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symptoms return

by Carol
(CANADA)

Hello Wray,

41 yr old, I started progesterone cream five months ago. symptoms include heavy bleeding leading to anemia and all the associated effects,, confusion, anxiety, depression, foggy thinking, fatigue and more. Of course none of the doctors I saw for the last five years thought to test my hormones and to date they do not believe to have them tested even as my cycles are getting irregular and the heavy bleeding is not ending.

When I started using the cream, (not Natpro) I would measure it free hand and it did help though I experienced estrogen dominance symptoms - bloating etc. as you describe. I increased it some more and I felt better but I wanted to be sure I was using the right amount as I was eager to get all the symptoms under control soon.( the cream am using claims to have 20 mg USP).

So this past cycle I bought mini spoons and have been suing 1/8 of a tsp twice a day. However I did have a worse cycle ( flooding and clots) than the last 5 months when I was using free hand measures. What could be the reason for this, I had expected it to work better than the last cycles. Also looking to fall pregnant.

Regards

Carol

Comments for symptoms return

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Nov 04, 2012
 symptoms return
by: Wray

Hi Carol By 20mg do you mean 20mg in a 1/4 tsp? This is the standard amount recommended by most people, but the 20mg/day is no where near enough. I normally recommend 100-200mg/day, but for heavy bleeding I've found at least 400mg/day is needed. So if the cream you are using contains about 960mg progesterone per container, another common standard, it would last you about 2 days. The symptoms you have i.e. 'confusion, anxiety, depression, foggy thinking, fatigue', plus the heavy bleeding and erratic cycles suggests you're now in Peri-menopause. You might consider taking at least 2000mg/day NAC (N-acetyl cysteine), this inhibits the MMPs which cause the lining to break down. We do have more info about heavy bleeding and the MMPs on our Menstruation page. Another nutrient you could consider is taurine, about 2000mg/day, often low in dysfunctional uterine bleeding, see here. And vitamin D, at least 5000iu's per day. As you live in Canada, your level is probably low, see here, here, here, here and here. Both taurine and vitamin D are vital during pregnancy. These nutrients are all referenced on our Pregnancy page. Please watch the videos at the end of the page. They are about the vital necessity of vitamin D during pregnancy and breast feeding. Please have a test done. For more info on vitamin D levels, test kits etc see the Vitamin D Council, GrassrootsHealth and Birmingham Hospital. Continued below.
Nov 04, 2012
 symptoms return Part 2
by: Wray

Hi Carol 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. You might like to read these comments by other women with heavy bleeding, see here (scroll down to CL), here, here and here. Take care Wray
Nov 05, 2012
 symptoms return
by: Carol

Thanks Wray,

You are doing a very good job making us understand all these. Doctors do not want to check hormones even when all the symptoms point to it.

I have increased vitamin D to 5000IU from 2000IU. And am increasing my cream as soon as I get more. I will also get the other supplements you suggested. I will order the other supplements as well. I did not mention that I have been found with fibroids since five years ago. I just wish I knew about progesterone when all this started and my health was still intact. I have not been able to convince my doctor to test my hormones. She blames the bleeding on fibroids( because they are sub-mucousal type) even though she says they are small enough not to pregnancy- kind of contradictory. I am having an ultrasound soon and curious to see if the cream will have affected the fibroids in any way in the five months.

I will post any findings here. Still looking for a doctor who will test my hormones in the meantime.

Since I used the cream throughout the cycle for the last three months am trying to follow my cycle this time but am experiencing severe bloating.

Thanks Wray.
Nov 06, 2012
 symptoms return
by: Carol

Hi all,

Just came from seeing my GP, he will not test for hormones nor vitamin D because I do not fall within the 'statistical group' prone to osteoporosis etc. Obviously he never heard of Vitamin D having anything to do with hormones, mood and the like. As for the hormones - the reason he will not order a test despite the cycles getting shorter and irregular and heavy bleeding; am menstruating and I have my ovaries. In short unless I had had an hysterectomy or ovaries removed there is no reason to test my hormones.

Now I have to resort to having these tests through an internet lab and then have to beg someone to interpret them, meanwhile I keep paying taxes for the medical system!

