Coming off a high dose

by Dolores
(Toronto, Ontario)

Hi Wray,

I have been following you for two years and I think you are wonderful. I am currently on 600 mg. of prometrium vaginally and it has worked amazingly. The reason I use prometrium is because it is covered by my insurance, so it is more financially feasible to use it. My issue now is that I want to come down from such a high dose and you said to only come down 16 mg at a time. I have now ordered natpro so that I can use both. I plan to take 5 prometrium and 84 mg. of natpro. Will this work and how long before I take 5 prometrium and 68 mg. of natpro? I believe I am now progesterone dominant and it is wonderful. I have been progesterone dominant for about one month, is that enough time? Can I start reducing the dose now? Will natpro work along with the prometrium?

Thank you very much for all the great work and great advise that you are giving women all over the world. I know that you have helped me immensely and I cannot taking you enough.

Dolores

Comments for Coming off a high dose

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Jul 27, 2012
Coming off a high dose
by: Wray

Hi Dolores Bless you for the kind words! Your idea is excellent, they will both work well together. It is best to reduce very slowly, you might find you can do it faster, just see how you get on. The last thing you want to do is come off too quickly and spoil all your efforts to date. I suggest staying on the reduced amount for about a week and then if feeling stable, reduce again. Depending on stress levels, you'll find some weeks you will have to continue for longer before reducing, others quicker. I'm so delighted you're feeling so good, that you managed to get such a high amount of progesterone from your doctor and on insurance too, that was a good move! I feel the month is enough, particularly as you'll be reducing the amount so slowly. This will extend the time quite considerably. If at any time you feel symptoms are coming back, just increase to the level you were using before. You are obviously well aware of adverse symptoms and why they occur, but as a recap for you….. Dark days/winter reduce progesterone, a lack of vitamin D reduces it's benefits, stress drops levels, large meals too! Plus phytoestrogens will affect levels, and it's impossible to avoid those, they are even found in meat, see here, here and here. Do let me know how you get on. Take care Wray

Jul 29, 2012
Feeling Foolish
by: Dolores

Hi Wray,

Thank you for getting back to me so quickly. I thank God for you everyday. I do, however, feel very foolish as I miscounted one day and took 800 mg. of prometrium instead of 600 mg. There was no reason to up the dose since the 600 mg. was working so well, so the very next day I brought it back down to 600 mg. This obviously did not sit well because I started having symptoms again, specifically, bloating, a little weight gain, interrupted sleep. What should I do? Should I wait it out, or should I reduce the dosage one day to say 300 and back to 600 the next? I am at a loss as far as what to do here. I could kick myself since I was feeling like a teenager again and I really disrupted it.

Please let me know.
Dolores
Toronto

Jul 31, 2012
Coming off a high dose
by: Dolores

Hi Wray,

I am so sorry, but I think I made a mistake. I wrote to you but I thought it required a new comment title and later realized that might not be the case. Anyway, I am writing again, this time with the original comment title.
The problem I am facing now is that I miscounted one day, almost a week ago, and took 800 mg. of prometrium instead of the 600 mg. that I have been taking and feel so good on. I felt great the day I took 800 as well but the next day, when I reduced it back to 600, I did not feel as well as I had been feeling. I have some bloating, a little weight gain, sleep disturbances and I am generally angry at the world. ee My question is, should I reduce it even further and then go back to 600 mg. or perhaps not take any for a day and then resume. The only other option is, of course, to increase it back to 800 mg. for a while but I don't think my doctor will be alright with that.
Please help me sort out this foolish thing I accidently did.

Thanks.
Dolores
Toronto

Jul 31, 2012
Feeling Foolish
by: Wray

Hi Dolores Don't feel foolish! It's so easy to do, I think this occurs to many women when measuring their cream. They don't use measure accurately and their dose goes up and down, sometimes daily. The measure doesn't have to be that accurate, a kitchen measuring spoon is fine, but the same amount needs to be used. In other words, not one day a heaped tsp and the next a flat tsp, or a heaped 1/4tsp, the next day a flat 1/4tsp. You would get those adverse symptoms again, reducing so suddenly. There are only two options, either stick it out as your body settles back down to the 600mg, or increase back to the 800mg, and then slowly reduce it. Do you have any cream yet, as that's the easiest option. You could use this to increase back up and reduce back down. And it doesn't matter what the title is, because you give your name. There are so many who use 'anon' and it's essential for me if they keep to the same title so I can follow their thread. I find myself repeating things needlessly not knowing which 'anon' I'm answering! Take care Wray


Jul 31, 2012
Coming off a high dose
by: Dolores

Hi Wray,

You made me feel so much better with your response. Thank you so much for being you. I have decided to go up to 800 mg. because I just don't want any symptoms. You will find that I am not like most women who are afraid of high doses. I will do whatever it takes to feel good. Unfortunately, I don't have any cream yet as it has been stuck in Grand Rapids, Michigan since July 26th. I don't think it ever really travelled and I am concerned as to why. I wonder if you could check into this for me as I would like to get back to normal as soon as possible.

