Progesterone: A Side Effect

As long as I’ve been reading and listening to the work of Ray Peat I’ve been hearing that progesterone has no side effects.  Progesterone is “safe in large amounts (except…can be anesthetic if hundreds of milligrams are taken at once),” Peat himself said to me in an email.

I beg to differ.

The hot flashes that I’ve been experiencing for the last 2 months became troublesome for me.  They were long, intense, and were paired with rage at times.  I couldn’t understand why I was having them – doesn’t progesterone supplementation fool your body into thinking you’re not experiencing perimenopause (or real menopause, for that matter)?  Things had been going well, and I was confused, so I asked Dr. Peat about it.  His response:

Some things that reduce hot flashes for some people are supplementing pregnenolone, interrupting the progesterone each cycle, using cynoplus only in the evenings, increased salt, and coffee. The natural ovarian cycle gives the liver time to adjust its enzymes, and with continuous progesterone supplements, the liver enzymes excrete progesterone more quickly, and weaken its effects.

I thought that was interesting about liver enzymes….maybe I was having hot flashes because I’d been dosing every day instead of just the last 2 weeks of my cycle.  I did this knowingly, attempting to reverse the hyper-estrogenation I’d inflicted on my body with the stupid and dangerous Wiley Protocol.  Of course, taking hormones in a non-physiological way is likely to cause problems at some point, so perhaps that’s what was going on.

I stopped taking the progesterone for a few days.  The hot flashes got worse.  This led me to believe it WAS perimenopause I was dealing with.  When the estrogen/progesterone ratio is too heavy in favor of estrogen, symptoms of menopause (or PMS, or other unpleasant things) occur.  So I reversed course.  I figured I’d take a LOT of progesterone, to get the hot flashes to stop.  Then I’d taper down and find my new “normal” dose, after determining the threshold below which they broke through.

So a few days ago I decided to dose 3 drops every 1-2 hours, aiming for about 30 drops across the day.  This would be 100mg of progesterone, about 5 times my normal dose, but according to Peat, still safe.  By 5:00PM I didn’t feel very good – kind of tired and tense.  I was in the habit of taking my blood pressure and pulse because I’d recently started taking beta blockers for my hypertension, which usually runs around 150/95. So I took my blood pressure and it was 165/105 – about 10 points higher than even my normally high BP, with heart rate around 105 (usually around 85).  I checked periodically throughout the evening and it remained high, but the next morning was a bit lower again. 

That next day I did the same thing – 3 drops of Progest E every 1-2 hours.  My hot flashes seemed to be getting less intense, so it seemed like the right thing to do.  Again, around 5PM I started noticing tachycardia.  I took my blood pressure and it was 164/107.  That’s when I started suspecting the progesterone had something to do with this, as I’d changed nothing else in the previous 2 days.

I hit Google and found this article about hypertension that occurs during pregnancy, which states the following:

In an article published in the July 7, 2000, issue of the journal Science, HHMI investigators Richard P. Lifton and Paul B. Sigler and colleagues at Yale University and Albert Einstein College of Medicine report that a mutation renders the mineralocorticoid receptor more sensitive to progesterone, a hormone that is produced in abundance during pregnancy. (…)

When the mineralocorticoid receptor is triggered by aldosterone, its normal binding partner, it switches on the cellular machinery that causes kidney cells to reabsorb more salt, ultimately raising blood pressure. Lifton’s group found that when women who have the faulty receptor undergo the hundred-fold rise in progesterone that occurs during pregnancy, progesterone overstimulates the receptor, causing salt retention, expansion of blood plasma volume and skyrocketing blood pressure.

So what this is saying is that some people have a protein mutation that makes them more sensitive to progesterone.  In such a person, progesterone in high amounts (such as in pregnancy….or, say, when you’re me and desperately trying to make hot flashes disappear) can cause the kidneys to retain more fluid…raising blood pressure.

I should mention, when I was pregnant I developed hypertension (not pre-eclampsia), which led to my daughter being born by C-section 3 weeks before her due date.  My blood pressure was so high she was in distress.  Before that I had not had a problem with high blood pressure, and after the pregnancy my blood pressure returned to normal.

So after finding this article I went to the drugstore and bought some diuretic pills and took one.  Within a few hours my blood pressure returned to it’s “normal” state of hypertension – 150s over 90s, and my pulse was back in the 80s.  I stopped taking the progesterone at that point – I guess that was 3 days ago now.  My hot flashes have almost vanished – just little reminders here and there.  I guess I increased my progesterone level quite a bit and it’s not dropping quickly.

I wrote to Dr. Peat to share this story and the article I found, and to ask if he’s ever encountered anything like this in his research or practice.  I haven’t heard back from him yet.  I’m trying not to make that mean anything.  He must know that everything he puts in print becomes fodder for the public so perhaps he’s choosing his words carefully.  Or maybe he’s off researching the issue intently.  Or maybe he just blew it off because it’s terribly inconvenient to have someone tell you that you were wrong and that in fact SOME people actually do have serious side effects associated with high doses of progesterone.

