Ratio?

by Kim
(NE)

Hi Wray,
Hoping you can help with the results I just got back. Some history, have been using Natpro for around a year (give or take)at about 100-150 mgs (this dose daily for the last 6 mos). Still have cycle, am 45 yrs old. Here are the labs, done about day 23 (cycle started the next day).
Progesterone 1.9 ng/ml
Estradiol 139 pg/ml
Vit D 44.
Had been off Vit D for a while. Now began again at 10,000 IU for a while to get it back up.

Any advice is much appreciated!! Thank-you for what you do, I have referred many people to your site and Natpro....

Kim

Comments for Ratio?

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Feb 13, 2012
Ratio?
by: Wray

Hi Kim I'm puzzled why your progesterone is so low, but then it was a blood test. Your ratio works out at 13.7:1, but how are you feeling? That's more to the point! If well then evidently the serum tests are not showing your true level. I'm very interested you're still using it daily, with no break. I did this while in P-M, I just couldn't bear the symptoms when taking the 'necessary' break! Please come back to me if you have symptoms you don't like, or don't understand why you still have them. You vitamin D is low to my mind, but the I'd rather err on the side of high than low! You've probably read on the site that the specialists are recommending a minimum of 50ng/ml, up to 80-100ng/ml, whereas the less conservative say 70-100ng/ml. Mine is now 91.9ng/ml, having been 34ng/ml three years ago…..too many hours sitting in front of this computer! Bless you for the kind words and the referrals! Take care Wray

Feb 13, 2012
Ratio question continued
by: Kim

Hi Wray,
Thanks for the help on my progesterone level. 13 is the ratio I was getting as well. I do not understand it whatsoever. I take hydrocortisone for adrenal fatigue as well as thyroid. I do have endometriosis adenomyosis. I take Metagenics estrofactors to try to block the estrogen as well as using all the progesterone. What do you think I should do? I am very symptomatic, extreme fatigue in the afternoons, low body temps, weight gain, water retention. I have done 5 rounds of HCG to lose the SAME 18 lbs that always come back on. I eat low carb, no sugar, or very little. When I do the HCG, I feel great. Have considered doing the HCG injections every other day just to promote hormone balance. I did have luck recently with high doses of Evening Primrose Oil, for one week I had temp averages (taken 3X a day) of 98.6. First time this has ever happened. Any advice you have for me is VERY much appreciated.

Kim

Feb 14, 2012
Ratio question continued
by: Wray

Hi Kim I didn't realise you had Endometriosis, in which case you need far more progesterone. Depending on the severity of the pain, which you don't actually mention, I recommend 500mg/day or more. Progesterone is also very helpful for adrenal fatigue. The adrenals first secrete progesterone, which they then convert into cortisol. If stressed the adrenals tend to rob other sources, notably the ovaries, this then upsets the reproductive system. In fact stress can stop ovarian function, and cause miscarriages too, as progesterone levels plummet. You already have high oestrogen with the endo, so you simply haven't enough progesterone to 'go around' so to speak. Oestrogen causes temps to drop, progesterone is thermogenic so raises them. During the follicular phase, which lasts from the first day of bleeding to ovulation, temperatures range from 36.45 to 36.7 °C (97.6 to 98.1 °F). Once ovulation occurs and progesterone is being secreted from the corpus luteum, temperatures rise by 0.15 - 0.45 °C (0.2 - 0.9 °F). Giving a temperature range of 36.7 - 37.3°C (98.1 - 99.2°F) during the luteal phase. This lasts from ovulation to bleeding, and in all women the luteal phase is always 12-14 days long. With dropping levels of progesterone the few days before bleeding, the temperature also drops. The rise in temperature is caused by the increased metabolic rate. The weight gain and water retention are all related to oestrogen. It's an excitatory, inflammatory hormone, besides being a mitogen encouraging the endo cells to proliferate. Progesterone inhibits mitosis, causing cells to differentiate. It's a potent anti-inflammatory too. It's also the best diuretic there is, over 1200mg/day is now given via IV transfusion to Traumatic Brain Injury victims. It's been found to reduce the oedema and inflammation that occurs due to the injury. I'm not sure how the estrofactors work, as it seems to comprise vitamins and herbs, one of which, the red clover, has oestrogenic properties. Far better to take Calcium D-glucarate. Oestrogen is metabolised in the liver by glucuronic acid, the process is known as glucuronidation. Glucuronidation is one of the major detoxification pathways of the liver. It removes carcinogens, toxins, tumour promoters, the sex hormones ie, the androgens and oestrogens, mineralocorticoids and glucocorticoids, aromatic and heterocyclic amines, polycyclic aromatic hydrocarbons, various nitrosamines, drugs, fungi etc. It's then excreted in the bile, but an enzyme in the intestine called beta-glucuronidase reverses the glucuronidation process. It breaks the glucoronide bond between a toxin and glucuronic acid, and releases carcinogens, toxins and excess steroid hormones back into circulation. Continued below.

