I may be trying a T3 only protocol to clear those receptors, but I need to get a saliva adrenal panel done first.

So I do not have any hyper symptoms at all. Mostly i suffer from extreme muscle spasms, that come and go, some muscle spasms that remain for days, stiffness and fatigue, anxiety from the muscle issue, no libido, very dry lips, thinning hair, no energy, etc., so more hypo.

So high over the range SHBG? I also read it could be from just being on sex hormones.

Can you shed some info on what is causing this? If it's high estrogen, I'm confused, b/c my serum estrogen is low, higher than my progesterone, I know, but it's not really high. So I wonder if my body is gobbling up my estrogen.

Is this SHBG issue I have also due to the estrogen dominance? Or is it all related to the Reverse T3 thyroid issue.
Apr 24, 2013
 Thank you--SHBG help now
by: Wray

Hi Corky SHBG rises if both testosterone and oestrogen rise, which it would do as you've been taking them. It's protective, as it means it's binding testosterone, oestrogen too. High rT3 can be caused by high adrenaline, are you Stressed? All those symptoms you give are suggestive of hypothyroidism, but are more likely caused by low progesterone and vitamin D. Do you know your vitamin D level, I suggest you have it tested if not, it appears to be very low. It's vital for the thyroid, see here, here, here, here, here and here. Both Progesterone and Vitamin D reverse myopathy, see here, here and here. This last abstract has nothing on it, so I've pasted a passage from the paper which I bought... 'Substantial relief of myopathic disability by progesterone therapy'.....
(We report about a 41-year old woman who was suffering from a general muscle weakness since her early childhood....From July 1998 until July 1999 the patient was treated with progesterone suppositorium 0.4 g once a day from the 14th to the 25th day of the menstrual cycle. In July 1999 her gait had improved significantly and she could get up from a chair more easily, even her ability to walk up and down stairs had improved....Progesterone dosage was increased from 400 mg to 600 mg. In January 2001 the patient reported enthusiastically about the improvement she had gained from progesterone-therapy. The patient reported a clear increase in strength in all affected muscle groups resulting in dramatic functional improvement.) Continued below
Apr 24, 2013
 Thank you--SHBG help now Part 2
by: Wray

Hi Corky And these for vitamin D,here,here, here and here. Both help Anxiety, Hair Loss and Libido. Progesterone will also help the very dry lips, see here. Dry lips are also a sign of dehydration. So it appears you are very short of both progesterone and vitamin D. Your ratio shows this for the progesterone, and all those symptoms too, plus these reflect lack of vitamin D. Finally a lack of vitamin D reduces the benefits of progesterone. Take care Wray
Apr 28, 2013
 Thank you--SHBG help now
by: corky

Thank you Wray for your quick responses. My vitamin D I started checking few years back before doctors ever checked it, and it was 28. I have since then taken at least 4000, iu a day, sometimes more. My level has stayed at about 55-68 on that dose that last few years. My last level was 68. I'm now taking 6000 iu a day, but maybe I should take 8000?

I'm not stressed, I did seem to feel stressed most over the last seven years after the removal of my ovary and tube. But I am balancing out better in that area. However, I do not handle any type of stress well at all, hence my needing to get an accurate adrenal saliva test done later this month. I have taken adrenal herb supports at times on and off over the years as well.

For instance, the minute i get that bullet in the back moving pain, my brain does that feedback loop, and I feel extreme stress, and anxiety. I'll take some GABA and rest and it goes away.

However, emotionally, I'm much better than I had been. Maybe it's the bio HRT, and all my supplements.

I'm wondering if my adrenals are not up to par and causing this Reverse T3 issue, because my D level is mid range, and much better, my iron and ferritin are also good, and my sodium and potassium seem fine as well.

As for the dry lips and skin, I do drink water all day, and I don't take hot showers every day either. I also think it could be the thyroid, or I was wondering again if it was the lower estrogen.

Right now, I can live with the dry skin, it's the muscle pain, confusing bullet like moving spasms that come on and go quickly, exercise fatigue, walking fatigue, muscle weakness, and absolutely no interest in sex, in the mind, or elsewhere that plagues me still.

i'm sticking with my 200mg of progesterone, but it does have the 2mg of bi-est in it. I will ask at my next visit to keep those separate, and work on the progesterone only for a few months and reasses.

I have read quite a bit on the progesterone and muscle issues, in fact the one you posted, I had read prior. It's because of that study and others, that I have mostly remained on progesterone in some dose, for the last five years. My thought is I have one old ovary barely visible on sonograms, and I have had no cycles, even when I cycled progesterone with estrogen. I had two days of spotting in December, so now I count all over. Prior to that I had gone 11 months without a cycle, prior to that 10 months, so that means, everything is low, but if I'm not ovulating, no progesterone, correct?

Thank you for your time.

Corky
Apr 29, 2013
 Thank you--SHBG help now
by: Wray

Hi Corky I don't believe the 200mg/day is enough. That study found by giving 400mg/day she had some relief, but the increase to 600mg/day did the trick. The whole process took 2 years. If they had given her the 600mg/day in the first instance it would have resolved much quicker. The same with the vitamin D, levels need to be high. 68ng/ml is not a bad level, but I feel it should be in the 90ng/ml range. If you're not ovulating you won't be making any ovarian progesterone, only a bit from the adrenals, brain and a few minor areas. Certainly not sufficient to help. I really feel if you want resolution you'll have to use at least 400mg/day and get your vitamin D much higher. If you've been suffering from those symptoms for five years, it's evident the 200mg/day is not enough. Plus adding more oestrogen to the system is just making it harder. You're adding back an inflammatory hormone. Take care Wray
Apr 29, 2013
 Latest labs--conversion help, seems high progesterone
by: JL

Hi Corky

If the 200mg progesterone is not helping with your muscle pains, then you need to increase to 400mg possibly more. Wray provided info on this see here .....
We report about a 41-year old woman who was suffering from a general muscle weakness since her early childhood....From July 1998 until July 1999 the patient was treated with progesterone suppositorium 0.4 g once a day from the 14th to the 25th day of the menstrual cycle. In July 1999 her gait had improved significantly and she could get up from a chair more easily, even her ability to walk up and down stairs had improved....Progesterone dosage was increased from 400 mg to 600 mg. In January 2001 the patient reported enthusiastically about the improvement she had gained from progesterone-therapy. The patient reported a clear increase in strength in all affected muscle groups resulting in dramatic functional improvement.)

Your vitamin D level could be a little higher, but is better than most who write in. I suggest you take the 8000iu's for two months, then drop down again to 5000iu's per day.
May 06, 2013
 How do I know what % my cream is?
by: Wray

Hi Corky Telling me the cream is 200mg means nothing. It's immaterial what the concentration is too. You could be using 200mg from a 1% cream. Or from a 10% cream, or a 20% cream. No amount of progesterone is 'too much', if symptoms are severe 200mg won't touch sides. Some women use 1000mg/day before they feel well. I don't know why you keep blaming the progesterone, it cannot cause weight gain, I have explained that to you. You are also using oestrogen, I've explained that is a mitogen causing cells to proliferate, including fat cells. These also secrete oestrogen so a vicious cycle starts. Please read the pages I've given you on your symptoms, they explain it all. Take care Wray

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