Keep well.
Nov 06, 2012
 symptoms return
by: Wray

Hi Carol I'm saddened to hear this, he obviously has no idea about vitamin D. I think very soon now they'll all realise that it's role in bone development is a minor one. Or any idea about progesterone either, in fact most think of it as a female hormone and a sex hormone, it's neither! Both Progesterone and Vitamin D regulate gene expression, have a positive fundamental effect on cell differentiation and growth, with anti-oxidative and autoimmune anti-inflammatory mechanisms. Both positively effect the nervous system by stimulating neurotrophic factors, quenching oxidative hyperactivity and regulating autoimmune responses. Their role is far more fundamental than many realise. If you wish to have a saliva test done for your hormones, then the best is ZRT Labs. They also do a blood spot kit for vitamin D, but are more costly than Birmingham Hospital in the UK. They'll send you a kit for about US$47, you send back your blood spot, and they'll send the results by email. But ignore their 'adequate' level, which they give as 50nmol/L, even the FDA has set theirs at 75nmol/L! As I said in my previous reply to you, specialists are recommending far higher levels. The barest minimum should be 125nmo/L, but the less conservative recommend 175-250nmol/L. I try to keep mine in this range, currently it's 230nmol/L. I have a test done every 6 months or so. You could always print out those papers I gave you on how low vitamin D levels are in Canada, and take them to your doctor, those should convince him. One even says 'Vitamin D deficiency has been linked to many diseases and conditions in addition to bone diseases, including........ adverse pregnancy outcomes.' Surely he knows you would like to fall pregnant? Take care Wray
Nov 07, 2012
 symptoms return
by: Wray

Hi Carol I can't believe I missed your remark about having fibroids, hence this addition. I'm delighted you've increased your vitamin D, but feel you'll need at least 10,000iu's or more per day because of them. Fibroids are caused by oxidative stress, which is often from a lack of antioxidants, in particular vitamin D. This has been found to shrink fibroids, see here, here and here. I wouldn't be surprised to learn one day they are caused by a lack of it. Please have a test done, then we can see how much you need to take. Progesterone can help too, as you'll see from the page I've given you, but levels far higher than 20mg/day will be needed. At least 200mg/day if not more. So I don't think you'll find any change with the ultrasound, or that they could possibly have grown. Oestrogen exacerbates them, as it's an excitatory, inflammatory hormone. It's also a mitogen causing cells to proliferate. High amounts of progesterone are needed to suppress it. Both progesterone and vitamin D are potent anti-inflammatories and anti-proliferating agents. Take care Wray
Nov 08, 2012
 symptoms return
by: Carol

Hello Wray,

Thanks for your continued help. I have noted about the vitamin D and have increased it, since it is not easy to overdose. I have increased my PC but trying to find a way to get it covered as am paying out of pocket now and if I have to use more the cost will get interesting. I may get a naturopath to prescribe it, as my ob-gyn does not believe my symptoms have anything to do with hormones.

The links you provided on vitamin d and fibroids are interesting.I have learnt so much about my condition online that I am shocked doctors are not aware of this.

Thanks Wray and I will post any new information here.
Nov 10, 2012
 symptoms return
by: Wray

Hi Carol I find the ignorance about hormones and their influence on us extraordinary. With over 4 million women in the States alone, suffering from PMS every month, countless millions going through peri-menopause and menopause, not to mention those suffering from puberty problems and post natal depression. That just about covers all females! Are there any who don't have problems? Do hope your naturopath can help you. Otherwise we do give a 30% discount on 20 tubes. Many women buy a box and share it amongst friends, or have their whole family on it, including husbands. Take care Wray
Nov 11, 2012
 symptoms return
by: Carol

Hello Wray,

Thanks for advice and insight.

I was just wondering about the NAC. I could only find the 600 mg strength . Do I have to take it throughout the cycles or can I use it to control the bleeding? - like in the second half of the cycle.

