Progesterone Blood Serum Level Out of Range

by Jules

Hi Wray:

Question for you.

I know from reading on this site saliva tests are more accurate, but my doctor only does blood. I am in my mid 40's. According to the Medline links you have, female mid cycle levels should be 5 to 20 ng/mL...I got mine back and it was out of range at 35. I do not take much progesterone...just one capsule of micronized bioidentical progesterone 100mg at bedtime for two weeks out of the month (I assume that 100mg in capsule form would be about the equivalent of 10mg - 20mg of cream). I also realize capsules are not ideal...but if such a small amount of progesterone shot me over the high end range, what would starting high levels of the cream do? Wouldn't that be too much for someone like me who is already over range on such a small dosage? I guess what I am wondering is....how far past that upper range can you go on a blood test without it being overkill or is this a situation where the suggested range they have is too low in the grand scheme of things and you can go waaaay higher than the end range of 20ng/mL? Is it possible that there are some women out there that just need a small amount of natural progesterone to keep them within their range and feeling well and that higher dosages of cream can just be too much for them???

THANK YOU WRAY!

Comments for Progesterone Blood Serum Level Out of Range

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Mar 20, 2012
Progesterone Blood Serum Level Out of Range
by: Wray

Hi Jules The bottom line, as you've mentioned, is are you feeling well on that amount. If so then continue with it, if not then you will need more. Although Medline gives 5-20ng/ml as the range, levels can go as high as 40ng/ml, see here. Saliva tests paint a very different picture, as it shows all progesterone in circulation, not just that found in the serum. Levels can go very high, you might like to see this page here. The other far more critical aspect, is the P:E2 ratio. We've found from Saliva Tests we run that the ratio should be 600:1 and over to feel well. Can you check yours? If your oestradiol is around 58pg/ml the ratio would be about 600:1. You are right, some women need a small amount, some far more. We have two I know of using in excess of 1000mg/day, see here. Although finding the ratio can show why we are struggling, symptoms are a better guide. The more severe they are the more is needed. For instance Dr Dalton would give 2400mg/day to her patients with post natal psychosis, Traumatic Brain Injury victims are given over 1200mg/day via IV transfusion. Incidentally over 70% are men. So if you're happy on the amount you take, please stick to it. But as you point out, oral progesterone is not the best Delivery system. Take care Wray

Mar 20, 2012
Hi Wray....
by: Jules

Hi Wray...

Thanks for your response. My estradiol is 60 pg/mL, so I guess my estrogen to prog level is pretty good....it seems a small amount of progesterone puts me at a good ratio. I'm not sure if I should mess with this ratio by taking more progesterone. I have a feeling I am just one of those women that needs a small amount. I feel well for the most part, but I do seem to bloat up alot/retain water and I think my breakouts get worse. If I don't take progesterone, I have noticed my stomach seems flatter and the acne backs off a bit...but the bad part is my cycle gets irregular again and I get wicked cramping a few days before. Overall, I have a VERY tough time with weight loss...but I am hypothyroid as well (on Armour Thyroid) and I know this may be playing a role. Wray, can I ask you a quick question about estrogen? I was reading online that it is recommended to have a minimum estradiol level of 40 to 50 to prevent bone loss...but that 60 or higher is optimal...with some saying that some women won't feel well until they get their levels above 100. I know there is a big range for estrogen and some women can feel well on the lower end while others feel better when their estrogen is higher. I have also read that some women who had low estrogen went on it and then were able to lose weight when they brought up their level. I have no plans on taking any estrogen (and I never have)...but have wondered about my level and if it is right for me. I know the estrogen/progesterone ratio is important, but if you were just looking at estrogen would you consider an estradiol level of 60 an "okay" level for a woman in her mid-40's? Also, could you give me some brief thoughts on evening primrose oil, Vitex and MACA for hormonal balance? Can any or all be used in conjunction with natural progesterone? THANK YOU SO MUCH!

Mar 21, 2012
Hi Wray....
by: Wray

Hi Jules Yes your ratio works out to 583:1 which is good. Bloating, retaining water are all signs of excess oestrogen, progesterone is an excellent diuretic. This is why they give it to TBI victims to prevent the oedema. And are you saying when you don't take progesterone your acne gets better? Ironically this is because it's not stimulating testosterone and oestrogen. Testosterone is the end result of a process, but it's this which causes acne, oily skin etc. If SHBG is low, free testosterone rises. Progesterone increases levels of SHBG, see here. By doing so the free testosterone becomes bound and therefore inactive. Please avoid all sugars, even those found in all grains, legumes and sweet starchy fruits and veggies and dairy. Fructose, sucrose and glucose decrease SHBG by 80, 50 and 40% respectively, see here. So free testosterone rises. Avoid all phytoestrogens too, these increase oestrogen levels, and counter the good progesterone does. The following paper lists in descending order the phytoestrogen content of foods, with nuts and oilseeds having the highest content, see here. I somehow feel you need more progesterone, for one thing it raises the basal metabolic rate, which helps weight loss. Plus of course it's an excellent diuretic. I feel your weight loss problem could be due to Insulin Resistance. This is caused in part by oestrogen, and a lack of vitamin D, see here, here, here, here, here, here and here. Plus a lack of vitamin D impacts on the thyroid, see here, here and here. Continued below.

