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Low Progesterone and slightly elevated cortisol

by Michelle
(Arcola, Texas)

Hi there - I'm 35 and will be 36 in August of this year. Back in March 2014, I began suffering from insomnia and this went on for about 3 weeks. After the third week, I went to my primary care who then diagnosed me with stress/anxiety disorder and placed me on Paxil and trazdone.

I did not have any symptoms of anxiety that I could identify with or any stress; however, my doctor said it could be ptsd from past stressful events. I went with it because I was desperate. I continued taking the meds from April until September without achieving any real relief from my insomnia.

Finally, I decided to have my hormone levels tested in September 2014 based on some information I found online that suggested it. I submitted saliva samples thru ZRT Labs and found out that my progesterone level was abnormal with a level of 30 when it should range between 75-270 premenopausal (luteal phase). Also my cortisol was slightly elevated at night at .09. I took this information to my pcp who advised me to continue taking my meds and I will eventually feel better.

I did more research and begin taking daily vitamins and making time to eat at least 3 healthy meals daily because my diet had been fairly poor. With these changes, by late October/early November I was sleeping again . I then weaned myself off the meds with coaching from The Road Back PRogram and was finally off by December 2014. However, I began suffering from anxiety - this time actually feeling anxious and having irrational thoughts and worries in mid to late January 2015. Then the insomnia came back.

I have not had my hormone levels checked again so I'm wondering if any of this could be due to the low progesterone that was never addressed? I started taking vitamins and supplements for natural anxiety treatment but I'm feeling weird, having hot flushes and dizziness in addition to headaches.

I'm afraid my doctor will just put me back on the meds again so I'm reluctant to make an appointment with her.

Any recommendations for me?

Comments for Low Progesterone and slightly elevated cortisol

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Feb 28, 2015
 Low Progesterone and slightly elevated cortisol
by: Wray

Hi Michelle Please read our pages on Anxiety, Peri-menopause, Hot Flushes and How to use Progesterone Cream. Hopefully you might get some info which helps. I still have to put the following into on insomnia onto a web page, but I haven't as yet, so I'm pasting the entire 'page' here, it's rather long! High cortisol at night will cause havoc with sleeping. Evening cortisol levels should be checked, as there seems to be a rise at that point in insomniacs. If cortisol is high, zinc can lower it, see here and here. Oestrogen if too high will cause insomnia, interestingly oestrogen suppresses zinc. High copper suppresses zinc and progesterone, but increases oestrogen levels. It seems oestrogen is to blame for so many problems, but with good reason. Insomnia is but one. One adverse affect it has is it stimulates glutamate. This is our most excitatory neurotransmitter, see here. Oestrogen also destroys beta-endorphin neurons in the brain, these produce endorphins which promote a feeling of well being and relaxation. And it increases free radicals, see here. The paper says "This loss of opioid neurons is prevented by treatment with antioxidants indicating that it results from estradiol-induced formation of free radicals". Insomnia has been linked to inflammation, the end result of excess free radicals, see here. Progesterone protects against glutamate toxicity, it also increases BDNF (brain-derived neuroptrophic factor) in itself protective, see here and here. If glutamate is too high, it allows calcium, an excitatory mineral, to enter the cells. This only makes matters worse, see here, here and here. Progesterone also protects against calcium induced excitotoxicity, see here. High glutamate will have a similar affect to high cortisol, making one wired and tense, it will be impossible to sleep with a brain firing at too rapid a rate. And if calcium is high this would imply magnesium is low, it certainly helps relax. Or it could be dopamine is too low. Stress depletes dopamine, leading to depression and a rise in cortisol and prolactin, the amino acid tyrosine reverses this. But the rate limiting step in dopamine synthesis is the enzyme tyrosine hydroxylase. Insufficient levels of vitamin D inhibit tyrosine hydroxylase, resulting in a disturbance in the dopamine pathway. The dopamine pathway requires the progesterone receptor. There appears to be evidence that dopamine is involved in regulating the sleep–wake cycle, see here. High levels of dopamine will also disturb it. There is also other evidence that adenosine is involved in the sleep/wake cycle, see here, here, here, here. High neuronal activity increases levels of adenosine, which then promotes sleep. But if neuronal activity was stuck in the on position, i.e. something was over riding the adenosine, or it's effect, insomnia would result. Could it be oestrogen, as progesterone increases levels of adenosine, see here. One interesting fact, and of possible significance, more women get insomnia than men. Women make far more oestrogen than men do. Or maybe it's a lack of nitric oxide (NO), also essential for sleep, see here. NO is made endogenously from nitrates found in food, and from the amino acid arginine, but a major source is the direct affect the sun has on our skin. The action of sunlight triggers the release of NO which is then absorbed through the skin. It's essential to get enough sun. Insulin Resistance is also associated with insomnia, see here. Any stress stresses the adrenals. These need sodium to function normally, so a lack of salt can cause insomnia, see here. It's a long article, but if you put 'salt' into 'find' you'll pick up the passages where salt is mentioned. This is an excellent, albeit long paper on sleep here. It states "In insomnia, which is a very common sleep disorder, objective sleep measures, EEG activity, physiologic findings, HPA axis activity and inflammation markers suggest that it is not a state of sleep loss, but a disorder of hyperarousal present both during the night and the daytime." Which fits all the above, the emphasis being on 'hyperarousal'. So if you think any of the above fits, or want to try the nutrients, I suggest you first have a vitamin D test done to find your level and to determine how much to take to bring it up if low. The most important cofactor for vitamin D is magnesium, a low level affects the efficacy of vitamin D. But a low level of vitamin D reduces the benefits of progesterone, circles within circles. Magnesium relaxes, it helps sleep too, see here, but above all a lack of vitamin D itself can cause insomnia, see here and here. Progesterone helps sleep too, it also helps relax and calm us, see here. So what's causing the insomnia? Is it high cortisol in the evening, low zinc/high copper, or high oestrogen/low progesterone, low vitamin D, low magnesium, low tyrosine, low dopamine/high dopamine, low sodium, a lack of antioxidants, low NO, low adenosine, IR, all of these or none of these? It's like looking for a needle in a hay stack, which one of the above could it be, if any, or maybe a bit of all! Take care Wray

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