Thanks

Carol
Nov 12, 2012
 symptoms return
by: Wray

Hi Carol The NAC does need to be used daily, as oestrogen is made throughout our cycle, apart from the first 3-5 days of the follicular phase. Oestrogen stimulates the MMPs which cause the lining to break down. There's more info about this on our Menstruation page. You could look on the LEF site, they are an excellent source of nutrients, and might have it in powder form, which is cheaper, or larger amounts. Take care Wray
Nov 25, 2012
 symptoms return
by: Carol

Hello Wray,

So well I went for the ultrasound and there has been no change whatsoever with the fibroids as you warned, infact a couple have grown by a few couple of mm. Good thing is it the NAC has had an effect on the speed of the break down of my lining and less clots. I have upped my vitamin D and cream, and shopping around for a naturopath to test my hormones and thyroid. I still believe the hormones and fibroids are connected.

Regards
Nov 27, 2012
 symptoms return
by: Wray

Hi Carol I thought as much, too little merely stimulates oestrogen. Which of course would make any fibroid grow. I'm pleased you've upped both the progesterone and the vitamin D, and delighted the NAC has helped you. Undoubtedly hormones affect the fibroids, as oestrogen is a mitogen stimulating cells to proliferate. The thing about both Progesterone and Vitamin D is their ability to inhibit mitosis, and therefore stop any excessive growth. If you can't find the naturopath, you can get hormone and vitamin D testing done by ZRT Labs, they send out test kits. Oestrogen also slows the thyroid, whereas progesterone by inhibiting oestrogen, allows it to work correctly. Plus the vitamin D is vital for it's normal functioning. Interestingly vitamin D also becomes a hormone, by it's conversion in the kidneys. Take care Wray
Feb 04, 2013
 Update
by: Carol

Small update here:

During the holidays I took a trip to a sunny place and where I managed to buy susten 100 mg, and used it one cycle. Made a big difference though I felt worse when I stopped during my period (must be because am not saturated yet). My period was not early, no clots though the amount was still heavy for me. Also soaking in all the sunshine must have helped. I got a compounded cream now at 40 mg x 2 through a naturopath and I can say I feel better enough to forget to take my iron pills and Maca some mornings, things I would not leave the house without taking a few months ago.

I have undergone some tests as well for vitamin D and thyroid, awaiting the results.


Regards
Feb 06, 2013
 Update
by: Wray

Hi Carol Thanks for the update. I still don't think you're using enough progesterone to help sufficiently, although I am pleased things are changing. I really feel you need to use 400mg/day to achieve any lasting benefit. Glad you got all that sun though, that would certainly help. Look forward to hearing about your results. Take care Wray
Feb 12, 2013
 How much.
by: Carol

Hello Wray,

Thanks for your suggestion.I have 200mg and 100 mg of Susten tablets can I combine them with the cream(40mg x2) to get to 400 mg?

Thanks

Carol
Feb 13, 2013
 How much
by: Wray

Hi Carol Yes you can combine them. It doesn't matter what form progesterone comes in, each is compatible with the others. Take care Wray
Feb 14, 2013
 Results back
by: Carol

Hello Wray,

Wow! so I got my results finally, the first ever hormones tests I have had since I embarked on 'this journey';

- Vit D 78.7 nmol/L( just came back from the tropics, will take another after awhile)
- Estradiol 398 pnmol/L
- progesterone 11.4 nmol/L

These tests were taken on CD 16 of a 28 day cycle. I think the ration between oestrogen and progesterone is not good here what do you think? This must be the cause of my problems.


Regards

Carol
Feb 15, 2013
 Results back
by: Wray

Hi Carol Well it's as I suspected, your P:E2 ratio is only 29:1! We've found from Saliva Tests we run that it's best if it's 600:1 and over. Your vitamin D is low too. The minimum is 75nmol/L, but I really feel it needs be in the range 175-250nmol/L for real health, my last results showed 230nmol/L. Please increase your dose to 10,000iu/day at least, you need to get it up fast. And please stick with the 400mg/day progesterone, time enough to reduce when you feel well. Vitamin D works best when combined with magnesium, it's most important co-factor, vitamin K2 is another. Please keep in touch. Take care Wray
Feb 16, 2013
 Thanks Wray
by: Carol

Thanks Wray will keep in touch.
May 28, 2013
 I need your opinion Wray
by: Carol

Hello Wray,

I had my first saliva test after about 2-3 months of supplementing with the cream. The PMS, mental fatigue is down, mood is better and sleep has been consistently okay.