I developed high blood pressure while living in California, around December of 2012.  At the time I was taking high dose progesterone and estrogen supplements, a la the Wiley Protocol.  I did stop taking those in March 2013, and then there was a period of time when I wasn’t taking any hormone supplements at all, until I started with the Progest E in November 2013.  Looking back at previous blog posts I see I’ve posted various blood pressure measurements over the past year or so:

  • April 2013: 145/88
  • June 2013: 135/83
  • November 2013: 155/109 (had recently started Peat-inspired plan, had increased salt and fluids and was taking Progest E, at a pretty low dose.)

What if progesterone supplementation is behind my high blood pressure?  I wasn’t taking progesterone between April and November, and during that period my blood pressure was lower (according to this blog, anyway), with the exception of the time I tried to drink 100oz of water every day.

I’m sure progesterone is safe for most people…but I’m curious how many people have this mutation?

Am I rare?

New plan: No progesterone supplementation for a while. If I find myself needing it I’ll take a few drops, but no more than 3 per day, and only during the last 2 weeks of my cycle.  Also no more extra salt. I’m also drinking celery juice and taking Hawthorn because I understand these things can be helpful for lowering blood pressure.  I’ve tried 3 different anti-hypertensive medications – 2 caused problematic side effects and one just didn’t work.  I tried everything I’ve seen Peat recommend for high blood pressure (eating MORE salt, high dose vitamin K, bag breathing, more potassium, magnesium/epsom salt baths).

There will be other new plans too.  Stay tuned.

Reconsidering Options

I really wanted Ray Peat’s work to be The Answer for me. I think Peat’s work benefits some people greatly – in fact, it may be the most brilliant nutrition and health advice ever.  But when it comes to deciding what I should put in MY mouth at mealtime, I don’t think it’s for me.  Here’s my analysis:

The Pros:

Progesterone – I had given up on sex hormone supplementation after my disastrous encounter with the Wiley Protocol.  I blamed progesterone for the fact that I gained 20 pounds, had heart palpitations, and became so fatigued that I could barely get out of bed.  At the time I concluded that progesterone was the culprit because I found a website on which a bunch of lay people decided it was so.  I was so fatigued and depressed I would have believed anyone.  Recently I’ve started supplementing with Progest E, the progesterone supplement developed by Ray Peat himself.  I find Progest E alone – without the estrogen that Wiley had me taking – to be wonderful, balancing, and soothing.  I imagine I’ll take it for the rest of my life.  Estrogen, not so much.

Liver – I’ve gone on and on about how eating liver once a week has made my skin look great.  This week I tried eating all 4 oz raw, washing it down with milk.  I thought it was a lot easier than trying to eat it cooked.  I’m considering just having an ounce or so raw every day or two.

Shellfish, bone broth, raw carrot, coffee, aspirin, vitamin K2 – all of these things I don’t mind taking or using and will continue to do so, just because the promise of better health is worth the effort.  I also love the smell of broth cooking in the crock pot.

The Cons:

Sugar – Yesterday I tried all kinds of things.  I tried a teaspoon of granulated fructose with breakfast and tested my blood sugar after – it was up 25 points at one hour and up 35 points at 2 hours. That part was ok, but also I felt hungry soon after, despite eating a 300 calorie meal.  So I ate ANOTHER 300 calorie meal and paired it with the smallest wedge of an orange ever.  It was a clementine orange – small as a baby’s fist, and I ate one small section of it.  An hour later my blood sugar had dropped 50 points and I was hungry again.  I then ate several hundred calories of protein/fat along with a very small amount of sugar (cuz Ray Peat said to), and within 45 minutes I was hungry.  Now, keep in mind, a pure protein/fat breakfast – without any sugar – normally keeps me satisfied for hours.

I thought about eating for 5 hours straight.

This is what pisses me off about those who say people get fat because of “food reward and palatability” (translation: fatties get fat because they eat too much cuz food is so damn tasty).  I HATE BEING HUNGRY AND WANT NOTHING MORE THAN TO JUST BE DONE EATING ALREADY.  IF I DIDN’T GET HORRIBLY UNCOMFORTABLE I’D BE CONTENT TO NOT EAT AT ALL.

So at that point I was fed up (not literally) so I got fed up (literally).  I ate a huge meal that would keep me satisfied for the rest of the day – it included all kinds of terrible things, including mayonnaise (PUFAs!), bread (gluten!  starches!), and industrial meat (inhumane! hormones! antibiotics! PUFAs!).  Some might call it a binge.  It was less food than I used to eat back in my binge-eating days, but I guess it was a binge.  And FINALLY, I was done being hungry.  That meal lasted through the rest of the day, all night, and well into today.  I didn’t get hungry again till 1:00PM – almost 22 hours later.  It was wonderful.

