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Discussion in 'Optimal Labs' started by motivatedhealthseeker, Jul 11, 2013.

  1. Hello
    My Progesterone to estrogen ratio is 22 to 1. Estrogen is ok but Progesterone is very low. Estrogen was 179.6 (lab value at 33-200) and Progesterone was 4.7 (lab value 1-22) The test was done on day 21. I am a 39 yo female. I am using 20 mg of progesterall by Dr Lee transdermally on day 12-26. Is this enough to bring up my levels into the upper 1/3 of the range as Dr Kruse recommends? Anyone else have similar issues? I also struggled with adrenal fatigue as well.
    Thank you!
  2. MsYo

    MsYo Silver

    It would depend on your absorption rate using Progesterall or any other BHRT cream. I am working through similar issues with initially low progesterone (10) I started almost a year ago and my most recent labs the value was (19). I use 25mg of biodentical hormones (from yams) on day 12-26. I also suffer from adrenal issues as well as thyroid issues. You should also review other lab details to guage your individual treatment plans. Also, be patient and persistant. I started with BHRT to help with reoccurring fibroids. Read the hormone 101/102 blogs for good reference info. I recently (this week) increased my Pregnenolone dose and I am noticing an improvement already.
  3. JanSz

    JanSz Gold

    fibroids------------> iodine

  4. JanSz

    JanSz Gold

    I am not a doctor.

    Check this post and couple posts below, may interest you.

    I look three ways (and more) when evaluating progesterone/estrogen.

    1. I am talking about blood levels of this hormones, preferably tested at LabCorp

    2. I would like levels to be as close as possible to dark blue line representing population average levels of progesterone and estradiol at given day in menstrual cycle.
    For estradiol this are good levels.
    For progesterone they are the minimum desirable.

    3. I would like to get P/E ratio about 200 as recommended by dr Lam (requires higher progesterone level than minimum)

    4. I would like to get P/E ratio about 500 as recommended by dr Kruse (requires higher progesterone than dr Lam's), those levels of progesterone are above top range (ie. much higher than the upper 1/3 that you have mentioned). They are rather comparable with levels of pregnant women in last trimester.


    This table at post above gives P/E2 ratios calculated as molar ratio using indicated calculator.

    Assume that it was a blood test, so we have

    E2=179.6pg/mL blue line on chart is at 130pg/mL E2 is little high
    progesterone=4.7ng/mL blue line is at 13 ng/mL, you are low comparing to minimum standard

    To get P/E2~500
    when E2=179.6
    To get P/E2~500
    when E2=130
    So far it was about P/E2 ratio
    But usually dr Lam and dr Kruse are describing P/E, where E would stand for Total Estrogens, where estradiol is only part of the Total.
    So, above requirements for progesterone may only go higher.

    You have two jobs and not one.

    You need to lower your Estradiol and check other estrogens.
    Eating cruciferous vegetables may help.
    High estrogens tend to raise SHBG and that will ruin your testosterone.

    The other job is to raise progesterone.
    When all works well,
    we produce a lots of pregnenolone from LDL cholesterol, facilitated by
    good levels of vit A (retinol from meat) not Beta-carotene (from vegetables)
    good vit D (100 loks good)
    good FreeT3 (and low RT3)---->>iodine & selenium & natural thyroid hormone & about 40 micronutrients as indicated by Spectracell test results

    get above into good shape

    That likely may not be enough. If we stop making enough pregnenolone it is hard to re-start production.

    I do not like creams. Not only they stain clothes and restrain access to water.
    Assuming that they work, they do not show on the blood tests. It is hard to work without benefit of testing.

    For my self I have found
    pregnenolone Micronized Lipid Matrix 150mg tabs from Nutricology
    I am a man 73yo.
    This pegnenolone saves my quality of life.
    It ends up raising my progesterone to almost 5ng/mL (respectable levels even for women),
    higher than what you have now.
    It ends up raising my morning cortisol to about 20, which is rather ideal top range number.
    I suggest that you give it a try.

    If you would like to try this, it would be a good idea to optimize Steroid Hormone Panel in more complete way rather than just P & E2.
    Lets cover at least your fatigue.

    Look at that post (link above) for tests at LabCorp that are useful.

    Last edited: Jul 11, 2013
  5. Jack Kruse

    Jack Kruse Administrator

    Jansz.........none of us are doctors.........we just have one speaking to us in our head.........do we listen to them? That is where the issue lies.
  6. Shijin13

    Shijin13 Guest

    Great break down Jan...
  7. WOW! Thank you soooo much for such a detailed answer! I have a ton more questions so please bear with me. I can not find a doctor to address these things to save my life in these last 3 years.. literally! Yes these were blood tests but not sure of which lab my doctor uses.I was trying to be brief with my question but I think having the whole panel results might be more beneficial:

    Estradiol E2 is 179.6 pg/ML (33-200)
    testosterone total 22 ng/dL (9-55)
    testosterone bioavailable 7.0 ng/dL (4.1-25.5)
    progesterone 4.7 ng/mL (1-22)
    free testosterone 2.7 pg?mL (1.3-9.2)
    sex hormone binding globulin 55 nmol/L (30-135) What are optimal levels for SHBG please?
    DHEA done on another lab 6 months ago 204 (31-701)

    The above tests are form Jan 2013 and I had another hormone test done from labcorp in June of 2012 and in that every hormone seemed to be low. Could it be the difference between 2 different labs or can results be that different in just 6 months. It was suppose to be done on day 21 but I ended up having cycle on day 18 so in reality it was day 3 of follicular cycle

    Estradiol 22.3 pg/ML (12.5-166)
    progesterone 0.3 ng/ mL (1.7-27)
    free testosterone pg/mL < 0.2 pg/mL (0-2.2)
    total testosterone 10 ng/mL (8-48)

    prolactin 23.8 ng/mL (3-20) My prolactin has always been midly raised and I read that gluten sensitive people can have mildly raised prolactin levels but Ive been gluten free for 3+ years and its still mildy raised?!

