Dr. Lam's advice seems to complete disagree with Dr. Lee's and this website's advice

by Sarah
(Cleveland, TN, USA )

If anyone running this website has time, I'd love for you to address what Dr. Lam says in this article:

I've read enough at this website and also read Dr. Lee's stuff many years ago -- the doctor who wrote "What Your Doctor May Not Tell You About Menopause".

I am educated enough that I'm not really "buying" Dr. Lam's article, but I admit what he had to say concerned me a little.

Thanks in advance if you can have a look and comment.

Comments for Dr. Lam's advice seems to complete disagree with Dr. Lee's and this website's advice

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Sep 03, 2022
Dr. Lam's advice seems to complete disagree with Dr. Lee's and this website's advice
by: Joy

Hi Sarah

Thanks for your question. Where to begin.

The endocrine system works synergistically and stress is one of the main disruptors to this synergistic balance. The underlying key point here is alleviating stress! A tough one these days! Proper diet and the correct use of supplementation according to what your body needs. As Dr Lam says, the ‘inappropriate use’ of any supplement could be counter productive. So the key really is the appropriate use of progesterone if one is suffering from adrenal fatigue and feels that using progesterone would be of benefit.

In the words of Wray, the author of this site:
"Dr Lam has an excellent overview of adrenal fatigue and hormone replacement. Although I don't agree with some things, it does explain clearly how the hormones interact. The 'pregnenolone steal', is actually the stressed adrenals using up most of the pregnenolone to make cortisol. This is self evident, as the stress response overrides everything else, which is why stress is so damaging. I would prefer to call it a 'progesterone steal', as the adrenal glands have to convert the pregnenolone into progesterone, which is then converted into cortisol. As he also points out, women with adrenal fatigue tend to have oestrogen dominance, simply because the progesterone is begin shunted to make cortisol.

"Stress causes progesterone levels to drops., Plus it causes a host of adverse symptoms to occur, from oxidative stress, which leads to a cascade of inflammatory cytokines, a drop in neurotransmitter levels, hypothyroidism, and not least stressed adrenals. The adrenals are the most overworked and overlooked glands in the body. They make many hormones, 10 highly active including the three stress hormones adrenaline, noradrenaline and cortisol. But before making cortisol they secrete progesterone, which is then converted in the adrenals to cortisol. But if stressed they tend to rob other sources of progesterone, notably the ovaries, which upsets the reproductive system. In fact stress can stop ovulation, which of course means no progesterone is made."

You may also be interested in this forum thread: see here

continued below...

Sep 03, 2022
Dr. Lam's advice seems to complete disagree with Dr. Lee's and this website's advice
by: Joy

When he states: "Although a natural compound, inappropriate use of natural progesterone can worsen sub-clinical liver congestion", we have not found any research that supports this and he does not provide the research papers, but find one that negates it, see here. Liver metabolism during treatment with estradiol and natural progesterone
"It is concluded that micronized natural progesterone is an attractive means of progesterone supplementation in postmenopausal hormone replacement therapy without any liver-related side-effects." - in this study they used up to 200mg dosage, admittedly this was orally administered but it was micronized so it is more effective, but not as effective as transdermal application due to having to pass through the gut and liver first, so it is doubtful that a full 200mg dose was received because of this.

With regards to "Abrupt withdrawals can also result in adrenal crashes and potentially cause irreparable damage". One should never abruptly withdraw from progesterone, this would be a case of improper use.

With regards to: "At this point, patients are told they have a hormonal imbalance and will need natural hormone replacement that can include estrogen, progesterone, and sometimes also testosterone. Typically, patients are also given thyroid support, vitamin C, vitamin B, glandulars, herbs, DHEA and pregnenolone at the same time. Such a multi-hormone approach is designed to replace diminishing hormones the body may be experiencing. The key to success or failure of such an approach lies largely in the dosage and delivery system of the hormone replacement. Some doctors tend to be quite aggressive, while others are more conservative.
This symptom patching "shotgun" approach…"
"While some people continue to do well on such a program, many report this multiple hormone replacement approach gradually loses effectiveness over time. Those who are already in advanced stages of adrenal fatigue prior to beginning such program are particularly vulnerable."
The author of this site does not advocate the need for estrogen and testosterone, but rather the precursor to these hormones, progesterone, she would agree that this cocktail of hormones would negate the positive effects of progesterone and lead to imbalances.

With regards to progesterone being stored in fat, we have not found any research to substantiate this but there is one paper which says it's not. The paper states " Despite the low serum progesterone levels achieved with the creams, salivary progesterone levels are very high, indicating that progesterone levels in serum do not necessarily reflect those in tissues." If the fatty tissues were indeed saturated, and little progesterone was entering the circulation, the study would have found the reverse, i.e. low saliva levels. Link to the paper, see here.

Using higher than 20 - 40 mg is advocated by Wray to overcome the estrogen dominance symptoms, If not enough progesterone is used and excess oestrogen is in the body, this will just aggravate oestrogen dominance symptoms as Dr. Lam states: "Because estrogen and progesterone receptor sites are very similar at the cellular level, estrogen receptor sites can ‘wake up’ when occupied by progesterone molecules, enhancing the action of estrogen for a short period of time. It is easy to draw the conclusion that this is a sign the body is responding well to the progesterone, and sufferers are encouraged to "brave through" this estrogenic effect, as it is supposed to eventually go away. However, ignoring the underlying dysfunction when alerted by the body is a recipe for disaster." - hence why Wray advocates using anything from 100 - 200mg instead, from her studies and experience she has found using higher doses allows the body to bypass these oestrogen dominance symptoms altogether in most cases.

continued below...

