Saliva test shows excessive high levels after using bioidenticals

by Marla
(Florida, US)

I went to the functional doctor because I was getting hot flashes and gained 20 lbs while taking the bioidenticals for the past 2 years. I was taking biest 50:50 2mg every night and nightly 150mg oral progesterone, both from the compounding pharmacy. The results of my saliva test showed excessively high levels of estradiol, progesterone and estrone. My estradiol was 20.4, progesterone 421 and the Pg/E2 ration only 21. Vitamin D was 40.

With 2 small fibroids found from the vaginal ultrasound, I stopped taking everything thinking my estradiol and progesterone levels were too high and didn't want to grow the fibroids with hormones. After 5 weeks, no weight loss and pretty moderate hot flashes and sweating in the day and my sleep. I kick off the covers at least 3 times and am sweating on my face, neck and chest. At least the bed is staying dry, so it's not drastic.

The doctor prescribed biest 50:50 .8mg and 185mg oral progesterone. I haven't taken it and after reading the studies and blogs from this site, not sure what to do about this estrogen dominance, with saliva test results as they are.

I'm feeling like I could open the 185mg progesterone and mix it with cream and apply topically, but I do not want to exacerbate the ED since that level is pretty low, compared to the 400mg recommended. Also, I am concerned that the saliva test showed progesterone at 421 while taking the oral 150mg dose.

Needless to say, I am confused and if anyone has any advice, I would appreciate it!

Comments for Saliva test shows excessive high levels after using bioidenticals

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Jun 05, 2015
Bioidentical hormones
by: Diane

Hi there~
Okay, first thing I think you need to do is educate yourself on Bioidentical hormones. Firstly, please order on Amazon the E book or the hard copy of a book written by Dr Michael Platt called The Miracle of Bioidentical Hormones. It will explain all you need to know. He is very accessible. His email address is in the book and I believe also on his website. I asked him why are progesterone creams bioidenitcal superior to orals (which is what your on) and he responded with the following:

"Oral progesterone goes into the tract and goes to the liver directly and is transformed into a different hormone called allopregnaneolone. This hormone will not block estrogen and will not prevent breast cancer.

The reason these doctors might think oral is superior to creams is because oral progesterone (allopregnanelone) is misinterpreted on lab tests as progesterone. Since it is not able to attach to progesterone receptor sites, the level in the blood stream is higher than with creams. Progesterone given through the skin very readily and quickly attaches to progesterone receptor sites. Once progesterone is attached, it cannot be measured. This gives the false impression that oral progesterone provides more progesterone."

I switched to bioidentical progesterone cream and never looked back. I apply 3 times daily btwn 250-300mg total. My symptoms are 90% plus resolved which is a Godsend considering how symptomatic I was. I am perimenopausal.
You also definitely need to be on Vit D3 10,000iu daily. Your level of 40 is far too low. Ideally closer to 100. Mine used to be 22 and now 88 and climbing. Vit D is critical for progesterone absorption.
Have you had your thyroid checked? TSH, Free T3, T4?
I take 12.5mg iodine brand called ithroid which helps boost our aging thyroid gland. My energy is greatly improved since. There is so much more, but do not want to overwhelm you.
Please read the book by Dr. Platt title above, read all pages on this website in the left margin. Click on Progesterone Therapy, menopause, What is Progesterone, Progesteone and Vit D, etc.. It can be overwhelming, but knowledge is power.
You will get to the otherside of this, but it will takie a lot of reading, learning and patience. Don't hesitate to ask questions.
Good luck.

Jun 05, 2015
High Progesterone
by: jo

Hi Marla,
I, too am taking Bio Identical Hormones. My dosage is 225mg of Progesterone, however I have half a troche at night before bed from Day 12 and I also take 150mg of DIMS in the morning also from Day 12 which is increased to morning and night at Day 20 for both Progesterone and DIM and then stopping at Day 28. I have noticed that symptoms have greatly decreased. However, I still occasionally get a little nausea, for which I take 2 nausetil tablets, this helps a lot. I still get shocking bloating, but have found that drinking fluids till the cows come home greatly improves this. I haven't had a saliva test and I am not sure if they do this in Australia. I am under the supervision of a gyn at the Australian Menopause Centre.

Jun 06, 2015
Thank you both
by: Anonymous

Thank you both for your recommendations. Yes, I have spent hours reading as much as I could on this site and will continue. I will order the book ASAP! I am currently on 5000 Vit D and will increase to 10,000 to get my levels up. I didn't mention I am post menopause, no period for 2 years. Thinking of adding DIM and Calcium D Glucarate to reduce the estrogen. Also, had thyroid work up and it is normal. I am most bothered by this awful weight gain and I hate that I am bigger than I've ever been in my life! I would deal with the hot flashes if I had to choose one or the other. If I eat any sugars or starches by stomach becomes so distended that I look pregnant. Luckily no GI discomfort but I hate that I work out 5 days and watch my diet and have no clothes that fit anymore. This is the most knowledgeable site I've found; there are so many conflicting theories out there so it's hard to know what is truly accurate. One thing I know for sure-I am done with the estrogen and oral progesterone! I would readily start the P cream, but I can't risk gaining weight if it at first stimulates the estrogen at the dose of 200mg, which is about what I could afford. The 400mg would be a crunch on the budget, but would supposedly not have the weight gain effect.

Jun 06, 2015
One question for Diane
by: Marla


Forgot to ask one question, which I will probably understand after reading the book, but, the oral progesterone showed up on the saliva test as 421. I didn't have a blood test for the hormones, so was the progesterone actually working?

I definitely felt the calmness and better mood with it but I started to get the hot flashes again and went to the doctor. That's when he did the whole work up with the saliva hormone panel and entire blood work for everything else. Regardless, my ratio is really bad at 21 and I realize I have to get the estrogen lowered and add the p cream.

Jun 06, 2015
Sublingual/oral/cream progesterone
by: Diane

Jo~ did you get a chance to read my comment above? Orals are the least effective way to take/use progesterone. Sublinguals although bettter, are still greatly swallowed. I highlighted Dr. Platt's explanation about orals/sublinguals. He also explains the differences in his book. It just may help with bloat to use the same dose as the sublingual but in cream form. You will absorb much better.
Cannot hurt to ask your gyno.
Good luck.

Jun 08, 2015
Have read so much...
by: Marla

Hi Diane,

I just finished Dr. Michael Platt's book and am convinced after reading it that using p-cream is the best route. I've read so much on this site and know that I have to start at a higher dose to avoid stimulating estrogen. I did not realize how long I have been off the bioidenticals-since 3/6/15.

I actually have been having fewer and less intense hot flashes probably due to not adding estrogen and stimulating it with the oral progesterone. My mood is stable and I'm not as impatient as I was before. Also, after reading this site, I've correlated that the hot flashes are associated with carbs and now that I'm eating cleaner, they are reduced. I still have a few night sweats and kick off the covers.

I hope the weight reduces as well and that is my main worry starting the p-cream. Can anyone tell me how much weight gain to expect if I don't get the right dose or enough p-cream right away? I am planning on starting with 200mg and adjusting according to symptoms.

Oh and did you get the keto strips to measure your urine for ketones? I really need to be burning fat and not carbs.

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