    I had to push to get these tests done as I was having cycles every 18 days or so twice a month..so one cycle normal and one with 18 days. It had started out with that happening twice a year about 3 yrs ago. So I knew I had to be low in progesterone for this to be happening. Anovulation I guess with pregenelone steal happening with adrenal fatigue etc.
    I was thinking of taking DIM plus for decreasing estrogen. I do eat broccoli or cauliflower as rice with lunch and dinner almost every day but its obviously not enough. I have read though that with adrenal fatigue one cant take precursor hormones as they will not be converted properly and that only end hormones should be supplemented. Any thoughts on that? Its hard to find enough thin skin to put 75 mg of progesterone cream on. I am also on 75 mcg of t3 for a reverse t3 issue I had last year..I stay on this for not even though reverse t3 issue is resolved but the reason for developing rt3 is still being addressed which is the low cortisol. I know t3 only is hard on your sex hormones so will try adding in NDT along with t3 in a while.
    What is the test I need to request to test all the estrogens? Estrogen fraction test? YOu mentioned transdermal progesterone creams do not show up on blood tests? So how does one see where they stand on a hormonal panel? Will I have to do a salivary test to see where my estrogen and progesterone stand? How long after supplementation should one test?
    Again thank you greatly for your time and patience..its very much appreciated!
  8. Thank you Msyo. Are you doing the progesterone cream transdermally and what have you increased your dose to currently if you dont mind me asking?
  9. THank you sooo much for such a detailed and thorough answer!! I wrote an huge long reply back but it didnt post?! So hopefully I can recover it and if not I will rewrite the long email.
  10. Hi Jansz
    I replied in detail to your post but the system kicked it back for some reason and my reply just posted recently from 2 wks ago..can you please glance at that when you can as I would love some advice on the situation.
    Thank you so much!
  11. JanSz

    JanSz Gold

    I will do my best, but that does not include being clairvoyant.
    Next time you write post, save it on a side.

    One thing I noted,
    after signing in and pressing Enter
    I am getting new page.
    If I start writing on that page, all is in vain, it disappeares, just the way you are describing.

    Do not open another page with dr Kruse forum, that will further mess up computer
    work only on that page,
    reload it
    reload it as many times as need
    in my case I see
    Welcome, JanSz
    do not see being asked to log in again
  12. JanSz

    JanSz Gold

    It happened unintentionally, but day #3 of cycle is the best information at this time,
    it should be easy for you to figure out beginning of menstrual cycle,
    so you should have no problem getting again tested at day 2-4.

    Estradiol should be slightly higher, but lets be happy with what it is.

    progesterone is definitely low.
    Please do not use any creams.

    Last edited: Jul 29, 2013
  13. Thank you so much for the posting tips..these will definitely come in handy! :)
  14. Thank you so much again for the detailed answer. I am still trying to wrap my head around it. :)
    I have read that DHEA or oral Progesterone is not good to take since its metabolized by the liver and is not as effective as transdermal creams? I see a lot of conflicting info on the net and not sure what is appropriate or not. I did see an article today by Dr Merocola where Dr wright talked about how men should be applying DHEA transmucusouly instead of orally as DHEA can turn into estrogen for the men. Can you please share any articles or any info about the oral progesterone?
    I have recently started using vitex or chasteberry and that seems to be helping with breast tenderness etc. I am still using the transdermal creams but using more vaginally than on skin. I am already on metformin so feeling a bit squeemish about starting cycloset even though it appears that this medication would cure a lot of my problems..resetting sleep wake cycles, controlling blood sugar issues, decreasing prolactin and increasing dopamine. I have read other peoples stories with it and I;m afraid to add another "medication" on the list. I never even took an aspirin and all of a sudden I am on all kinds of stuff within last year so its been overwhelming. I dont want to be stupid and not do what I need to do either. Chaste berry is natural plus atleast it will help with decreasing prolactin levels and increasing dopamine and increasing Progestesterone levels. What are your thoughts?
    Thank you ever so graciously again!
  15. JanSz

    JanSz Gold

    Search dr Kruses website for discussion on tender breasts and solution that works. (iodine)

    Progesterone, I would use it only in a second pass, if still not up to good levels. First I would prefer to get most out of pregnenolone-MLM.


    When reading stuff posted on internet, the biggest job is in figuring who to trust.

    Watch for proposed solutions.
    Some of them may be good, but other are better.

    Last edited: Aug 6, 2013
  16. MsYo

    MsYo Silver

    I paint my breasts with Iodine and I have painted my Vulva. Almost immediate relief. Great suggestions JanZ. I am using pregnenolone and iodine with much improvement.

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