Still struggling to find the right dose to stop fluid and weight gain

by Julie
(Oregon, USA)

Hi Wray, I recently started using NatPro after using Emerita for months and I must say that I absolutely LOVE your formulation. I wanted to thank you first and foremost for creating such a wonderful product and I also wanted to thank you for helping guide us through this frustrating hormone maze. I've read through many of these pages and have learned a lot.

I am 42 and have probably been suffering from estrogen dominance since my 20's but didn't realize it until three years ago. I have two children and though both of my pregnancies were "normal", it was during my pregnancies that I developed allergies, thyroid problems, and adrenal problems. I had regular but heavy periods until age 39 when I developed dizziness and fairly extreme edema. My vitamin D was low (19) and my food allergies were off the charts. I changed my diet drastically though I was already eating well and at a healthy weight. Shortly thereafter my periods stopped completely and I gained over 20 lbs of fluid in my legs. I've been working with an amazing naturopath to regulate my thyroid and we hoped that once that happened, it would have regulated my female hormones and my estrogen dominance, too, but no such luck. Now we understand that in my case, estrogen is the root of my problems.

My estrogen level isn't that high (46 last time we checked) but my progesterone is way too low (.5). For months I was using too little progesterone cream (20-40 mg) and gaining fluid like crazy (over 30 lbs) and it wasn't until I went up to 200 mg that I finally got my period again. I'm currently using 240 mg of NatPro per day (120 twice a day) and though I am no longer experiencing allergies, breast tenderness, or hair loss, I'm still gaining. I researched some of the other herbs and supplements I was taking to see if they could be causing the weight gain and learned that both DIM and vitamin D can unfortunately cause estrogenic effects in some people. Weird, I know. I stopped taking 5,000 vitamin D (my level is up to 50 now--still low but for me, pretty good) and my DIM plus and started to lose fluid immediately for the first five days. I kept my progesterone dose the same, too, but as of today, I'm gaining again. So very frustrating.

My questions are these: Can fluid still be caused by too much estrogen when all of my other estrogenic symptoms are gone? Also, how long to do you stay at the dose that finally makes your estrogen symptoms go away? Are you supposed to decrease the dose once you feel stable? How do you know when you are stable and how do you know the difference between estrogen symptoms returning and the need to decrease?

Thank you so very much for your time and patience :)
Julie

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Apr 30, 2015
Still struggling to find the right dose to stop fluid and weight gain
by: Wray

Hi Julie Thanks for the kind words, so pleased you like the Natpro. Judging by your age and your symptoms you are definitely in Peri-menopause. Oedema is a problem with so many of us, and although oestrogen is a major culprit in women, there are so many other things which can cause it. For instant a sluggish thyroid can be behind it, so in your case it's probably a bit of both. And there are cases where there's no known cause. These are some causes……….
pregnancy
kidney disease
heart failure
chronic lung disease
thyroid disease
liver disease
malnutrition
medication, such as corticosteroids or medicine for high blood pressure (hypertension)
the contraceptive pill
See here.

Your P:E2 ratio is 108:1, which is too low to my mind. Have a look at our Saliva Tests, you'll note the ratios are 600:1 and over. Although some women do well on less, I'm delighted it's so high as it means the progesterone is being absorbed well. You say "vitamin D can unfortunately cause estrogenic effects in some people". Although this appears to be the case I've found that it's not true. In fact a lack of Vitamin D reduces the benefits of progesterone. What it does do, much like progesterone does, is cause Oestrogen Dominance to raise it's ugly head. But once levels have risen, this effect goes, much as it does with progesterone. There are many women on this site who've written in saying they found this the case. So please don't stop it, it's the most important nutrient there is. But make sure you are taking enough magnesium, it's the main co-factor for vitamin D. And how long do you stay on the amount that makes symptoms go away, forever! Joking apart, our symptoms will fluctuate. So the amount of progesterone needed will fluctuate too. These are a few things which cause progesterone levels to drop, or to be less effective……
lack of or drop in Vitamin D
dark days, especially winter, probably because vitamin D drops in winter due to lack of sun
high oestrogen
high testosterone
low SHBG (sex hormone binding globulin), this binds testosterone and oestrogen making them inactive. SHBG drops due to consuming sugars, and all foods which convert to glucose, i.e. grains, legumes, sweet starchy fruits and veggies.
high LH
high FSH
high stress
high adrenaline (comes from Stress or excitement, and a drop in blood glucose), this stops progesterone entering the cells
sugars of any kind
large meals, because of the increased metabolic clearance of progesterone
alcohol, this reduces progesterone levels and increases the androgens, ie testosterone
high insulin
high level of phytoestrogens in the diet
oestrogenic herbs
oestrogen mimics or endocrine disrupting chemicals (EDCs)
contraceptives
HRT
Insulin Resistance
a defective luteal phase
high copper/low zinc
high prolactin