Sep 03, 2022
Dr. Lam's advice seems to complete disagree with Dr. Lee's and this website's advice
by: Joy

When he states:
High dose progesterone is often prescribed to control or offset estrogen overload and excessive bleeding. This can trigger a host of side effects and toxicity issues. - we have not found this to be the case.

Again here:
"While a one-time overdose of natural progesterone cream is rare (except in people who are very weak or sensitive), the body’s ability to handle excessive progesterone can be overwhelmed over a long period of time. Progesterone side effects and toxicity are eventually triggered due to a cumulative saturation effect of progesterone in the cells. The common belief that natural progesterone is "harmless", even in high doses, is quite naïve." We have not found this to be the case either, we have many people using a dose their body responds well to in order to feel themselves again, anywhere from 100 - 400mg a day (usually reduced over time once balance has been obtained) and they have got their lives back, Wray included, who herself suffered with extreme stress, PND, and Severe Adrenal Fatigue.

Other Studies in support of high dose progesterone see here and here.

Please also see these pages and the associated research papers linked to each page, see here, here, here, here, here and here.

"Progesterone and it's metabolites are potent anxiolytics. By reducing the response to stress, the already overworked adrenals can relax. The progesterone metabolite allopregnanolone increases dopamine release. Dopamine is the neurotransmitter responsible for good mood, motivation, reward, and a normal sexual response. Libido drops when stressed due to dropping dopamine levels. Dopamine drops because much of it is being converted to adrenaline and noradrenaline. The third stress hormone cortisol is also made in the adrenals. These first produce progesterone before converting it to cortisol. Progesterone has antioxidant and anti-inflammatory properties. It also counters the action of aldosterone, preventing retention of water and a subsequent rise in blood pressure. It increases SHBG, substantially lowering free testosterone.
Supplementing supplies much needed progesterone to help calm, thereby decreasing adrenaline and noradrenaline, to increase dopamine, for it's conversion to cortisol, to combat the inflammatory process that occurs with stress and to prevent water retention and a rise in blood pressure."

See here, here, here, here and here.

I have found no evidence (research papers) about progesterone toxicity or the use of it contributing to brittle adrenals except for what Dr Lam has written on his page. It is a pity he does not give the research / reference papers as this would be good to read and further help our research.

There are many more points in this paper I could go into but the information I have provided via the extra links, contains all the answers you could be looking for and I think there is enough reading here to keep one busy for a while!

Sep 04, 2022
by: Anonymous


I CANNOT THANK YOU ENOUGH for all of your exhaustive research in response to my inquiry. I am often frustrated at how much conflicting health information (and advice) abounds. I have been studying for 30+ years, to help myself and others, and regularly empathize with why people "give up" and do whatever their doctor happens to tell them to do (if anything).

I have been using NatPro for adrenal fatigue, chronic stress and "early" (not technically but it seemed early to me) menopause. I have varied from using 2 pumps a day (100mg) to only 1 pump a day (50mg, which is still more than most "natural health experts" advocate), and find consistently that my mental health and anxiety is much better when I stick with 2 pumps a day.

Thank you for confirming what I thought I knew and also for giving me much more to read to further my understanding.


Sep 05, 2022
Thank you for your help Joy
by: Joy

Hi Sarah

Glad we could help. It's been proven that anything less than 100mg is not effective and merely aggravates estrogen receptors and that would defeat the purpose of progesterone therapy. It really is rather simple, the medical professional only have to take the time to read the research papers!

If you are still battling with 100mg per day, increase it to 200mg and see how you go. Experiment, see what works for you best.

Have you tried the adrenal fatigue cocktail? I take it everyday and found it most beneficial.

* 125ml Orange Juice or *Grapefruit Juice, you are looking for vitamin C
* 1/4 teaspoon Celtic Sea Salt or pink Himalayan
* 1/4 teaspoon Cream of Tartar

Mix the above at the start of the day with enough liquid for two (2) applications i.e. 8oz/125ml of orange juice. Drink it mid-morning, as well as mid-afternoon. In addition, any time that you are feeling particularly anxious it would be advisable to prepare another mixture and take it.

PLEASE NOTE: * Grapefruit/juice can affect some people in that it can cause interactions with many medications. Before drinking grapefruit juice one should consult a doctor. Essentially, grapefruit juice can block the action of intestinal CYP3A4, so instead of being metabolised, more of the drug enters the blood and stays in the body longer; this can be dangerous. Please always read inserts of your medication. For those who have blood sugar problems, use lemon juice mixed with a little water, you are looking for vitamin C.

The original source of this recipe was Susan Blackard, NP, ND, PhD at the Rejuvenation Health Centre in Springfield, MO.

Sep 06, 2022
Worsening estrogenic symptoms on higher dose
by: Natalie

Hi joy

I just posted my own query, but after reading this lengthy and well researched thread, I'm further confused.

You say that Wray suggested 100 to 200mg cream to try and override the stimulation of the estrogen receptors that happens at lower doses.

Every time I increase - I'm now, at 250mg, I seem to get horrific estrogenic symptoms. I never get out if them, they just get worse. Any thoughts?

Sep 07, 2022
Worsening estrogenic symptoms on higher dose
by: Joy

Hi Natalie

I answered your question on your other post. Apologies, I think I called you Natalia.

Take care.

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