Thank you so much for your time.

Dolores
Toronto

Aug 01, 2012
Coming off a high dose
by: Dolores

Hi Wray,
I am so sorry to bother you again, I understand you must be so busy answering so many questions but I'm afraid I have a big problem. My cream seems to have gone awol. The tracking system seems to just have stopped the day after it was sent, so I haven't been able to start decreasing my dosage. As a matter of fact, if you remember, I actually increased it to 800 mg. vaginal prometrium from 600 mg. and it worked, I feel great except for one thing. This is one very embarrassing thing and hard to talk about, but I feel I need some help. I have a very sensitive clitoris. I mean I can't wipe it properly after urinating and apparently some websites tell me it comes from high progesterone dosages. Is this true? If so, what do I do about this? Needless to say, my husband is not happy about this at all because there is no way I can have sex.
Also, Wray, is l00 mg of natpro(when and if I ever get it) the same as 100 mg. of prometrium and will it absorb the same transdermally as vaginally? Hope I haven't talked your ear off, but I am concerned and in pain. It really doesn't bother me in day to day activities, it is only when I touch it for wiping purposes or heaven forbid, sex!!! I hope there have been others who have brought this up.

Thanks.
Dolores

Aug 06, 2012
Coming off a high dose
by: Wray

Hi Dolores Sorry it's taken so long to get back to you. I was asked by a friend to baby sit her house and dogs, and it's in the country. So the travelling and settling in took up some time, plus I took time off to watch some of the Olympics! Thanks so much for the kind words, and I do hope your cream has arrived by now, but I have made enquiries for you. I do know it seems to take 3 weeks to get to Canada, I have no idea why though, as it takes 3 weeks to get to Europe. Progesterone is blamed for most of the adverse symptoms if they occur! VVS is caused by excess oestrogen, it's an excitatory, inflammatory hormone. VVS is usually found in premenopausal women or women on oestrogen replacement therapy (HRT.) It's associated with a number of symptoms, one is peripheral neuropathy. Progesterone is known to regenerate nerves, see here. Another is Candida, progesterone reverses the inflammatory oestrogen response, see here. Mast cells are also implicated, progesterone has an inhibitory affect, see here. Whereas oestrogen stimulates mast cell secretions. Significantly higher levels of TNF-alpha are found in women with VVS, progesterone inhibits TNF-alpha, see here and here. Continued below.

Aug 06, 2012
Coming off a high dose
by: Wray

Hi Dolores In the USA 61% of chronic pain patients are women, starting at menarche and decreasing at menopause. In some cases symptoms of VVS increase at mid-cycle and at menses, when the oestrogen to progesterone ratio is high. Please try applying some of the cream to your clitoris and all around the whole area in fact. 100mg Natpro is the same as 100mg Prometrium, and it's absorbed very well. You might like to see our page on Saliva Tests, we run them periodically to check the absorption. I use some in my vagina every night, and recommend others do if they have problems with dryness or inflammation. We also have a page on the various Delivery systems which might interest you too. Please let me know how you get on. Take care Wray

Aug 07, 2012
Coming off a high dose
by: Dolores

Hi Wray,

Thanks for getting back to me and I hope you had a good rest while babysitting. I should tell you that the cream did arrive today and you would think I had been sent gold, I was so excited to get it.
The VVS went away as mysteriously as it came, so I don't even know what to call it. It is just a relief not to have it anymore, but should it return, I will definitely take your suggestion. Right now, I am back to the 600 mg,/day and I don't have any symptoms to speak of except that I would like to lose 10 pounds to be truly happy and it just does not seem to want to come off. I take in very few calories, mainly because these days, I just don't have time to eat. With the kids being home from school, I am always running around driving them somewhere. Any suggestions as to how I could maybe shed these last few pounds?
Thanks for all your help, and may God bless you for the astounding work you are doing. You have so many women functioning normally and you should be so proud because we would all be such a mess without you.

