HRT mess!
Posted: Thu Nov 02, 2017 7:33 am
I could post the following in any number of current threads but decided to create a separate post so as not to muddy the others. (BTW, hi and hugs to all my old friends and amazing new members. Our site is like no other and far superior IMO .)
The back story: I started the .1mg estradiol patch and 100 mg of progesterone Feb. 2016. I pulled my own labs every 3- 4 months as my gynecologist doesn't believe serum or ANY hormones labs are meaningful. She just treats by symptoms. My labs the day I started the patch were: estradiol undetectable and progesterone 1.9 ng/ml. Since then, I've watched my estradiol steadily climb and my progesterone diminish. I was also supplementing with 10mg micronized dhea as my levels have always been 50's which is very low end. I quit the 10 mg dhea February 2017 because my hair started thinning significantly, now I'm not convinced that was the problem.
Current situation: I visited both my gynecologist and dermatologist for annual exams this month. I've previously expressed my concern over the estradiol increase to my gyno, but she dismissed them immediately. At my visit two weeks ago, I mentioned my sister is on 200 mg progesterone continually (no cycling) and the gyno said, "you can go on that too, no cycling is needed". So, she wrote me a script for the increased dosage of progesterone. She also ordered ultrasound to monitor endometrium and a very large and growing fibroid. Meanwhile, at dermatologist, he suggested labs for the hair loss. So, I got the pelvic ultrasound, paid for my own hormone labs and also submitted for the dermatologist labs. Here are the results: Estradiol 150 pg/ml, Progesterone .4 ng/ml, dhea-s 33.3 ug/dl (below range), testosterone and free testosterone undetectable, Ferritin 10 ng/ml (below range), RBC just under range. The ultrasound revealed a ridiculous and concerning increase in endometrial lining from 3mm a year ago to 11mm now. My gynecologist has not contacted me regarding the ultrasound, I picked up the report myself from radiology.
Obviously I have extreme estrogen dominance and mildish iron deficiency anemia. I probably need to call my gynecologist re: the thickened lining situation. Since I just had a normal pap smear and pelvic ultrasound, I'm assuming she's not concerned about cancer and that's why I've not heard from them? She might be thinking the increased progesterone will shrink the lining?
My plan: I change my estradiol patch twice a week. So starting this week, I'm taking the patch off twelve hours before each change so I'm completely estrogen free for 24 hours a week in the hopes this will knock back on the estradiol. I'm taking the doubled progesterone every night. I'm focusing HARD on iron rich foods intake with vit c for absorption. (being a vegetarian makes increasing iron more difficult for sure). I'm also taking one ferrous fumarate pill a day. I'm a heterozygous carrier for hemochromatosis, but don't think that's an issue to be concerned about now. I believe the hair loss is a combo of low iron, low progesterone. I plan to retest my labs in one month. I'm hoping to see an increase in progesterone, decrease in estrogen, increase in testosterone and dhea-s (I read progesterone can affect all of these). I will consider supplementing with ashwagandha or possibly dhea if I don't see improvement in say 2 months? I guess I'll request a repeat ultrasound in three months? I am definitely experiencing a very low mood which I attribute to all of the above. I'm doing fairly well with disciplining myself with my normal regular exercise and giving myself breaks from social obligations when I'm feeling especially down. I do practice mindfulness and self talk . Hoping this all turns around soon.
Any advice on my plan is welcome. Thanks! Silver (I'm 53, apoe 4/4)
The back story: I started the .1mg estradiol patch and 100 mg of progesterone Feb. 2016. I pulled my own labs every 3- 4 months as my gynecologist doesn't believe serum or ANY hormones labs are meaningful. She just treats by symptoms. My labs the day I started the patch were: estradiol undetectable and progesterone 1.9 ng/ml. Since then, I've watched my estradiol steadily climb and my progesterone diminish. I was also supplementing with 10mg micronized dhea as my levels have always been 50's which is very low end. I quit the 10 mg dhea February 2017 because my hair started thinning significantly, now I'm not convinced that was the problem.
Current situation: I visited both my gynecologist and dermatologist for annual exams this month. I've previously expressed my concern over the estradiol increase to my gyno, but she dismissed them immediately. At my visit two weeks ago, I mentioned my sister is on 200 mg progesterone continually (no cycling) and the gyno said, "you can go on that too, no cycling is needed". So, she wrote me a script for the increased dosage of progesterone. She also ordered ultrasound to monitor endometrium and a very large and growing fibroid. Meanwhile, at dermatologist, he suggested labs for the hair loss. So, I got the pelvic ultrasound, paid for my own hormone labs and also submitted for the dermatologist labs. Here are the results: Estradiol 150 pg/ml, Progesterone .4 ng/ml, dhea-s 33.3 ug/dl (below range), testosterone and free testosterone undetectable, Ferritin 10 ng/ml (below range), RBC just under range. The ultrasound revealed a ridiculous and concerning increase in endometrial lining from 3mm a year ago to 11mm now. My gynecologist has not contacted me regarding the ultrasound, I picked up the report myself from radiology.
Obviously I have extreme estrogen dominance and mildish iron deficiency anemia. I probably need to call my gynecologist re: the thickened lining situation. Since I just had a normal pap smear and pelvic ultrasound, I'm assuming she's not concerned about cancer and that's why I've not heard from them? She might be thinking the increased progesterone will shrink the lining?
My plan: I change my estradiol patch twice a week. So starting this week, I'm taking the patch off twelve hours before each change so I'm completely estrogen free for 24 hours a week in the hopes this will knock back on the estradiol. I'm taking the doubled progesterone every night. I'm focusing HARD on iron rich foods intake with vit c for absorption. (being a vegetarian makes increasing iron more difficult for sure). I'm also taking one ferrous fumarate pill a day. I'm a heterozygous carrier for hemochromatosis, but don't think that's an issue to be concerned about now. I believe the hair loss is a combo of low iron, low progesterone. I plan to retest my labs in one month. I'm hoping to see an increase in progesterone, decrease in estrogen, increase in testosterone and dhea-s (I read progesterone can affect all of these). I will consider supplementing with ashwagandha or possibly dhea if I don't see improvement in say 2 months? I guess I'll request a repeat ultrasound in three months? I am definitely experiencing a very low mood which I attribute to all of the above. I'm doing fairly well with disciplining myself with my normal regular exercise and giving myself breaks from social obligations when I'm feeling especially down. I do practice mindfulness and self talk . Hoping this all turns around soon.
Any advice on my plan is welcome. Thanks! Silver (I'm 53, apoe 4/4)