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Progesterone and Arthritis

by Helen
(England)

Hi Wray

I suffer from RA and I am in the middle of a flare up this year, I have recently had a vitamin D test done which shows me as deficient (a level of 30 when it should be over 50). I have two children and my husband and I are trying to conceive number three. My eldest was born in a sunny country whilst I was also in the middle of an RA flare up. My youngest was born here in the UK 3 years ago whilst I was in Remission. I had no problems conceiving my son. I fell pregnant the second month of trying and had an uncomplicated pregnancy and birth. My eldest however, was preceded by an MC after which my OBGYN put me on progesterone until week 12 after I had ovulated (I carried her to term + 2 and had a natural birth). This time round I noticed that I had a short period of 23 days last cycle so I had some hormone tests done (FSH, Day 21 etc) The day 3 test came back fine but the day 21 came back low and my Dr thought I hadn't ovulated. But I had and I fell pregnant. I had a low rise on my chart and low temps plus a late +HPT. After three days I started to bleed and I am having another MC (Chemical). My question is do you think that the Vitamin D, Progesterone and Arthritis is linked? I have upped my Vit D to 1600 IU a day in an effort to boost my levels, do you think I should demand Progesterone suppliments after ovulation as well? THanks Helen

Comments for Progesterone and Arthritis

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Oct 29, 2012
 Progesterone and Arthritis
by: Wray

Hi Helen This is all most interesting to me. Your "do you think that the Vitamin D, Progesterone and Arthritis is linked?" is spot on! Levels of vitamin D are generally very low in the UK, so much so that rickets is now making a comeback. Unfortunately the NHS has a ridiculously low 'adequate' level of 50nmol/L, even the FDA has now increased it to 75nmol/L. Specialists are saying it should be no less than 125nmol/L, the less conservative that it should be 175-250nmol/L. I try to keep mine in the 225-250nmol/L range. We don't begin storing vitamin D until levels get to 100nmol/L, but this doesn't leave anything to actually help. To my mind I classify your level as dangerously low. The 1600iu's won't help to bring it up either, the minimum dose should be 5000iu's, but with your level I would suggest 10,000 to 20,000iu's per day. And then have another test in 3 months to see if its high enough. One women in the UK I've been trying to help, is about to give birth this week. She had a vitamin D test done last week and her level came back as 70nmol/L, she'd been taking 23,000iu's per day! We're both hoping the foetus was using it all up. Vitamin D is vital for ovulation, conception, but in particular for the health of the child. A lack causes miscarriages, see here, here and here. So I'm not surprised you had one. Low progesterone also causes them too. We do have more info about this on our Pregnancy page, and more info here too. As for arthritis, I'm not surprised you have that either. A lack of vitamin D increases the risk for it, see here, here, here, here, here and here. Continued below.
Oct 29, 2012
 Progesterone and Arthritis Part 2
by: Wray

Hi Helen And more here and here. In fact it's low in all the so called 'autoimmune' diseases, and the inflammatory diseases too. One very recent study queried this designation, wondering if the autoimmune problem was nothing more than a deficiency of vitamin D, I've thought this for some time now. It's vital for every cell to function normally. If interested, you could look through these two excellent sites, Vitamin D Council and GrassrootsHealth. Progesterone is low in arthritis too, oestrogen high. Arthritis is regarded as a TH1 immune response-driven disease, as a higher level of Th1 is found in RA patients. Th1 induces inflammatory cytokines, Th2 induces anti-inflammatory cytokines. Studies have found that induction of Th2 cytokines can reduce inflammation. Progesterone causes a shift from TH1 to TH2 immune response, increasing the anti-inflammatory cytokines IL-4 and IL-10. On the other hand oestrogen is an excitatory hormone and enhances the immune response, causing inflammation. Moreover, oestrogen stimulates the production of matrix metalloproteinases (MMP’s) which are enzymes that degrade protein and cause inflammation. Excess MMP’s are found in RA. Excess oestrogen is found in RA, see here, here, here, here, here here, here, and here. Continued below.
Oct 29, 2012
 Progesterone and Arthritis Part 3
by: Wray

Hi Helen Vitamin D also induces the Th2 response. I was so fascinated by the apparent synergy between Progesterone and Vitamin D that I did this page on them. Plus a lack of vitamin D reduces the benefits of progesterone. Another fascinating aspect for me, you say "I had a low rise on my chart", this invariably causes a miscarriage. It's essential that there is a sharp rise in progesterone after ovulation, see here. But there should also be an exponential rise in progesterone about 50hrs prior to ovulation. It's always been believed, and still is by everyone including the medical profession, that progesterone is only produced by the corpus luteum after ovulation. But as far back as 1930 it was thought there must be another source. This was confirmed in the 1960's, and re-confirmed in the 1980's, that there is a surge of progesterone about 50 hours prior to ovulation. This surge comes from the brain, see here, here, here and here. Oestrogen also surges about 50 hours prior to ovulation. This pre-ovulatory progesterone surge, coupled with a continuing exponential rise after ovulation will ensure the embryo embeds well. So I recommend to women wanting to fall pregnant that they start progesterone within the 50hr surge. You can try getting progesterone from your doctor, I hope you succeed! It's essential to use enough, and to start it well before pregnancy too. Progesterone stimulates oestrogen, which can cause unpleasant symptoms, much the same as those experienced in early pregnancy, when progesterone is rising. There's more info on our Oestrogen Dominance page. So enough should be used to prevent this prior to falling pregnant, and not while pregnant! I normally recommend 100-200mg/day, more if symptoms are severe. You don't have any, beyond the arthritis, well you haven't mentioned any. So I feel somewhere in this range should be fine. Continued below
Oct 29, 2012
 Progesterone and Arthritis Part 4
by: Wray

Hi Helen Another nutrient you could consider taking is taurine, vital for the developing foetus, and after birth. Taurine is an essential amino acid for newborns, as they can't convert it from cysteine as adults can, and only receive it from breast milk, see here, here, here, here, here and here. If you have problems getting the progesterone from your doctor, and would like more advice on it, and vitamin D too, please contact Julienne here. She's a dear friend of mine and has been helping me for over 15 years with progesterone. Apologies for the length of this, but it's essential for me to give you all the info. You can then make an informed decision. Take care Wray
Oct 30, 2012
 Big thanks
by: Helen

Thanks, That's really helpful. I've read with interest all the points you've commented on and I wonder why doctors aren't a little more pro-active when talking about these things with their patients. One question though, is that amount of progesterone to be used throughout my cycle or just from two days before ovulation? Thanks again.
Nov 01, 2012
 Big thanks
by: Wray

Hi Helen I'm glad it was of help, it all ties together. But it does take time to right itself, that's if you should consider the progesterone and increasing your vitamin D intake. Progesterone should normally be used during the luteal phase, that's if you want to follow your cycle. But I really feel with all your symptoms it would help to use it daily, through any bleeding too. Do this for about 2-3 months, or until you feel stable. Then once you do, you can stop using it at your next period and only start again during those 50hrs prior to ovulation. A mini microscope is helpful for checking ovulation, unless you have markers you know that tell you when you have. Like the cervical mucus and a raised temp. You might need more than just the progesterone and vitamin D, Inflammation is helped by many other nutrients too. It might be an idea to add some of these to your protocol. Do let me know how you get on. Take care Wray

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