DESPERATE!!!!

by Kalini
(USA)

Hello Wray,
I took the quiz for progesterone deficiency and scored a 61. I would appreciate information on progesterone therapy. I have no history of depression or anxiety and then suddenly in August I began with periods of Shortness of Breath and that escalated to full blown panic attacks, chest pain (with hospital visits, cardiologists visits, pulmonary visits), I had to leave my job and my family doctor started me on antianxiety and antidepressant medications, both of which are minamully effective. They then recommended a therapist and psychiatrist for the medications, that he now wants to increase everything and add more medications. I looked back prior to this nightmare beginning I had irregular periods with spotting in between, heavy flow some days and then would just stop completely, to just start again, whenever, for several years. At the time that the shortness of breath started, I was in chronic pain and had several major personal and professional stressors and now realize that I did not have my period for two months, at which time I experienced panic attacks and was not able to function. Unfortunately, I was diagnosed with Factor V (a blood clotting disorder) several years ago, but I have never had a blood clot and had several surgeries with no complications prior to this diagnosis. I did go back to my gyn and requested blood work, my progesterone level a year ago was listed as postmenapausal 0.06, per the report. This time I was informed that all my estrogen levels where within normal range, when I asked about my progesterone, I was told that it was low, but it was probably due to the time of the test. I asked for progesterone replacement and I was told that he could only give me progesterone with estrogen and since my estrogen levels were normal that was not an option. Prior to this visit I was told to contact my hemotologist to get permission for progesterone replacement, if needed, the hemotogist doctor agreed, as long as it was a low dose and the gyn monitored me, but instead the gyn told me I was in perimenapause and we will continue to monitor my irregular periods and check labs again later, also recommended a biopsy of uterus, which I declined at the time. Now I have tried everything and prior to when I would be due, my anxiety, which never goes away, increases and makes many days unbearable. I have tried to call an endocrinologist to help with what I believe is a hormone imbalance, as well as, my hemotologist and family doctor, requested a return call to disgust whether or not one of them will help me and prescribe progesterone. In the meantime, I have felt so desperate that I have gone to my local health food store and stood in front of the pro-gest for up to 30 minutes reading and re-reading the instructions and debating whether or not to treat myself and hope that I would do no harm or cause a blood clot. So as you can see I am at my wits end and just want my life back and feel like no one is listening or cares. So any information you can offer, along with advise regarding progesterone therapy, including if you think I should try it, if it is safe, and how much I should start with, would be greatly appreciated.
Thank you so much for your help and reply.
Kalini

Comments for DESPERATE!!!!

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Apr 01, 2013
DESPERATE!!!!
by: Wray

Hi Kalini Your gyn's diagnosis about being in Peri-menopause is correct, it's the most difficult time. Unfortunately the 'progesterone' he would have given you would have been a progestin, not what you need. All your symptoms are easily related to low progesterone and high oestrogen. Your progesterone was the same as mine when tested, and my oestrogen was also 'normal'. They never check the ratios which are critical. We've learnt from Saliva Tests we run, that it should be 600:1 and over to feel well. If your ratio is anything like mine was at 5:1 then I know exactly how you feel! Oestrogen causes smooth muscle to constrict, hence your shortness of breath. Progesterone is essential for normal respiration, see here, here, here, here, here, here, here, here, here and here. Adrenaline also causes shortness of breath, as it too constricts blood vessels. The panic attacks are caused by a sudden increase in adrenaline. Adrenaline is released when stressed, it could be real or perceived. Or a sudden drop in blood glucose causes it to be released too. Oestrogen destabilises blood glucose, whereas progesterone does not, see here. It's essential to avoid all sweet, starchy foods, and foods and drinks which contain sugar/fructose too, as these convert to glucose too quickly, which would upset blood glucose. We do have a page on Nutrition, I feel the Paleo Diet would suit you best. Continued below

Apr 01, 2013
DESPERATE!!!! Part 2
by: Wray

Hi Kalini There's more info about panic attacks on our Anxiety page, which gives a list of nutrients which help. Please consider taking some. Taurine is particularly good, as it calms the heart and mind too, about 2000mg/day. Inositol too, as that sensitises the body to insulin and helps with glucose disposal, excess insulin causes blood glucose to drop too quickly, which causes an outpouring of adrenaline. Plus inositol cures panic attacks for obvious reasons! You need a minimum of 4000mg/day, up to 18,000mg/day for this, see here, here and here. If there's excess adrenaline in the system, progesterone cannot enter the cells, so worsens the affect. The chest pain is also caused by oestrogen, it causes prolongation of the QT interval, which results in palpitations, arrhythmia, Torsades de Pointes and sudden death. Whereas progesterone shortens the QT interval, see here, here, here, here, here, here and here. You say you have Factor V, a deficiency of this can lead to bleeding, but a mutation such as Factor V Leiden (FVL) leads to clots. I'm not sure which you have. Assuming you have the mutation, then oestrogen increases the risk of clots, irrespective of whether a person has protein C and/or S deficiency, or hyperhomocysteinemia. Having any of these pathologies increases the risk further, oestrogen in any form is contraindicated. Please see our page on HRT. Continued below

Apr 01, 2013
DESPERATE!!!! Part 3
by: Wray

Hi Kalini And these papers here and here. In FVL, factor V remains active, which allows over production of thrombin, leading to excess clotting. Oestrogen increases the affect of thrombin, progesterone on the other hand decreases it by 10-15%, please see here. It also protects against lipid peroxidation and atherosclerosis, please see here and here. When initially using progesterone it stimulates oestrogen which can make matters worse. There's more info on our Oestrogen Dominance page. To prevent this occurring or lessen the affect, you would need about 400mg/day progesterone, you might need more. It is trial and error finding the right amount. Please have a vitamin D test done. This is such a vital nutrient, essential for all cells to function normally. A lack reduces the benefits of progesterone, leads to destabilised blood glucose, depression and far more. For more info on vitamin D levels, test kits etc see the Vitamin D Council, GrassrootsHealth and Birmingham Hospital. 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. Take care Wray

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