T Nation

Female Hormone Issues


#1

KSman: I was wondering if I could get your time to help my wife out with some thoughts and advice.

I have been on HRT SINCE about 2008 and am blessed with a good doc and the knowledge both he and I have gained from you over the years. I recently began reading more of your posts about the lack of help available to women in this field, and I believe my wife is a case in point.


KSman is Here
#2

can you finish the story?

She is?
painful breasts for ?part? of cycle
painful breasts - yes
PMS or mood problems
breakthrough bleeding
labs to post
TSH, T3, T4, fT3, Ft4 data
has been using iodized salt for years
has low body temperatures when she wakes up or can’t make 98.6 in afternoon? - thyroid basics sticky
hair thinning, gets cold easily, outer eyebrows sparse
dry skin - in summer

Suggest KAL brand * progesterone cream [amazon has it]. Apply to inner arms, under breasts or inner thighs starting at ovulation and stop when her period starts. The next period will probably be unaffected, but next cycle after that will show progress. Amount is up to her judgment and feelings about what is going on with her body.

  • Have seen KAL work well. But one gal I worked with tried another brand when a local shop stopped carrying KAL and her progress was reversed. KAL had restored her cycles, cycles stopped with other brand and came back with KAL. [So she was able to avoid a few years of menopause.]

She can apply in the morning or at bed time. Some women seem to freely convert progesterone to cortisol in their adrenals and that can interfere with sleep, otherwise progesterone seems to improve sleep. She will have to experiment.

Consider vitamins and fish oil. She can use iron in her vitamins and men should avoid supplemental iron.


#3

[quote]KSman wrote:
can you finish the story?

KSman; 45 years old, always been 110LB 5’4" until about 18 months ago. In a years period about that time began hot flashes, never cold, dry skin, crappy all over feelings and; gained 45 lbs. PCP continued to say it was all very normal, but under constant prodding, eventually got her to see an Endo. Prior to Endo visit, we did a full blood testing to have with her on her first visit. Apparently they did not pay much attention to that. They did a number of tests (of which we know nothing) and eventually diagnosed insulin resistance and metabolic syndrome with the only cure being to diet and exercise. BTW, she did have uterus removed about 6 years ago, kept ovaries. This was doctors recommendation as a result of constant bleeding and terrible cramping during cycle. That seemed to be a great cure for about 4 years.

Current condition, about the same. Weight up, no energy, dry skin, hot flashes, yes painful breasts (no cycles anymore) just most of the time. Mood is good, just tired of always feeling crappy and no amount of dieting and exercise seems to help the weight issue. Hair if fine, no eye brow issues. I have ready sticky(s) on thyroid and most all I can find on these issues on your posts. I am attaching blood tests.

She is?
painful breasts for ?part? of cycle
painful breasts - yes
PMS or mood problems
breakthrough bleeding
labs to post
TSH, T3, T4, fT3, Ft4 data
has been using iodized salt for years
has low body temperatures when she wakes up or can’t make 98.6 in afternoon? - thyroid basics sticky
hair thinning, gets cold easily, outer eyebrows sparse
dry skin - in summer

Suggest KAL brand * progesterone cream [amazon has it]. Apply to inner arms, under breasts or inner thighs starting at ovulation and stop when her period starts. The next period will probably be unaffected, but next cycle after that will show progress. Amount is up to her judgment and feelings about what is going on with her body.

  • Have seen KAL work well. But one gal I worked with tried another brand when a local shop stopped carrying KAL and her progress was reversed. KAL had restored her cycles, cycles stopped with other brand and came back with KAL. [So she was able to avoid a few years of menopause.]

She can apply in the morning or at bed time. Some women seem to freely convert progesterone to cortisol in their adrenals and that can interfere with sleep, otherwise progesterone seems to improve sleep. She will have to experiment.

Consider vitamins and fish oil. She can use iron in her vitamins and men should avoid supplemental iron.[/quote]


#4

Blood Test Page 2


#5

Blood Test Page 3


#6

Blood Test Page 4


#7

Blood Test Page 5; FINAL


#8

TSH is high and fT3 is below mid range. Need to know body temperatures and other things, see my fist post.

“This was doctors recommendation as a result of constant bleeding and terrible cramping during cycle. That seemed to be a great cure for about 4 years.”

  • might have been managed with progesterone cream.

LH/FSH are elevated and all ovarian hormones are low. Ovaries can’t play the game any more.

There is nothing to do now except HRT. You can ask LEF if they can make referrals for your location. LEF can also supply compounded creams if you can get a script.

If thyroid function is low with low body temperatures, the mitochondria in her cells are working slow and not burning fats and sugars. That can lead to insulin resistance and increased cholesterol levels.

With her hormone levels, she is probably also loosing muscle and that is less calories burned and she gains weight.

rT3 is not a problem

IGF-1 indicates that GH levels are getting lower. That contributes to low energy and muscle loss, again contributing to fat gain. Increase fat insulates the body and calorie burn to maintain body temperature again reduces calorie gain.

She needs HRT and thyroid function in good order to gain energy/vitality, loose fat and gain muscle. She can then expect some progress with exercise. Weight/resistance training needs to be part of that as muscle burns calories 24x7.

She should seek out an age management doc. That doc might get her onto GH at some point. She may do well if the other things are fixed.

Get and read this book: Natural Hormone Balance for Women, Uzzi Reiss
He has a book after that which I heard is good but I have not read it.

With HRT, she can get back to a good spot. Mood and libido will be good. Breast pain will resolve when she gets E2 and progesterone right. Vaginal moisture will be restored.

DHEA is a little low. 25mg would be to much and might increase unwanted hair. She would try 12.6mg OED.

5,000iu vit-D3 per day, take 25,000 for first week.

Consider vitamins and fish oil. She can use iron in her vitamins and men should avoid supplemental iron.

Need to know body temperatures and other things, see my fist post.


#9

We had followed her temperatures for several weeks per your original sticky on that issue. Her mornings were above 97 always and she was reaching the higher temperatures by mid day. I remember they were right in line with your sticky. She does have hot flashes on a regular basis.


#10

Blood Test Page 1.


#11

Hot flashes are skin flushes, vascular and are driven by peaks of LH. The HPOA has these blasts of activity. Progesterone cream may provide some relief now until she can get full HRT care. Get KAL brand progesterone cream. Amazon has good prices. Have seen problems when women switch to other brands, so all are not created equal.

Some current body temps would be useful. We do not have enough thyroid lab data, body temperatures are the bottom line.

Tell me about history of her iodized salt intake.


#12

Have ordered the KAL from Amazon:

We eat normal salt in our food and With her temperatures looking good we never really thought about IR.

Is there some more thyroid tests we should run?

Btw, am reading the book now. Downloaded off e-books


#13

She needs fT3 mid range or a bit higher.
fT4 is low relative to mid range
TSH is high

Iodine deficiency can explain the above.

IR is an attractive option, cheap and can avoid a life time if Rx thyroid meds.
You can also test for thyroid antibodies, doc might think that there is no reason.

Normal salt is non-iodized?

What about your body temperatures?

She does need HRT, progesterone cream is one step in right direction. Most doctors will be of the mind that what she is going thru a normal process.