← The Thyroid (and Hormone) Fixer Podcast: Thyropause, Menopause, Metabolism and How to Fix It
The Thyroid (and Hormone) Fixer Podcast: Thyropause, Menopause, Metabolism and How to Fix It
614. Progesterone Deficiency: The Real Midlife Crisis — What the Experts Want You to Know
01:00:16
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A
Consider the amount of stress that we're under today. It's not your mother's menopause anymore, or your grandmother's. Our families weren't exposed to the toxins, to the stressful news, to chemicals and poor food quality. The things that we're faced with are enormous now. So we need every bit of progesterone we can get.
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B
Welcome to the new and completely reimagined Thyroid Fixer podcast, A podcast that refuses to sound like every other health show out there. We're here to disrupt this entire space, and now you are part of that disruption. If you're listening right now, it's because something inside you finally said, I'm done being ignored. And I'm here to tell you. Good. Because this is where everything changes for you. This is where you say, no more. No more being dismissed by your doctor. No more being told your labs are normal. No more recycled medical advice. No more recycled biohacking advice. No more being told you accept what you know isn't right here. You'll get truth. You'll get clarity. You'll get information you can actually use, tools, strategy, and guidance you can apply right now to take back your energy, your hormones, your metabolism, and your life. Every episode will give you something real, something that moves you forward, something that reminds you that you were never the problem the system was. This is the Thyroid Fixer podcast. This is your turning point. This is where you rise. Get ready. We're about to disrupt everything you thought you knew about thyroid and hormone health. Let's go. I need to talk to every woman who's been told your labs are normal while your body is screaming at you and rebelling against you. Fatigue, brain fog, the weight that will not come off, mood swings, hair loss, feeling dismissed, frustrated and confused. I get it. And that is exactly why I wrote my new book, the Thyroid Fix. The no nonsense guide to fix fatigue, Fogginess, and fat that won't budge. That just says it all. And it is now available for pre sale. So I need your help to spread the message. I am giving you an ask as my listener and a promise at the same time. If you pre order the Thyroid fix, my promise to you is to continue delivering all kinds of free advice, information, content, education, empowerment, because that's what I love to do, whether it's here in the just fix your thyroid Facebook group or I'm on live. I will give you everything I possibly can if you do me one favor, which will be a favor for yourself as well, and pre order the Thyroid fix. Now. This book is not another list of supplements, vague advice. It's not a diet plan. It's not filled with recipes. It is a clear, honest guide. It is the Thyroid Bible. It is the last thyroid book that you will ever need because it teaches you how to read your own labs. No other book has done that. It teaches you what medication and dose you need. No other book has ever done that. It will help you to understand why you are being misdiagnosed, why you're being under treated and why you can't talk about hormones, weight loss or menopause without talking about the thyroid. I called it Thyroid Bible because like I said, this is going to be the thyroid book of the next few decades. When you pre order, you're not just supporting me, you're telling the publisher. This message matters and it needs to get out to the world and it needs to get into the hands of women who have been ignored for far too long. So will you go to thyroid fix book.com and pre order a copy of yours today? It'll be shipped to you on May 12th and you will get free entry to our all day live event where I will be there answering your questions live, teaching live, and bringing in amazing guests for you to also connect with and ask your questions too. So thyroidfixbook.com pre order yours today. I honestly don't think that we can talk about progesterone enough because there's questions coming up every single day in our Facebook group and the topic of progesterone is ever evolving and there's so much information around it on the benefits of it, beyond aesthetics. I mean, protection of your bones, protection against cancer. And this needs to be talked about. And you know, I'll even share a quick story. I got a text just the other day from a patient who's been suffering with fibroids. And of course her conventional doctor, her OB gyn said let's just do a hysterectomy. Let's just take it all out. I'm like, wait, wait, wait. Why don't we first try increasing your progesterone? Because that really is the first line of defense against heavy cycles, fibroids, a