Mar 21, 2012
Hi Wray.... Part 2
by: Wray

Hi Jules Do you have enough iodine? And are you eating enough protein? The amino acid tyrosine combined with iodine make up the two thyroid hormones, T3 and T4. The conversion needs selenium, do you have enough of that? And bone loss, it needs more than oestrogen to prevent that! Vitamin D is vital, followed by magnesium it's most important co-factor. With enough vitamin D, more than enough calcium is drawn from the gut into the blood. Osteoclasts cells are responsible for bone resorption, or removing old bone to make place for new. Oestrogen slows down the action of osteoclasts. The last thing we need is for this process to slow down, as it prevents new bone being made. This leaves us with old bones, so I don't believe in the hype about oestrogen and bone loss. Osteoblasts are immature bone cells found on the surface of bones. They make a protein which is mainly Type 1 collagen, this forms the matrix into which minerals are deposited. Progesterone and testosterone stimulate osteoblast activity. 60pg/ml is fine for oestrogen, we do have a page now on Hormone Testing which gives you all the ranges. I don't have any info on evening primrose oil, mainly taken for it's GLA content. If you eat nuts and seeds you'll get enough. These papers on vitex might help you, see here, here, here, here, here and here. Maca apparently has no affect on oestrogen or testosterone levels according to this one paper, see here. And yet this paper said it increased oestradiol levels, see here. If this is so it could cause Oestrogen Dominance symptoms. It does appear to increase diastolic blood pressure slightly too, see here. One woman made a comment on this site saying that hers increased. It does nothing for progesterone, neither does the vitex. Take care Wray

Mar 22, 2012
Hey Wray...
by: Anonymous

Thanks SO MUCH for all that info. I love that sheet on the Hormone Testing ranges..I'm marking that one in my Favorites to refer to!!! As far as diet, I am eating very "clean"...low sugar/nothing processed/etc. Higher protein, low carb. Lots of water and no soda/alcohol/coffee. I take digestive enzymes/probiotics/l-glutamine for gut health. I do take an amino acid powder supplement because I do some hardcore workouts. I take a selenium supplement of 200mcg daily to help with thyroid. Iodine level is good...I did a 24 hour urine iodine test and had an 86% excretion rate, so no need for me to supplement. I take 5,000iu of D3 daily (I was at 50 the last time I tested - - probably higher now). I just got some results back from the lab as I recently saw a dermatologist about the acne issue. She tested my DHEA-S, which was 150 (range of 18-245). She suspected I might have high testosterone levels/PCOS and that would be contributing to the breakouts...however, the results show a Total Testosterone of 32 (range 8-60ng/dL) and a Free Testosterone of .4 (range of .3-1.9 ng/dL)...so my free T is actually low normal...I haven't had a chance to discuss the results yet with her....but should I be getting acne breakouts with testosterone levels like these??? My SHBG level was taken a few months ago...it was 91 (range of 18-145 nmol/L). The only meds I take are the oral micronized progesterone and the Armour Thyroid. I also supplement with DIM for breast health, GTF chromium polynicotinate, R-alpha lipoic acid, milk thistle, calcium-magnesium, b-vits and fish oil. I know I read on here about zinc possibly helping as far as the acne goes - - maybe I should supplement that and see what happens??? You mentioned using more progesterone....so even though I am in a good place currently with the 583:1 ratio, how much would you suggest increasing? I apologize if I ramble...but you are a wealth of knowledge and I truly appreciate your response!

Mar 24, 2012
Hey Wray...
by: Wray

Hi Jules Glad you like the hormone testing page, I did it out of desperation! So many ask me, and of course need to know what their results mean. Rarely are they told. Well you are on so many good supplements, plus know what you should and should not be eating, I can't add more! The only thing left is the zinc, please try it. I suggest 100mg/day, high but I've found this helps if it is the reason. Once it has, you can reduce back to the normal 15mg/day. Rather try this before changing the amount of progesterone you use. Do let me know, and thanks for the kind words! Take care Wray

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