Insomnia for over a year....

by Angela

I started off using bioidentical progesterone as advised through Dr. John Lee's book and even through articles on Ray Peat's website. This worked well for me for quite sometime. Until our family went through a very difficult time a little over a year ago. That's when my insomnia began and the cream didn't seem to help. I would lay awake at night with a racing heartbeat.
After trying pretty much everything(supplements) from tryptophan to melatonin. I sought the help of a naturopath. She began me on Tri-est sublingual with progesterone and testosterone, DHEA, vitamin d, iron(as those were low), adrenal support. After a couple of months of doing this, I wasn't getting a period and I was still not sleeping. I requested that I be put on a progesterone only troche. Which ended up being a 180 mg progesterone troche. When I first began this my heartbeat increased so much that I had pulsatile tinnitus. My Dr. advised I go to the ER. I decided to first take a magnesium bath and supplement with extra magnesium to see if that would help and it subsided. Afterward though, I was feeling very cautious when taking the troche, as the smallest amount was very stimulating to me.

A couple a weeks ago, I was reading your website and decided to just try taking more until my symptoms subsided. As I increased the amount i didn't have the tinnitus issue this time and I was very pleased to find that it helped calm my heart rate. It's been helping me sleep better, not as i good as i used to sleep, but definitely better. The first week I was taking between the troche and progesta care between 500 to 800 mg. to get my heartrate to calm and help me sleep. The second week I began using your cream in lieu of the other, along with my troche. But, I was needing closer to 1200 mg to get my heartrate to subside to sleep.
Well, my compounding pharmacy now will not renew my prescription since I filled it twice in two weeks. They need my dr's approval to fill another one so soon. I've messaged my doctor about this asking if she would also add a 600 mg. progesterone suppository since I seem to be needing more at night to sleep. Your cream works well, but I'm having to use a lot of it and I'm not sure if using 6 tsps. a day will lessen the efficacy. Anyways, it doesn't sound like my doctor is willing to work with me using higher levels at this point,so we'll see. But, the higher levels are the only thing that is bringing relief, helping me sleep, and feel better.

So, your cream is all I have at the moment. Can I keep using it at the levels mentioned above and have it remain effective? I am using the cream every place conceivable each day. Once my symptoms subside and my sleep is more consistent, I would then work down from there. As my hormones go through there different phases I expect the amount of cream I need will probably change as well. Also, when applying the cream if I shower a few hours later do I loose some of the benefit?

I also want to thank you! It is such a blessing to find a website that is so thorough. There can be a lot of confusion in the differing information on the subject, much that isn't helpful. I really can't thank you enough for the time you've given to offer your help and insights. I appreciate also that you share in the experience firsthand as well!

Comments for Insomnia for over a year....

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Mar 04, 2015
Insomnia for over a year....
by: Wray

Hi Angela Bless you for the kind words! It's so interesting you found the magnesium bath helped, I have those every night, very calming too. Which makes me wonder if you lack Vitamin D, magnesium is it's most important co-factor. But a lack of vitamin D not only reduces the benefits of progesterone, it also causes insomnia, see here and here. Please have a test done, it could be this is what you need, in which case you can reduce the amount of progesterone. It's not dangerous the amount you're using, just very costly. Last year I used 1 tube a day for 2 months due to stress, now I'm down to 1 tube every 4 days. But there are many other things which cause insomnia. I've done a potential webpage, but unfortunately I'll have to paste it here as I haven't formatted it yet! 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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