thickened uterine lining. Like, let's do all of that before we just randomly rip out a woman's reproductive parts, right? Progesterone helps us sleep. It takes the place of antidepressants. It really is the new Prozac. It's the healthier version because none of us are Prozac deficient, but we can be progesterone deficient So I wanted to take the best of the best of all of the different progesterone episodes and put them together and highlight those parts of the interview, whether it was me talking or me talking to an expert talking about progesterone, taking parts of those interviews and putting them all together so we can just brain dump it into your head. It's kind of like speed learning. This is the Cliff Note version of four to five different progesterone podcasts, all just put together for ease of understanding and for just to highlight the most important parts, because this is what you need to know about all things progesterone. First of all, we have to start with. Progesterone is the calming hormone. It's the, the best friend that comes in and puts her arm around you and goes, you know, everything will be okay. You don't have to get upset. Let's just, let's zen out a little bit, have a glass of wine, talk it out, and then get a really good night's sleep. That's what progesterone does. So it balances everything out. And the other beauty of progesterone is that it stops growth. It is anti proliferative. So any little cancer cells in our body, whether they're in our breast tissue or elsewhere, progesterone helps to keep them from growing, to basically stop their reproduction into more cancer cells. But let's go through all the wonders of progesterone and really when you should start noticing that your progesterone levels decline. Now, if you're in your 20s and you've been put on birth control, which is synthetic hormones, ladies and birth control, that can be a whole other podcast of how it absolutely tanks your thyroid and does horrendous things in your body. But if you're in your 20s and you were diagnosed with polycystic ovarian syndrome, one of the key components of PCOS is low progesterone, which creates an estrogen dominant state. So just side note, with estrogen dominance, I know a lot of you women hang on to that. You're like, I'm estrogen dominant. Are you? Or are you just progesterone deficient? Is it that you are not metabolizing your estrogens properly? Are you pushing them down the Wrong pathways, the 4 oh or the 16 oh pathway? Or do you have adequate levels, beautiful levels of estradiol? You're methylating, fine, but you have really low progesterone. Because progesterone is the first hormone to go. It can go in your 20s it can go in your 30s. And we see a lot of women with low progesterone having issues with fertility because it is the fertile hormone progest progestation. So we need progesterone to successfully implant the egg to support a pregnancy and then we also need it to carry that baby throughout pregnancy. So we can see progesterone tank in a woman's 20s and 30s. Definitely by 35, we see lower levels of progesterone across the board in all women. And this really is where progesterone hormone replacement, bioidentical progesterone hormone replacement should start to occur if a woman is cognizant enough to be working with someone who knows what they're doing and to get tested at that particular time. Now, the symptoms of low progesterone, well, they can be the similar symptoms of estrogen dominance, because like I said earlier, we want progesterone to be adequately paired with estradiol. So if you are truly estrogen dominant in that you have low progesterone, you will still have those estrogen dominant symptoms. So estrogen dominant symptoms, weight gain, water retention, moodiness, heavy cycles, brain fog, edema, poofy face, all of that kind of thing goes along with estrogen dominance. So let's say your estradiol numbers are perfect, but your progesterone is coming in at a 0.5, at a 1, at a 2. Well, that's low compared to the estradiol. So let's use an estradiol example. Let's say your estradiol is coming in when you test it on day 19 to 22 of your cycle. It's coming in in the 1/ hundreds. Well, it's not that you need less estradiol or that we should be blocking it in any way, shape or form because estrogen has its own benefits, like, oh my God. But what you need is progesterone to come up and balance the estradiol. Using bioidentical progesterone, as opposed to birth control, is a much better choice if you had that choice. Now, again, as I always say, if you're in your 20s, don't want to be pregnant, you're on birth control. I get it, I get it. I, I wouldn't want you to roll that dice and, and throw a huge curveball in your life. If it can be prevented. If there's any other way that you feel comfortable preventing pregnancy in your 20s, then do so to avoid the synthetic hormones from going into your body. And the host side