Dolores

Aug 20, 2012
Coming off a high dose
by: Wray

Hi Dolores Bless you for the kind words! It does give me so much delight to hear someone is getting better. Some don't of course, but there are so many variables, it's impossible to know what else is occurring in someone's life. I'm so pleased the VVS or whatever it was has gone, I only hope it never comes back. I love your comment about getting the cream, it's gold for me too, as I've run out before and do not like the return of symptoms. The probable reason for not being able to shed those pounds, is you're not eating enough. Sounds strange, but as soon as you go into what the body regards as starvation mode, it will slow the thyroid down, this slows the basal metabolism, plus it keeps the fat stores and stores any calories you eat as fat. Please try to increase your food, particularly eat breakfast. It's best if this can be a high protein meal. You might like to see our Nutrition page. There are links to a few different eating options, hopefully you'll find one which suits you. As soon as you feel stable you can begin reducing the amount of progesterone you're using, there's no point in using too much, it becomes very costly! Take care Wray

Sep 03, 2012
Coming off a high dose
by: Dolores

Hi Wray,

Its been a while since I have talked to you. I hope all is well with you. I did receive the Natpro and it does work just as well as the prometrium. Bless you for coming up with such a Godsend.
I did want to ask, however, how exactly you know you are stable. I am still on 600 mg. between the vaginal prometrium and the Natpro and some days are definitely better than others. I believe that this fluctuation in days means that I am not yet stable or progesterone dominant. Am I right on this? And how do I know when I am completely progesterone dominant and can start reducing the dose? Were you on a dosage this high in the beginning and how long did it take for you to become progesterone dominant? I know everyone is different, but I would like even a ballpark figure just to feel better. I hope you don't mind me asking.
Also, I love putting the Natpro on my face. I am also on a complete facial system of purely organic creams, exfoliants, serums and sunblock. Can these other creams interfere with the Natpro at all. Right now, I put the Natpro first, wait an hour and then go on to put the rest. Is this wise or should I not put anything but the Natpro on?
I will wait to hear from you.
Thanks again.
Dolores

Sep 03, 2012
Coming off a high dose
by: Wray

Hi Dolores Thanks so much for coming back to me, and the kind words too. Unfortunately there are always going to be up and down days, even now I have them. And that's after 15 years of using it. There are so many hidden stressors in our lives, each affects us adversely, even if we're not aware of it. I know you began writing in at the end of July, but I'm not sure how long you'd been using the 600mg/day prior to that. If it's been about 3 months I think you could try coming off using the amount I suggest and see if it affects you badly. If not stay on that amount for a few days, and then reduce again. It's easy enough to increase the amount if too soon. No I didn't use anywhere near that amount. The doctor I found who would check my progesterone too, not just oestrogen, was not familiar with it's use at all. So I was going by what I'd read in books, the web had not started then for the general public! It took me 6 months to come right. I knew nothing about oestrogen dominance then, and probably got it, but my symptoms were so bad, I wouldn't have known the difference! I'm so pleased you like putting the cream on your face, I do every morning and night too. In fact it's very good for the face, see here. I'm so pleased you're using all those good things too, and not the ones full of toxins. The other creams won't affect it at all, the progesterone is absorbed within minutes. In fact I often add immediately after applying the Natpro, a thicker cream I make, I find my face needs it sometimes. Particularly when the weather is dry. Continued below.

Sep 03, 2012
Coming off a high dose Part 2
by: Wray

Hi Dolores I've just re-read our page and see I haven't mentioned vitamin D at all, very remiss of me. You live in Canada where levels are often very low, see here, here, here and here. Please have a test done, a lack of vitamin D reduces the benefits of progesterone. In fact I was so fascinated by these two I did a page on them, see Progesterone and Vitamin D. For more info on vitamin D levels, test kits etc see the Vitamin D Council, GrassrootsHealth, Birmingham Hospital and Vitamin D Links websites. 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 the latest research indicates it should be 10,000iu's per day, see here. Take care Wray

Sep 03, 2012
Coming off a high dose
by: Dolores

Hi Wray,

Thank you for reply so quickly. I also forgot to mention that I am on 10,000 IU of vitamin D and have been for at least 3 months now.

I do wonder about water. I often wake up with a very dry, pasty mouth. I hate drinking water but I will do it if necessary. How important is it to drink at least 6 glasses of water per day?