I want to share the results for your opinion,

Estradiol = 3.4pg/ml range 1-9
Progesterone= 1800 pg/ml range 300 - 6000
Testosterone = 44 pg/ml range 15 - 45
Dheas = 16 ng/ml range 3- 11
Cortisol noon = 0.89 ng/ml range 1 - 7
Cortisol HS = .50 ng/ml range 0.2 - 1.3

My naturopath was worried about the testosterone but we decided to watch. Do you think there is any reason to worry? Can supplementation raise it? Since the symptoms of bleeding are not going away do you think I may have a problem with the adrenal in addition to low progesterone? Is there any way of knowing for sure.

Howvere, I did have an abnormal reaction during withdrawal the last cycle - towards CD 6 I experienced bloating that I was forced to start the cream right away and the bloating went away. Another problem I have had with the last cycle and this one is the return of huge clots and flooding ( had to leave work today to change my clothes). All the other cycles have been manageable. I have been using 200 mg CD 8 to period - 100 from cream and 100 from susten.

My naturopath thinks I should keep away from alcohol, beef , milk and gluten products. Well I have not been disciplined enough and had a bit to drink , drank and ate organic milk and meat and bread ( who knows if the labeling is correct).

What do you think of gluten and hormones?

Can the body convert progesterone into estrogen and cause the symptoms am trying to get rid of?

Thanks again for the help you are giving us.

Regards
May 30, 2013
 I need your opinion Wray
by: Wray

Hi Carol I'm delighted the mood problems are better, I have found the emotional side does respond far quicker than any physical symptoms. Your testosterone is on the high side, but then your DHEAS is high, and that ultimately converts to testosterone. I would suggest waiting for a bit to see if it goes down. If your LH is high it could be one reason, as this stimulates cells in the ovary to make testosterone. When you say supplementing, do you mean with progesterone, if so the answer is no. You say the bleeding is still going on. Please confirm you're taking the 2000mg/day NAC, 2000mg/day taurine, at least 5000iu/day vitman D (dependant on levels) and 1000mg/day bioflavonoids. There's more info on our Menstruation page.
I'm not sure how the adrenals will affect bleeding, it's not something I've come across before. I did suggest you use 400mg/day progesterone to help stop the bleeding, plus those other nutrients. Are you still using 400mg/day and the nutrients? Alcohol does affect hormone levels in women, see here and here. It decreases progesterone levels and increases androgen levels, both the total testosterone and free testosterone become higher. I would suggest staying off gluten products, all grains in fact. But organic beef and milk won't harm you at all, unless of course you have an allergy to dairy. The body does ultimately convert progesterone into oestrogen, but the pathway is not that simple. It follows....

Cholesterol → Pregnenolone → Progesterone → 17-OH-Progesterone → Androstenedione → Testosterone → Oestrone ⇄ Oestradiol → Oestriol (also Oestrone → Oestriol).
As you can see it's testosterone which is converted to the 3 oestrogens. In fact we make more testosterone each month than oestrogen, but most of it is converted to the oestrogens. This is an excellent chart showing all the pathways. Take care Wray
Nov 14, 2013
 Update so far and Iodine/ progesterone dominance
by: Carol

I have been using progesterone for close to a year now. I have better sleep and energy has improved. Unfortunately the fibroids are not budging and may have even grown. The flooding did not stop and then I started spotting ( more like a day 3/4 period on some days) continously. I am confused not knowing whether this was due to the fibroids having grown, I had an MRI and it showed a very enlarged uterus and 2-3 problematic fibroids, one seems to have appeared out of nowhere since 2011. Is the enlarged uterus a side effect of the cream?

The spotting reduced and even stopped for two weeks when I reduced progesterone from 400 mg to 100 gm/day. Is it possible that I have progesterone dominance after using 400 mg only 3 months? I also lost my cycle. What can I do to regain my cycle? The insomnia and lack of energy has not come back even at the lower dose.

I am getting ready for a myomectomy since time is not on my side.Overall I do not using the PC because it has made so much difference in my quality of life.