effects that come with it. If not, okay, we'll give you a pass. But if you are in your 40s, late 30s, and you tell me that you are on birth control, I'm calling on you and it's time to be an adult and be responsible and find another form of birth control, because that's not worth. Now that you're a responsible adult and you're not in college and, and going to fat parties, it's time to. And even if you're jumping around with partners, it's time to grow up and use a responsible method of birth control. You don't have to put harmful hormones in your body. Now, some doctors out there are in the know enough to know actually how much progesterone, real progesterone, bioidentical to give a woman to act like birth control. But that's not really the topic of our discussion here. We want to go over just all the benefits and he says, more geared toward my ladies and per menopause and menopause, because that's really when we see progesterone levels drop. And that is where this becomes so vital for supporting your body. Okay, so we said pro gestation progesterone is necessary for a fertilized egg to implant in the uterus. And then, as we said, it helps prevent miscarriage, especially during those first 12 weeks of pregnancy before the placenta begins producing its own progesterone, insufficient quantities. So if the mother's progesterone level is too low, then the uterine lining can break down and that can cause a miscarriage. Now, there's many causes of miscarriage. Actually, thyroid dysfunction is the number one cause. Progesterone being low, comes in at number two. And oftentimes we see those two together. So if you're one of my ladies out there listening that you've had multiple miscarriages, my heart goes out to you, number one. Number two, we absolutely have to look at your thyroid function, your thyroid hormone values, and your progesterone level. So by the second trimester, the placenta takes over the production of progesterone to produce the very, very high levels required during pregnancy. Now, some women still will take a progesterone replacement through their pregnancy and then be able to come off of that after. But many women stay on progesterone if their bodies are not able to make enough and just for that extra, extra security, extra layer of support, then by the third trimester, the placenta makes massive amounts of progesterone, in fact around 300 milligrams compared to the average 25 milligrams made in ovulation. So babies are actually exposed to very high amounts of progesterone. That says a lot about the safety of progesterone, right? So very similar to these doctors running around saying hormones cause cancer, to which we argue, show me a 16 year old or a 14 year old that has breast cancer. Pretty much doesn't exist. So hormones do not cause cancer. Synthetic hormones cause cancer. Our creator gave us hormones. Hormones give us life. Hormones sustain our life. And as we look into the animal population, animals shrivel up and die as soon as they lose their hormones. We live in a westernized society with conventional sick medicine that can keep us alive through a variety mechanisms and drugs to extend our life beyond our fertile years when our hormones start to decline. So we either enter into old age and break down and feel like absolute garbage, or we replace those hormones that are no longer being properly made to give our bodies the protection, the life, the sustenance that it needs so we can live our best life till the day that we pass by whatever means. But we don't have to be like animals and throw in the towel and say, well, can't produce babies anymore. Time to shovel up and die. We don't have to do that. We have options. You have options, but you need to know the pros and the cons. Not too many cons.
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A
Spoiler alert.
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B
Not too many cons. You have to know the pros and the cons in order to make an educated decision for yourself. So if our creator gives us hormones and if the developing baby is exposed to massive amounts of progesterone, I think we can be safe in keeping our hats to the safety of progesterone. So actually though it. Progesterone is a sex hormone, when we talk sex hormones, estrogen, progesterone, testosterone, but it does not produce secondary sex characteristics like estrogen. So estrogen will convey feminine properties. Think you know, breasts and hips and, and a boot. And testosterone is the masculinizing properties, muscle tone, strength, just overall body comp development. So progesterone is also essential for fetal brain development. I talk about this all the time when I'm talking about thyroid as well. So when we're looking at even pre pregnancy, pre pregnancy, I tell women over and over and over again, please get your thyroid optimized, make sure that you are taking iodine, make sure you are taking a very high quality