Thanks.
Dolores

Sep 03, 2012
Coming off a high dose
by: Wray

Hi Dolores We are obviously on the web at the same time! Ah I'm pleased you're taking the vitamin D and such a good dose too. A dry mouth can also be an indication your oestrogen is still too high, and not necessarily a water issue per se. There's an 'autoimmune condition known as Sjogren's syndrome which causes a dry mouth, dry eyes too, see here, here, here and here. Although with the amount of progesterone and vitamin D you use, I would be really surprised if you had it! But oestrogen does water water retention, drawing water mainly from the gut, but the mouth would also be affected. But I still don't see how this could be. I don't believe we need to drink water as we're advised, you might like to read what Ray Peat has to say about this, see here. Take care Wray

Sep 17, 2012
Doctors' opinions
by: Anonymous

Hi Wray,

I am sure you can probably see who this is. I did this under anonymous this time because I am going to be mentioning certain people, and I feel more comfortable doing it this way this time. My doctor decided to play hardball with me this time, and eventhough my old family doctor who retired prescribed 600 mg. of prometrium for me, my new one said she would not prescribe more than 100 mg. She totally did not understand what kind of a problem this would be for me to all of the sudden come from 600 mg. down to 100 mg. She obviously doesn't understand hormones at all which is a big problem as I am questioning her knowledge in general. As a result, I went to see a Dr. Agnes Schlanger who was recommended by many blogs. She supposedly is an expert in hormones eventhough she is a family doctor in Toronto. She recognized your name right away, but is in total disagreement with you on almost every point about progesterone. She told me that at 600 mg. I was totally overdosing and that high doses of progesterone have been linked with breast cancer. I did not buy this at all which just angered her. She also would not prescribe more than l00 mg. of prometrium which is why I have now put in an order for your cream. I am just sorry I didn't order more, I don't know what I was thinking except that I was mad as hell! I will use Natpro instead so all is not lost, but I would like to hear your opinion on this breast cancer thing. I did tell her that I didn't put much stock in it especially since before I started using progesterone, I used to get this totally frustrating, annoying itch inside my nipples. When I say inside, I mean it was an internal itch that could not be scratched and it was driving me insane. Since using the progesterone, that is an annoying memory which has never been repeated. I don't think this example can totally dismiss breast cancer possibilities, but in my mind, it does tell me that it is doing something good as opposed to giving me cancer. Am I crazy for this way of thinking, or is there something to what she says?
I will look forward to your answer. This doctor was also very distant and cold, her office seemed to cater to botox and other skin aging procedures and the office also had no rhyme or reason for who they put into the examining rooms first. I got there before two other ladies who were put into the examining rooms before me and the one who got there last, was seen first. I do not recommend anyone going to see her at all!!!

Sep 18, 2012
Doctors' opinions
by: Wray

Hi there Yes I do recognise you! How sad it all is, and to ask someone to drop from 600mg to 100mg would put them into severe oestrogen dominance. I'm delighted you're using the Natpro of course, but find it sad you can't take advantage of your insurance. There are still so many Progesterone Misconceptions. Most think it a pregnancy hormone, and has a small role in our menstrual cycle, and that's it. But progesterone affects the very genes in every cell, and it does this while still a foetus. And if high amounts of progesterone caused breast cancer, then surely every woman who fell pregnant would get it? We make over 400ng/ml per day during the third trimester. And Dr Dalton would prescribe amounts of 400, 800 and up to 2400mg/day for her post natal psychosis patients. Surely they would all have got cancer? And what about the 1200mg/day given successfully to Traumatic Brain Injury victims? How could they be so irresponsible if they knew it would cause cancer? And all the women who get 200, 400 and 600mg/day for IVF treatments or to prevent Pregnant women miscarrying? One woman who wrote in said her doctor was giving her 1600mg/day to prevent recurrent miscarriages. Somehow I think the doctor has it all wrong, such a pity you got that off-hand treatment in her office. Women with low levels are at greater risk of getting cancer, than those with high levels. Finally it has been used successfully to treat many Cancers. There are numerous papers on this page you could look through. I'm fascinated about your 'itch', and very happy it went. Botox and anti-ageing makes money, progesterone doesn't. And yet it's excellent for ageing, see here, here, here, here and here. I think I'll stick to progesterone! Take care Wray

Oct 07, 2012
Coming off a high dose
by: Dolores

Hi Wray,

I hope you are well. I have to ask you something that has me a little worried. Eversince I have been using Natpro along with the vaginal prometrium, I have been feeling my ovaries more. Something like when I used to ovulate and you feel one side or the other, but in this case, I feel both sides at one time or another. Is this normal? I never experienced this when I was on the prometrium only, but since my doctor refused to give me the dosage I was on, I have been making due with what she does give me and Natpro. It is only when I started doing this, that I feel my ovaries. If you google this symptom, it gives very scary possibilities of ovarian cancer, cysts, etc. Please put my mind at ease and tell me this is normal.
I have also wondered if the outer coating of the prometrium could possibly cause any damage since I use it vaginally?