Feb 14, 2012
Ratio question continued Part 2
by: Wray

Hi Kim There's evidence beta-glucuronidase activity is increased in breast and prostate cancer. Calcium D-glucarate inhibits beta-glucuronidase, see here, here, here and here. Incidentally this enzyme is produced by undesirable gut bacteria, supplementing with probiotics suppresses the bacteria, and subsequently the beta-glucuronidase. hCG can cause ovarian hyperstimulation, see here. It also increases oestrogen and testosterone, as it stimulates egg production. But unless there's an active corpus luteum present, I don't see what benefit it would give. hCG stimulates progesterone production only if there is a corpus luteum, and only if the woman is pregnant. A meta analysis has found no benefit either, see here, and this paper here If as I've read, you have to eat only 500 calories, this in itself would cause weight loss, without the need for hCG. But the weight would come back again once calories are increased, which it appears to have done with you. You might benefit from the Paleo Diet, see our page on Nutrition for more info. I'm not sure why you are taking temps? Do you want to fall pregnant, or are you doing it to see if your progesterone has increased them? A lack of vitamin D affects the thyroid, see here, here and here. A lack of the amino acid tyrosine also affects it, and causes feelings of cold. Tyrosine is the precursor to T3 and T4. A lack of iodine and selenium adversely affect the thyroid too. It strikes me you have far too much oestrogen circulating, and need to reduce it. I said oestrogen is a mitogen, well it stimulates fat cells to proliferate too. But fat cells are a source of oestrogen, so a vicious cycle starts. You also appear to have Insulin Resistance, this is caused in part by excess oestrogen, testosterone too, and a lack of vitamin D. So we come full circle! Continued below.

Feb 14, 2012
Ratio question continued Part 3
by: Wray

Hi Kim Please increase your progesterone, not necessarily to the 500mg/day, that's only if pain is severe. Please increase your vitamin D, endo is caused by oxidative stress, so you need high vitamin D levels to combat it, plus other antioxidants. Consider taking the Ca D-glucarate, and possibly tyrosine. The IR page gives a list of nutrients to help the fatigue. If you do increase the progesterone please see our page on Oestrogen Dominance first, as this can occur when increasing it. Take care Wray

Feb 14, 2012
Ratio
by: Kim

Hi Wray,
I cannot thank-you enough for all the explanation and time you have given me :). In response to you, I am taking temps as I am trying to titrate my thyroid/hydrocortisone dosing, I am 45 years old and have two raised children. I have no pain whatsoever from the endo, before pregnancies, I would have cramps so bad they put me on the floor in pain. I couldn't find any help from Doctors. If I only knew then what i know now..... I continued to have awful heavy periods throughout my 25 years, leading to anemia. I did have a tubil ligation about 15 yrs ago, hoping that would end the heavy periods, NOPE!!! I blame this for leading to all of this hormone imbalance I deal with now. The Dr never told me what it could lead to of course. I have never heard of calcium d glucarate, but I will get some tomorrow. I was glad to read your advice about increasing the progesterone, I was hoping you would say that, it is what I was thinking. My thoughts behind the HCG was to help increase the progesterone levels. While doing the diet, my energy is good and periods were not bad at all. I did want to ask you one thing, I was at the Las Vegas A4M conference last year, one of the speakers made comment that if a woman uses to much progesterone it will become estrogen giving the woman the opposite effect. Have you heard or encountered this? It had me a little worried.

Thank-you for ALL your time....

Kim

Feb 15, 2012
Ratio
by: Wray

Hi Kim Glad it was of help! Ah I see now why you're doing the temps, have a vitamin D test done instead and see if that has a bearing on the thyroid! How sad you went through all that agony needlessly, if only they knew more about progesterone. And heavy bleeding….oh dear that too is helped by progesterone. I don't know if you still have it, but the explanation is quite simple. MMP's are enzymes that break down protein. They play a role in the breakdown of endometrial tissues at the end of the menstrual cycle, see here. Progesterone suppresses MMP's, see here. So it's only when the corpus luteum stops making progesterone at the end of the cycle, that levels plummet and the MMP's can begin breaking down the lining. In some instances they can cause a pathological reaction if excess oestrogen is present, as oestrogen stimulates their production. This can lead to inflammation, spotting and/or excessive bleeding in the uterus. If a low level of progesterone is present, and a high level of oestrogen, the lining will continue to grow. With a high level of MMP's the lining will also continue to break down. This of course leads to heavy continual bleeding. Using high amounts of progesterone, ie about 400mg/day or more, reverses this, and the bleeding stops. See this comment here. Pity about the Tubal ligation, it can cause adverse symptoms, and women are not warned! I have just done a web page on all the myths, urban legends and other extraordinary stories about progesterone. Not up yet, but soon I hope! If a woman uses too little progesterone it will stimulate oestrogen, testosterone too. But if a high enough amount is used it will suppress both these hormones, as evidenced by the heavy bleeding info I've given above. Each month women make more testosterone than oestrogen. Continued below.

Feb 15, 2012
Ratio Part 2
by: Wray

Hi Kim Below is a copy/paste from our Contraceptives page which explains what occurs…

Progesterone is the hormone from which first testosterone and then oestrogen are converted. But LH is needed to stimulate this conversion, causing proliferation, differentiation, and secretion of androgens by the theca cells which surround the ovum, hence the rise in androgen levels.

With excess androgens, oestrogen also increases. The androgens, notably androstendione, migrate from the theca cells to the granulosa cells where they are converted by the enzyme aromatase into oestrogen, particularly oestradiol. The theca cells also produce oestradiol without the need for conversion.

Exactly the same process occurs in men, but they don't make as much aromatase as we do, so convert far less androstendione into oestrogen. Except when they get older, so their oestrogen levels rise. Many women with breast Cancer are given aromatase inhibitors, to prevent the conversion. Far better to use progesterone! It inhibits aromatase induction, see here. Take care Wray

Feb 15, 2012
Ratio
by: Kim

Wray,
Thank-you sooooo much for all your help. I will raise my Natpro to 500 and keep you posted. You are the BEST!!!!

Kim

Feb 16, 2012
Ratio
by: Wray

Hi Kim Bless you! I don't know if you have to go as high as 500mg/day, very costly! But it should turn you around quickly. Then you can begin reducing, but please remember to do this slowly! do let me know how you get on. Take care Wray

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