prenatal vitamin, and check your levels of progesterone, because it is not worth rushing a pregnancy to have A baby who is developmentally delayed. And I often, over and over again on this show, share about my experience, my current experience with my stepson who is now almost 12, autistic, non verbal, developmentally delayed across the board, and really will not be able to be on his own at any point in time. So, I mean, beautiful, beautiful kid, love him to death, but I really, I, I feel for all of us involved because he's never going to be out there thriving and being on his own. And that's, that's heavy. And anyone listening to this, who I mean, we see autism on the rise right now. That's a whole other podcast. What toxins? Misdiagnosed and undiagnosed thyroid issues. My heart goes out to you because it's tough, it's a heavy burden. So if I can step in and give a warning or a piece of advice to any woman out there thinking of getting pregnant, wanting to get pregnant, trying to get pregnant, I don't care if it takes you another year, get your thyroid optimized first because you don't want to give up 40, 50, 60 years of your life. On the other side, you know, you want a child that you can let go in the world to be his or her own person and, and be on their own. So progesterone, again, is also essential for fetal brain development. There's an author of a really good book. It's called what your doctor may not tell you about breast cancer, Dr. David Saba. And he indicates that progesterone deficiency during pregnancy is one of the leading causes of improper brain development and unborn children leading to ADD autism. So this may occur because progesterone is essential for the development of the regions of the brain necessary for shutting information or for shuttling information or for just processing information. There's another researcher, Dr. Katherine Dalton. She's been studying progesterone for over 30 years, and she often touts that women who use progesterone during pregnancy have babies with higher IQs. So that's really interesting as well. So not only can progesterone come in, in that beginning stage and protect the baby's brain, help sustain pregnancy, but can also contribute to higher IQs. Now, progesterone will also help prepare the breast for lactation. So progesterone has that relationship with estrogen, and we are supposed to make 100 to 500 times more progesterone than estrogen. So by balancing estrogen, progesterone can help prevent heavy bleeding, reduce clotting, reduce heavy cycles, help with Menstrual cycles in general and then actually help extend cycles that are too close together. So if you're one of the women out there, or even one of my patients, we have you on bioidentical hormone replacement. You start having two cycles a month, which is common when you start shifting hormones around. We might need to increase your progesterone because that comes in to help regulate the menstrual cycle. And then progesterone also enhances the beneficial effects of estrogen. So if you're, whether you're taking estrogen or. Again, back to what I said in the beginning, we're balancing the problems of excess estrogen or low progesterone. Progesterone comes in and acts like a balancer. Progesterone is also necessary for the creation of estrogen receptor sites in the cells. So this is one of the reasons why we tell you to take a break from your progesterone because there still is the, the factor, even if you don't have a uterus. Now, if you don't have a uterus, your doctor probably told you that you don't need progesterone. Another myth, another fallacy that we have to throw out. You need the progesterone even if you have a uterus because of all the other benefits that we're going to talk about today, including the one we already talked about, anti proliferation, protection against breast cancer, all cancers. But we also need to take that break from progesterone so that estrogen can exist on its own for a few days out of the month, whether it's 3 days, 7 days, 14 days. However, your practitioner is having you cycle or break from your progesterone, you need to take that break. Because what ends up happening is if you take progesterone ongoing, then there's a blocking of the receptor sites of the cell and progesterone is required in order to use estrogen and then it increases the sensitivity of those estrogen receptors. And this is why so many women using progesterone can. You can literally alleviate estrogen deficiency symptoms like hot flashes just by using progesterone. So we always tend to think about, oh, I'm getting a hot flash, it must be low estrogen might be. Let's just start with. For anyone that's maybe just tuning in and has, hasn't heard me talk ad nauseam about the benefits, can you talk about what are the benefits of pro, what is progesterone? I know it's a hormone, but you can go deeper and then what are all the benefits of progesterone?