Wray, do you know anything about iodine? I started taking small doses( lugols) twice a day still with PC and the spotting reduced further. It detoxes bad things ( heavy metals and even it is said to help regulate estrogen synthesis). My immediate results with it are reduction of some of the heavy feeling in pelvic area, more clear headed,reduced spotting. Could it be that oestrogen dominance is also a pollution thing/connected?

Though it gives some nasty effect in the beginning. I still take also NAC and vitamin D.

Regards
Nov 15, 2013
 Update so far and Iodine/ progesterone dominance
by: Wray

Hi Carol I would take a guess at your vitamin D level still being too low. The fibroids will cause inflammation, which uses up the vitamin D. The 10,000iu you’re taking may not be enough. I gave you those papers on fibroids, maybe you could read through them again. It could be you do need to have them removed, unless you try increasing your vitamin D to 40,000iu per day, see here. When they say enlarged uterus, do they mean the lining, or the actual muscle itself? Both can be due to excess oestrogen, it causes the lining to grow, plus it causes the tissues of the uterus to retain water. If you find the lower amount of progesterone is still helping you, then I’m pleased. There’s no point in continuing with a high amount needlessly. Iodine is essential, there’s now a deficiency epidemic. There’s more info on our page about Breast Tenderness and Breast Cysts. Oestrogen does suppress it. One drop of Lugol’s contains 6.25mg, I take 5 drops a day. I’m not sure what you mean when you say “Could it be that oestrogen dominance is also a pollution thing/connected?” Connected to what, and by pollution do you mean in the environment. If so then yes, most of the chemicals we make, i.e. pesticides, herbicides, many industrial chemicals all mimic oestrogen, none of us can avoid it. Our Stolen Future is an excellent site. Take care Wray
Nov 26, 2013
 Update so far and Iodine/ progesterone dominance
by: Carol

Wray,

In response to your last comments and thanks for your time as always well researched advice. They meant the uterus is enlarged itself and also due to the fibroids ( but you know what I would not be excited too much by the writer of the MRI report, to me it was tinged with dismissive air - you know how some mainstream medical people regard women in my age bracket), my RE was not too concerned, and explained the thin endometrium as due to the continuous bleeding.

Now my plan will be iodine and PC after ovulation, get the myomectomy just so to speed things as the bleeding is wearing out my health and holding back my life( RE reckons the one causing the bleeding is 50% in to uterus and should go- we'll see). I have noticed that the clotting has gone down in the 2 months of iodine/ PC but still very heavy.

As to my comment on oestrogen dominance vs pollution vs iodine - I have noticed in my research and in a couple of places it is mentioned that heavy metal toxicity ( , bromine, mercury, chlorine in tap water, aluminium etc. can lead to the same symptoms as estrogen dominance even cause it. At least one source said that iodine improves PC uptake by clearing up the liver and the cells so they take PC efficiently. Am not sure am clear here but it kind of made sense when I read it.

Apparently bromine is one of the worst and I have seen one resource that said gluten intolerance could actually be bromine intolerance because most wheat flours are processed with bromine.

I did read Our stolen futures four years back and no longer heat food in plastic, plastic wrap, glass water bottle etc. Not always easy but have made the changes I can make.

Regards
Nov 29, 2013
 Update so far and Iodine/ progesterone dominance
by: Wray

Hi Carol Thanks for clearing up the enlarged bit, fibroids would certainly play a role there. I think the myomectomy a wise choice, the fibroids will continue to cause trouble unless they shrink which is a very difficult to achieve. You are right about heavy metal toxicity, they are finding that some minerals are now found to mimic oestrogen.....uranium, arsenic, cadmium, lead, antimony and mercury. Iodine is essential to the thyroid and breasts too, plus a number of other areas. Unfortunately the halogens, of which iodine is one, are everywhere. Iodine is lowest on the periodic table and is the least reactive, so gets shunted out of the body by all the other halogens. Bromine is just above iodine and is used by bakers as an 'enhancer' whatever they mean by that. Chlorine follows and is used to 'disinfect' our water supply and more. Finally fluorine, better known as fluoride in our water and toothpaste. All these merely add to the body burden, and deprive us of iodine. Take care Wray

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