Take care Wray

Apr 30, 2015
Magnesium supplements
by: Julie

Thank you, Wray! You bring up some very good points. I had assumed that the fluid was solely because of estrogen/low progesterone but you're right, there could be many factors. And, you've convinced me to stick with the vitamin D. It's funny that you mention magnesium because I recently stopped taking magnesium supplements because of the estrogen effects! I would get low back pain and muscle weakness similar to PMS after taking 200 mg magnesium citrate. I've read magnesium glyconate is better so maybe I'll try that instead. I'm also intrigued by the possibility of low SHBG so I'll look into that as well.

Thank you again!!

May 02, 2015
Magnesium supplements
by: Wray

Hi Julie It's very interesting you get the same 'oestrogen' effect after taking magnesium, I've not heard that before. But it does stand to reason as it's the main cofactor for vitamin D. Often people complain of getting pain when taking either vitamin D or magnesium. A lack of magnesium causes substance P to rise, see here and here. Substance P is a nociceptive, neuropeptide involved in causing pain and nausea. Substance P inhibits progesterone, see here, but if enough is used, progesterone suppresses substance P, see here. "Accumulating evidence indicates that the neuropeptide substance P is predominantly involved in neurogenic inflammation and pain perception...... Intriguingly, decreased pain sensitivity is found to be associated with high plasma progesterone levels. We hypothesize that progesterone may attenuate nociception and associated inflammatory response." Oestrogen stimulates substance P, see here. So it's essential to use enough progesterone to inhibit oestrogen. And enough magnesium and vitamin D too. Mg citrate is one of the best, it's the one I take. But you might do better on the glyconate. Take care Wray

May 04, 2015
What about other hormones?
by: Julie

Hi Wray, thank you for including those links. It's good to see that it's not all in my head. I'm going to increase my vitamin D intake to 10,000 since it is not something I've tried before and as you said, taking too little can create e-Dom symptoms. I'll keep going with the magnesium as well.

Also, I read some of your advice to another commenter where you recommended not increasing NatPro if she is already taking an adequate amount (I'm currently up to 320 mg) but not getting an improvement in symptoms. Am I correct in that interpretation? I'm wondering because it feels like I still need to increase my dose to relieve symptoms but I'm not sure I should do that if other things could be interfering.

Lastly, can taking a lot of progesterone upset the balance of other hormones? I'm not referring to estrogen in this case but what about cortisol, testosterone, and DHEA? Just wondering
how those things might be affected.

Thanks again for your help :)

May 05, 2015
What about other hormones?
by: Wray

Hi Julie The problem I find is people thinking progesterone is going to cure all their symptoms. So they keep increasing the amount and then complain it's not working. There are so many things which can cause it not to work, some I give you. But I've found vitamin D an essential nutrient, most people's levels are too low. I would encourage people to get it up high, before wasting money on high amounts of progesterone. Yes some do need high amounts, but rather get vitamin D sorted first. I've found diet plays a huge role too, many thinking they eat a good diet with low carbs/high fat when in actual fact they are not. Just because something is labeled as 'good' or 'healthy' it isn't necessarily either! So by all means increase the amount you are using and see how you feel, it won't harm you. Cortisol is made from progesterone in the adrenals. So if it's too high due to Stress, progesterone will help to suppress it. If too low I've found progesterone relieves the adrenals of having to make it. See our page on Anxiety. A woman makes more testosterone each month than oestrogen, but most of it is converted into oestrogen by the enzyme aromatase. So yes progesterone does suppress testosterone, but so too does aromatase. Excess testosterone is not a good thing. The weight gain over the stomach is related to hormones, particularly testosterone. In fact the menopausal ovary is an androgen producing organ, see here and here. It also causes an increase in visceral fat, see here and here. As one paper puts it "As testosterone progressively dominates the hormonal milieu during the menopausal transition, the prevalence of MetS increases, independent of aging and other important covariates. This may be a pathway by which cardiovascular disease increases during menopause." The 'menopausal transition' can take years. I've no evidence that progesterone lowers DHEA levels. Take care wray

May 08, 2015
Makes sense
by: Julie

Thank you, Wray. I will take your suggestions and see how things go. I feel like I'm getting closer so I'm keeping my fingers crossed!

Cheers!

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