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A
Oh, well, the list is endless. And I'm learning something new almost every month or so about progesterone. And that's probably one of the problems, because we're taught primarily that progesterone is the hormone that goes up during the luteal phase. That is, at ovulation, you will have a substantial rise in progesterone and eventually it drops and you'll start bleeding. And because of this menstrual chart, which shows progesterone being very low in the first part of the cycle, everybody focuses in on the luteal phase. However, it's a big mistake. That menstrual chart should have bullet holes in it or something because the progesterone on there is expressed in nanograms per mil when you do a test. And the estradiol is picograms 1,000 times lower. So if in your mind you can picture this graph, that line for progesterone needs to be astronomically off the page if it were in the same unit as the estrogen. And I think, hence people underestimate how important progesterone is relative to estrogen. Needs to be there and needs to be a lot. It's the most predominant sex hormone that women make. First is progesterone, then it's testosterone, then it's estradiol. Yet our culture has focused everything on estrogen, estrogen, estrogen. Finally, 1922, we have a article published by Jerry Lynn Pryor, who is a hero of mine. She's a menstrual cycle researcher in British Columbia, that progesterone is effective for vasomotor symptoms. So what is happening as women start to drift into the perimenopause years? Vasomotor symptoms and sleep problems are some of the primary things that come up. Yeah, this is being ignored entirely. But what is becoming in shorter and shorter supply is the progesterone, because it's been documented that young women 20, 30 years old have missed ovulation. So they're missing that oh, big surge that they would normally have. The other thing that happens during perimenopause is estrogen levels are the highest in the whole lifespan of a woman during perimenopause. So we have this extreme difference happening. The estrogen is getting higher, the progesterone is getting depleted from lactobulations. But even more importantly, I think is because progesterone is one metabolic step away from cortisol. Anytime that we're under stress, progesterone to the rescue from the adrenal glands in the first part of the cycle, from the ovaries in the second part of the cycle. But consider the amount of stress that we're under today. It's not your mother's menopause anymore or your grandmother's. Our families weren't exposed to the toxins, to the stressful news, to chemicals and poor food quality. The things that we're faced with are enormous now. So we need every bit of progesterone we can get. So when I started my career, I started working for Women's International Pharmacy, and we were specializing in the treatment of severe PMS. And the guidance for this came from Dr. Katerina Dalton. Her work is from the 1950s, so we're talking about 70 years or so. And so what we found was that we could do oral progesterone in oil compounded. And that was the whole point of the pharmacy, because Dr. Dalton used suppositories, vaginal suppositories, after trying injectables, which are very painful, but certainly you get the full amount of progesterone. The suppository dosing was like 400 to 600 milligrams.
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B
I was just going to say that I was going to ask you because I knew she used really high doses back then.
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A
Right. So she. And that you might have to do that two, three times a day easily.
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B
So 400 a couple times a day. So some women were getting literally 1200.
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A
Yeah. So I can't speak for Dr. Dalton's time, but I can speak for women's international time. At the time, the highest dose I saw in a woman would be like 2,500 milligrams. So it wasn't all oral capsules. The doctors that were working with PMS would be using the capsules. We'd have rectal solutions, vaginal suppositories, lozenges, creams, gels, anything to help this woman get to enough progesterone. So we also learned from that experience was that these doses of progesterone were effective for the most part. There are exceptions, but it was effective. And if women were still bothered with PMS symptoms, it's like, take more, okay? And their doctors even provided them with emergency doses, like maybe a troche to suck on for an emergency. And that was good because it would give you a very high peak level very quickly if you did it. So we would call that when it seemed not to be quite, quite enough, we would call that, you know, that your protocol is not quite Enough. It's emergency. You need to use more. Now, we worked with women. Some of these women were in such severe pain and full of symptoms. We had people threatening suicide when they called and they were. Couldn't get out of bed with massive, massive migraines and everything in between, really huge anxiety and heart palpitations and running to the hospital only to be told, your heart is fine. Go home with no solutions. And we just knew all you had to do was take more progesterone.
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B
Okay.
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A
So I was quite used to all these lovely doses of progesterone and how well it would work. So then along comes Dr. John Lee on the scene. Okay. He wrote a great book, the Multiple Roles of Progesterone. A remarkable hormone he called it, and it is a remarkable hormone. But I think he only touched the surface.
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C
Okay.
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A
But he did us a big disservice, too. And this disservice was that you only made about 20 milligrams of progesterone per day. That's all you need.
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B
So what year was this? So Dalton comes in in the 50s using high doses and even emergency doses. When did this author release that book?
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A
Oh, so that was probably late 80s, early 90s.
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B
Okay. So that's really where. When. When we started seeing women getting their hormones stripped away anyways. From the Women's Health Initiative. Yeah, yeah.
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A
Making this even worse.
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B
Yeah.
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A
And so I did a deep dive into this once. I said, where did he get this information? 20 milligrams per day. And I got no joy in it. I couldn't find anything. Pubmed or some of the scientific literature, could not find this. And so Dr. Ray Pete, if you know his name, he was the one who inspired John Lee to use progesterone for women with osteoporosis or to protect from osteoporosis. So Ray Peak has. He has quite the following now. And he's got a remarkable brain. He had a remarkable newsletter. So I emailed him and I go, where did this 20 milligrams come from? He goes, I don't know. Dr. Lee was in the habit of making things up. Oh, my God. What?
