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Post by Karen on Apr 28, 2012 17:02:45 GMT -5
I meant to reply sooner but forgot about this one. Taking ANY kind of hormone treatment can mess with your hormones. Any time you take a hormone treatment, your body recognizes it and tells itself, "Hey, we have enough, slow down production!" Essentially, hormone treatment suppresses your own production to an extent. That's why docs won't test hormone levels while on birth control. Yes, it is possible to test while on bio-identical progesterone treatment, but just keep in mind it's a test of your overall progesterone levels, not just what your body is making. And, keep in mind that your levels could drop while on supplementation because your body is making less in response to the external supplementation. That's often why, when supplementing, we have to adjust doses a bit to find the sweet spot. If you want a good baseline on what your body is doing on its own, it could take a few months after going off hormonal treatment before really getting a good idea. I know I saw somewhere in here a discussion about too much progesterone converting into estrogen. It is, indeed, possible, but it's not something that automatically happens. If you take a look at the steroid hormone cascade, there are a few conversions necessary to get from progesterone to estrogen, and as you can see, progesterone can convert into several other steroid hormones. The important thing to note is that the conditions must be right in order for that to happen. Just because it can turn into estrogen doesn't mean it's going to. Based on what your body needs and the resources it has available to convert into another hormone could mean it turns into something all together. As long as your doctor is testing your progesterone AND keeping an eye on estrogen levels on a regular basis, you should have a good idea of what the progesterone is doing to you. I haven't ready any good books out there regarding BI progesterone and endo. For a while, I was convinced that Dr. John Lee had it all figured out, but after reading more about how the body actually functions and why, a lot of what he claims with progesterone treatment just doesn't make sense. If you're working with a doctor that is trained in BI progesterone, tests you at the same time during your cycle, and understands it's about balancing your hormones rather than overwhelming them, the results can be pretty amazing!
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Post by DeAnna on Apr 29, 2012 5:56:07 GMT -5
@ Karen, I think that you are my twin. We have a lot of the same issues in common.... thyroid, adrenals and the lovely endo. Ive read the John Lee Book. I thought that he had it figured out too. What about progesterone treatment doesnt make sense to you? Just wondering cause I have been treating his book like its the Living Bible. Anyway, I had surgery about a year ago and 2 days ago, my pain reappeared. So bummed. Im going to be posting some stuff on here in the appropriate threads but just wanted to say that I am glad you are here. You are such an awesome resource
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Post by Karen on Apr 29, 2012 8:03:29 GMT -5
I have to admit, it's a bit comforting knowing I'm not the only one trudging through all that, but on the other hand, I wouldn't wish it on anyone! In general, I agree with Dr. Lee that you should always get hormone levels tested, that you should only be on just as much replacement as YOU need (if any) and not a bit more, and that you should start low and increase slowly. All that makes complete sense to me. However, he's big on saliva testing but I've heard a lot of conflicting info on that. He's also big on creams, but I've heard some pretty strong opinions to the contrary. It's been a while since I read the book, but from what I recall, he had some pretty hefty claims about progesterone supplementation - weight loss, less bloating, energy etc. He covers them in his 'side effects' of too much progesterone, but in reality, it's just the nature of the hormone. Here's what I mean: In our bodies, progesterone is dominant between ovulation and our period. During that time, your body is assuming it might be pregnant so it starts to prepare the body for a baby. Progesterone slows down your metabolism so your body can absorb more nutrients for the baby it hopes to be carrying, it will retain more water so you're hydrated, it'll make you more sleepy so you'll conserve energy for the baby, etc. This happens every single month. Obviously, if you're not pregnant, you'll have your period. Supplementing with progesterone can actually increase the effect of these things. Dr. Lee made it sound like progesterone would do the opposite. Do I think he's off on everything? No. Do I think progesterone supplementation is the wrong thing to do if tests reveal it's necessary? Absolutely not! However, I think he can be a bit misleading in the benefits of it. For me, the benefit of progesterone supplementation is to keep the pain at bay, try to regulate my cycles, and try to balance my hormones. But, I don't have any misconceptions any more about what progesterone will really make me feel like. Does that make sense?
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Post by DeAnna on Apr 29, 2012 21:28:31 GMT -5
Then above makes sense, but Ive been so involved in thyroid stuff lately that I cant speak to the bio identicals cause Im just not knowledgable enough. I am at a cross road and need to make a change so maybe you can tell me what you think, My ND had suggested a hormone panel while I was on BCP's (b/c I take them non stop for endo). She said it would be fine if she used a particular test. She Didnt go into detail about the test she was suggesting, but it makes no sense to me. I just dont feel you could accurately check levels if you are on BCP's. I think I read a post where you agreed. ALso, I was having constant breakthrough bleeding on my current BCP so I stopped it, had a full-on period and then the bleeding stopped. That was 2 weeks ago. Now, wondering of I should restart BCP's or is it safe to stay off of them for 2 months, get the hormone panel and then start natural progesterone. It is super tough to find an endo specialist that agrees w bio identicals and also tough to find a bio identical doc (like an ND) that knows about endo. On that note, I wish we could add a section on the "recommended specialists" homepage that included ND's/integrative docs that were endo knowledgable. My surgeon was Nezhat and he wont even discuss bio iodenticals. My other option is to start a different BCP. I was given a free pack of Natazia by my OBGYN. Ive asked my pharmacist to do some research for me on this drug cause its relatively new. I did my own google search on it and its sounds promising. The estrogen in it is different than other BCP estrogens in that this type is supposed to inhibit endometriosis. But of course, there are risks. And the biggest one is an increased risk of blood clots. In the meantime, Im having pain again. Not sure if its endo or adhesion pain but its weird that the pain started to flair back up while Ive been off the BCp's. Thoughts? Anyone use Natazia yet?