Dairy – I’ve had some sort of nasal congestion or phlegmy cough for the last…oh, about 6-7 weeks.  About the same amount of time I’ve been following Peat’s dietary recommendations.  I thought I was just getting one cold after another.  But it occurred to me today that maybe the addition of lots of dairy into my diet was causing this.  I’m going to take a break from dairy for a few days and see if my forever-cough clears up.  Then I’ll add it in again to see what happens.

So what’s next for me?   I’m fairly desperate to lose the 5-or-so pounds that I’ve gained in the last 2 months since eating carbs.   As well as the 20 pounds I gained following the  Wiley Protocol.  As well as the 40 pounds I was overweight when I started this blog.  So now, I’m going back to eating what makes me feel good – mostly low carb with small amounts of potatoes here and there.  I know low-carb isn’t ideal.  But what I’m doing now – getting fatter and hoping there’s magic in milk – isn’t doing my health any favors.  No more fruit.  No more sugar.  Maybe no more dairy.  I’m going to stay away from PUFAs as much as I can.  I’m going to exercise at least 30 minutes a day to manage my blood sugar.  I’m going to count calories again, and stay at or around 1500/day.  Finally, I’m going to continue to supplement with thyroid hormone, so my broken metabolism has a shot at making it’s own steroid hormones.

It’s possible my body will be running on cortisol till the day I die.

Right now, I’m ok with that.

That’s all.

Progest E and Milk

My cycle is super screwed up.  If you’re male or otherwise offended by discussion of my period, I give you permission to leave.

Ok, where was I?  Yeah.  My cycle.  In the last 2 months I’ve had my period 3 times.  And before that it was 10 weeks with no period.  So a bit unpredictable.  I’m not sure what’s up with the current extremely short cycles I’ve been having lately – 3 of em! – since October 1st…but I’ll tell you what.  I don’t like it.  And it’s not like they’re these cute little 3-4 day jobs either – no, they last 7 or 8 days each.  So I pretty much have my period, have a 10 or 12 days off, and then I have another one.  Awesome!

It wasn’t always like this.  For a long time I had 25-day cycles.  Every 25 days I’d get my period.  It was a bit shorter than most people – I guess the average cycle for most women is 28 days – but it was predictable.  Then almost 3 years ago I had a miscarriage.  Since then they’ve been all over the place…sometimes long cycles, sometimes short.  It makes it very hard to predict exactly when I’m going to be really really moody.

Well today was 10 days after day 1 of my most recent period.  My mood was not good.  I felt like killing someone.  I had a headache.  These are not common things for me anymore, especially since I started eating Peat-style.  I took a guess and decided that maybe I’m ovulating today – it’s exactly halfway through a 20 day (ridiculously short) cycle, so maybe…?  I just ordered Progest E, which Dr. Peat recommends for balancing excess estrogen in the system, particularly beginning on ovulation day and throughout the rest of the cycle.  So today I took 3 drops of it.  My wanting to kill someone went away within 10 minutes.  All of my other obnoxious hormone-related symptoms went away within a couple hours.  I feel back to normal.  Placebo effect?  Maybe.  Or maybe it actually did what it’s supposed to do.  I’ll keep taking it for the next 10 days.

In other news…my fasting blood glucose was 129 today – higher than I like it, of course – but I’m not surprised.  I find it’s higher in the AM if I don’t eat in the middle of the night, due to the release of stress hormones.  Still, my body isn’t storing enough glycogen to get through the night.  It’ll come in time I’m sure.  But today I decided to test my post-prandial blood sugar to see if I’m actually showing signs of insulin resistance.  From what I understand, you want your blood sugar to be below 140 after 2 hours.  So I ate breakfast (orange juice with sugar added and cheese), and tested it 2 hours later – it was 118.  Oh good.  Well, I’m not too worried then.  I’ll keep tracking my fasting blood glucose though because it makes a nice graph.

So I took my little girl off of milk about 6 months ago.  I did this because Jack Kruse told me to and I trusted him without requiring much explanation or proof.  I no longer feel that he’s trustworthy, and I now realize there are a lot of nutrients in milk that she should have access to.  So I’ve been gradually introducing dairy again into her world – first with butter, then with cheese, and a few days ago I started mixing regular cow’s milk in with the flax milk she currently drinks.  In the last few days she’s developed skin problems – 2 different rashes on her face and a small rash on her arm.  She tolerated the cheese and the butter really well, so I think there’s some additive in the milk that isn’t working for her.  I hope that’s all it is.  I’ve been giving her liver to make sure she has enough Vitamin A – and oh my god, she loves it!  She never asks for more meat, and she asked for more liver twice!

Speaking of Jack Kruse, I prowl around his forum now and then to see what he’s up to.  He seems to be recommending the use of crystals now.  *shm*  I could say more, but it seems pointless and a little mean.  I will say this though – several of the regulars over there have been complaining of iodine supplementation causing thyroid problems.  Be careful with that stuff, people.  High TSH is not as meaningless as some people would have you believe.  (To Jack’s credit, he doesn’t recommend iodine supplementation, so I can’t point the finger at him for that one).