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B
Oh, okay. To the detriment of women everywhere. We're going to write a book with false stuff in it. That's good.
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A
Yes. A lot of this stuff was. Was true about what progesterone does. However, he sends me back a reference and it said, oh, it was something like a hundred milligrams per day was measured in the venous return from the ovaries. And in Dr. Katarina Dalton's book, she has an interesting thing. Kind of blew my mind because I hadn't read it earlier, but she measured the progesterone levels in the peritoneal fluid. So she actually punctured some bellies and got some fluid, and the level in the peritoneal fluid was 100 times the serum level of progesterone. So, hello, what does that mean? Okay, so now we know much more. Now, like, progesterone is made by the adrenal glands. It is made by the ovaries. It's made by all your nerve cells. So every. Every little schwann cell on your nervous system tissue makes its own progesterone. It makes its own pregnenolone, uses it right there. That shows up on nothing. No tests that we have available.
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B
So that won't get picked up in any testing. The ones the progesterone that's made in the nerve cells won't get picked up.
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A
None yet. I will say exogenously, if you use progesterone and you have nerve pain, tingling, or no sensation, you can put progesterone right on the tissue, sucks it up, and you can see remarkable changes. In an hour? In an hour maybe. So it's lovely that our body will take this exogenous progesterone and use it. Then our brain, which is full of cholesterol, it has its own independent hormone manufacturer system there, Makes a ton of progesterone right there, uses it right there. Again, we don't measure that. I've gotten in the habit of looking up things like its relationship to hormones. It's every. Every weird thing. And so I started seeing that we were talking about mast cell activation syndrome all over the place.
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B
Yes, that seems to be a hot topic.
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A
Yep. Yeah. Well, how does that occur? In each mast cell, you have, again, a whole hormone factory. And when estrogen is dominant with not enough progesterone in that little factory, histamine gets stumped. If progesterone is adequate, then it never gets stumped in the first place. So progesterone is a very potent antihistamine. And so you can have stuff disappear like, oh, stomach pain,
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B
my gosh. Okay, this seems like a miracle hormone because we know, like, you mentioned bone, bone remodeling, obviously. I mean, we didn't even get into all of the symptoms of perimenopause and menopause, which are helped by progesterone, like the hot flashes and the vaginal dryness. I mean, we all think estrogen when we Think hot flashes and vaginal atrophy. But progesterone comes in as well. Sleep, mood, brain function. We're going to talk about its effect on the thyroid, but with, with everything that you're saying, it seems to be almost too good to be true. Like a miracle hormone. And essentially it is.
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A
Yes.
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B
In your opinion, would you, would you call it a miracle hormone?
- [34:13]
A
It, it truly is. And, and the, all these hormones come from cholesterol. They're the sex hormones, the adrenal hormones, vitamin D, bile. There's so many that are from this main molecule. I begin to think it's like cholesterol is like maybe the God molecule or something. It's so needed and so pervasive. Of all these hormones that come from cholesterol, I think progesterone's activity is the most diverse. So then we come across a situation that happens when you use those small doses of progesterone, that 20 milligram, 30 milligram and a lot of the over the counter progesterone products have a dose in that range. With a whole foods or whatever, you're going to get a very low dose progesterone. And John Lee, of course would say this is perfect. That's all you need.
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B
Mm. Now, partially though, Carol, isn't that because there's a, there's a governing body, the fda, D A, whoever that's saying, well, if this is over the counter, you can't put more than. I think the cutoff is 50 milligrams per dose. I mean, obviously you can use more of that cream, that oil, the serum, but it don't we have like a cap on over the counter supplementation for
- [35:38]
A
progesterone used to be in that area, I think like 0.2%. But there are companies that are using quite a lot more and that has shifted legally. So you can find 100 milligram per dose, 200 milligram per dose. And thank God for it because it's a whole new opportunity for women to help themselves or work with a practitioner who has as some background in this to help themselves when their conventionally trained doctors don't have a clue what's going on. So thank goodness for that. One company's been developed with higher doses of progesterone because the owner had catamino epilepsy. So this is when you have seizures in the luteal phase. So hello, progesterone is involved and there's lots in the literature about using progesterone to treat it and you can high doses of progesterone will stop these seizures, and it's probably good for other types of seizures, too. But that's less clear in the literature. Remember, as I said, the nerve cells need this. The brain needs this. So progesterone has quite a bit of application.