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Post by Karen on Apr 30, 2012 18:28:02 GMT -5
I have no idea why someone would test your hormones while on BCP as BCP will suppress the hormones that your body is making. No matter what test she uses, your own hormone production will be lower than normal, and it won't pick up the synthetic hormones from your BCP. You may want to question her more on that one. If it were me, and particularly if I were paying out of pocket for it, I'd pass. She may have a valid reason, but I haven't come across one yet.
As for going off BCP for a few months to get tested, I'd have to defer to you and your doc if that's 'safe'. You can do it, of course, but just be aware that any protection from the BCP in terms of symptoms management may go away. If you're ok with that, then go for it. However, if you're shopping for a new doc to do testing and prescribe progesterone, it may be more wise to wait until you have a doc lined up that is willing to go down that route before you make any drastic changes. The doc may have you transition right from one to the other as someone suggested in this thread previously.
Regarding a thread for specialists for integrative practitioners, good idea! I'll start it!
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Post by DeAnna on May 1, 2012 5:44:58 GMT -5
Good thoughts Karen. Found an OBGYN specializing in endo on another endo blog. Thanks for all the good advice
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Post by DeAnna on May 1, 2012 5:59:51 GMT -5
One more thing Karen, how did you find the doc you mention at the start of this thread? Did you contact your local compounding pharmacy? And was this person an ND or OBGYN or ? Unfortunately, I have found the ND I sought may have been knowledgable on thyroid stuff but not so much on the bio identicals hormones (for the reasons we discussed above). I have gone to an OBGYN, recommended for her knowledge in bio identicals, but when I mentioned that I had endo... she told me that she would not suggest bio identical hormones, that I should stay on synthetic. Ive had 2 other docs say the same. (My surgeon, Nezhat and dr Andrew Cooks NP also said same.)
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Post by Karen on May 1, 2012 6:52:33 GMT -5
I was referred to my doctor by my therapist. She had seen her and thought I might like her. She's a MD and did a fellowship in OH/GYN, but to be honest, I don't know her specialty. She has a private practice and is the only doc there.
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Post by redwood on May 1, 2012 10:36:10 GMT -5
DeAnna - did they explain why they didn't recommend bio-identicals? I'm very curious.
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Post by latika on May 11, 2012 10:06:51 GMT -5
I got my blood tested today and next week I will know more about my hormones which I am eager about, but I am afraid that they won't know the right values because I'm taking Visanne. We'll see. I'm looking forward to starting with the bioidenticals, but this gyn who I am about to see for the first time is really careful about prescribing bioidenticals, because they can also harm you if they are not taken the right way. I'm just interested ... how much do you pay for your hormones per month?
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Post by redwood on May 11, 2012 10:16:39 GMT -5
I usually paid about $40-$50/month for troches. It depended on where I was getting them. Different pharmacies had different prices. The cream seemed a little less than that. Karen could tell you how much she pays for the oral capsules. I heard they were less than the troches also.
As for the Visanne, now I pay $65/month if I buy 3 months at a time ($75 if only one month at a time). Usually it's cheaper if you get more of them at the same time (same with the troches and cream).
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Post by Karen on May 11, 2012 15:39:27 GMT -5
I agree that different pharmacies likely have different prices. My doctor told me that progesterone was typically around $1/pill, depending on the dose. This is for a compounding pharmacy. If you were to get prometrium (name-brand BI) from a pharmacy, you'd likely pay your name-brand copay. However, prometrium only comes in 2 doses so it doesn't allow for the minor adjustments in doses that compounded formulas offer.
I'm not sure that your hormone labs will be valuable since you're on hormonal treatment, so keep that in mind as you review them with your doc, but I hope your doc will at least consider bio-identicals! I'll admit - they can take some tweaking to get just right, but when you find the sweet spot, it can be worth it! Let us know how your appointment goes!
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Post by latika on May 16, 2012 11:48:19 GMT -5
My update: I gave blood last week and today I had my appointment at a new gyn. She was amazing, I can't believe that somebody tries to understand you and listens to you and I didn't feel like a number this time. She said I have low estrogen and okay progesterone (due to Visanne). She said this was strange, because in endometriosis you should have high estrogen. She also said I don't look (physical appearance) like I am high in estrogen. There can be many reasons for this, she said it could be Visanne or some other thing. I talked to her about stopping the Visanne pills and trying to get pregnant in the near future, so I guess I took my last Visanne pill yesterday . After two weeks I have an ultrasound check-up and then she will put me on bioidentical progesterone. I just hope endo won't come back soon this time (like it did the last time).
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Post by Karen on May 16, 2012 12:14:28 GMT -5
The visanne shouldn't affect your progesterone levels as it is a synthetic protestin. However, it could be suppressing your estrogen levels a bit. Since you're on hormones, it's hard to tell what is really going on, so take it with a grain of salt. I have low estrogen, too, but we found my thyroid was way off, which can affect hormone levels.
If you're trying to get preggers, are you knowledgeable about temping and fertility indicators? If not, check out the book in my signature. It'll give you the tools you need to figure out how it all works and what you can look for.
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Post by latika on May 19, 2012 13:11:41 GMT -5
Thanks, Karen. I have a check-up 10 days from now and my gyn will advise me on what to do next. I just hope this endo beast doesn't appear again!
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