Thanks.
Dolores

Oct 08, 2012
Coming off a high dose
by: Wray

Hi Dolores The Natpro is absorbed very well, we know this from Saliva Tests we run. It makes me think that possibly the prometrium is not being absorbed as well, and by adding the cream you are getting more progesterone than previously. Or it could be that over the time you have been using it, the ovaries are beginning to wake up. I have no other explanation for it. I very much doubt if it's anything serious either, with the amount of progesterone you're using. Have a look through the Cancer page again, and we also have one on Ovarian Cysts you could look through. If you're concerned though, why not have a scan, it would put your mind at rest. I feel I've been very dim! When you originally wrote to me, you said you were using the prometrium vaginally, I didn't give it a second thought. Now you have mentioned the outer coating, the penny has dropped. I suggest opening the capsule and adding the contents to a small amount of cream and then rubbing that on your skin. It could be you were not getting the full benefit of the progesterone as the coating was not dissolving fully. Then the capsule would have come out with the urine. You can still apply progesterone in your vagina, either using a finger or applicator. I put some in mine every night, and have never suffered from vaginal dryness, inflammation or Candida since doing so. Let me know how you get on if you follow this suggestion. Take care Wray

Nov 07, 2012
coming off a high dose
by: Dolores

Hi Wray,
How are you? I did have a conversation with you not long ago, but unfortunetly you thought I was someone else. Somehow the comments got entangled between two people. Doesn't matter, however, you answered me with great wisdom the way you always do.
I am just wondering, with Christmas coming up, what effect does alcohol have on estrogen dominance. I am not a big drinker, but every year at Christmas time, with the parties and social gatherings, I find the alcohol consumption does up. I am only asking because I have had seven weddings this year, and I noticed that the day after each wedding, I would have symptoms eventhough the amount of progesterone I was using did not change. I found I had to add more the next day and decrease it slowly back in order to return to normal. Does alcohol have an impact on estrogen?
Thanks so much for taking the time to answer me. I value your opinion so much more than any doctor as I have found they really know nothing abouy this.
Talk to you soon,
Dolores

Nov 09, 2012
coming off a high dose
by: Wray

Hi Dolores I do find I get entangled, but not when they put their name as you always do, makes my life much easier! I can understand the anon using that above, but when there are so many anions on a page, I haven't a clue who I'm addressing. Or whether I'm giving them the same advice as before. If they stick to the same subject heading it does help, but some change it, then I'm really stuck! Yes alcohol does have an impact on us, it raises oestrogen and testosterone, and lowers progesterone. Spirits don't contain carbs, whereas wines and beers do. But all alcohols, be they spirits, wines or beers, do have a calorific value, see here, which gets added to the total daily caloric intake. There is a paradox to drinking alcohol. Studies have found it increases appetite prior to a meal, so people tend to eat more, see here. This is probably because it drops blood glucose levels, see here. But it doesn't appear to increase weight gain, certainly in men. One reason given it is increases the metabolic rate, which also causes thermogenesis. There is another paradox here too. In men it doesn't appear to affect weight gain, see here. But in women it affects hormone levels, see here and here. It decreases progesterone levels and increases oestrogen and androgen levels, both the total testosterone and free testosterone become higher. Testosterone is notorious at increasing visceral fat, which causes abdominal fat gain, see here and here. The lowered progesterone, higher testosterone probably accounts for the increased risk in breast cancer risk among women, see here and here. Higher testosterone is also associated with an increased risk for Insulin Resistance and heart disease, see here. Continued below.

Nov 09, 2012
coming off a high dose Part 2
by: Wray

Hi Dolores Sugars, large meals too, drop progesterone levels, this causes SHBG to drop. If bound to SHBG (sex hormone binding globulin) testosterone becomes inactive, progesterone raises levels of SHBG, see here, so preventing the rise of free testosterone. High testosterone can cause severe PMS. SHBG drops if sugars are eaten, even those found in all grains, legumes, dairy and sweet starchy fruits and vegetables. Fructose, sucrose and glucose, reduce SHBG by 80, 50 and 40% respectively, see here. Thereby allowing testosterone to rise. It's best to avoid all the foods and sugars mentioned, including excessive alcohol and large meals. I would imagine some are more susceptible to the impact of alcohol, it appears you are. I know I am, because like you I'm not a big drinker. I suggest, when confronted with a celebration involving food and alcohol, to increase the progesterone prior to the event. If possible during it too. This might stop the drop after it. But 7 weddings, plus things like Halloween, Thanksgiving, and Christmas......how do you manage it?! Bless you as always for the kind words! Take care Wray

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