- [36:56]
B
If you are exhausted, gaining weight, you. You have brain fog. You just feel off, and you're tired of doctor hopping and wasting money. Listen closely. So many women bounce from provider to provider, trying supplements, protocols, and then functional approaches that never truly address the thyroid. Months turn into years, and you're still stuck feeling like garbage, wasting your precious life. So this is why we offer a thyroid and hormone solution call. It's not a lab review. It's not treatment. It's clarity and strategy to determine whether you're a good fit for working with our clinic. We specialize in thyroid optimization and hormone optimization together. Because they go hand in hand. You can't do one without the other. You have to do them both. We prescribe in all 50 states, and if you become a patient, we take care of you from start to finish. Testing, treatment, optimization, and ongoing support. You don't have months or years to waste feeling this way. And you shouldn't have to keep throwing money at people who don't truly understand the thyroid and hormones. So if you're ready for real help, go to drami.com that'S-R-A-M I e.com and click book a call in the top right corner to schedule your thyroid and hormone solution. Call and just let a us help you get your life back and be that badass human that you are meant to be, that you deserve to be. Okay, let's tie in the progesterone to thyroid function because I find this so interesting and I don't talk about it enough. What is that connection?
- [38:38]
C
All right, so we'll go that from a couple different angles. So if you are in your 20s and 30s and your thyroid isn't working well. So this is not perimenopausal thyroid. I mean progesterone. So if you're, if you're not making adequate T3, you won't necessarily ovulate. Every month, I also see women in their 20s and 30s who are not cycling and they are having horrible periods, huge amounts of pain, lots of the symptoms of, of that we talked about, of people who don't have women who don't have enough progesterone. And the reason for it is because their thyroid isn't functioning well. Now, the thyroid, as you know, Amy, there's ways to make the thyroid function? Well, a lot of it's nutrition, some of it could be stomach acid related. But the, what the mechanism is, is if you don't have enough active T3 hormone, it downregulates your gonadotripone, releasing hormone from your hypothalamus and that then reduces follicular stimulating hormone, which is what makes the follicles mature and makes estrogen, which then reduces the, or eliminates the luteinizing hormones. So you don't ovulate because your thyroid isn't working. And so that's one way that women have impacts on their progesterone from their thyroid not working properly. And then the other way is say you're in perimenopause now. You're, you're coming from the imbalances now from the hormone, sex hormone side, not from the thyroid hormone. So there's a thyroid hormone dysfunction. And what that does to the hormones. Now we're talking about what the hormones do to the thyroid. So if you've got too much estrogen in conjunction to progesterone, now a lot of people call that estrogen dominant. So what that does is, is that if there's an imbalance, your thyroid globulin increases, so binding up the thyroid. So therefore you don't have as much bioavailable to the body. The thyroid globulin binds up the thyroid. So then you don't have a good robust amount of thyroid. And so that's one mechanism. And then the other thing is if you have enough progesterone like normally and normally functioning women who have a good cycle, progesterone actually reduces thyroid binding globulin and increases thyroid action in the body. And that's like at the genetic level. So that's what progesterone does. So progesterone has a very positive effect on the thyroid. So you can kind of imagine, there you are, there you are in perimenopause and you feel like crap because your estrogen is so high and your progesterone so low. And now your thyroid starts to, to go too. So you have lower thyroid function, your hair starts falling out too, and you're just ready to just go to bed for the whole day. And so when you give somebody progesterone in this, in this scenario, it can actually improve thyroid function by stopping it from being so bound, then increasing its action sort of. There's a couple studies, I was looking at a study about how progesterone helps thyroid and it's really I didn't totally understand the whole. I'd have to really do a deep dive in it, but it looked like it was more sort of genetic. It helps the release of thyroid hormone from the thyroid, and it also helps its action, too. So that's what I found. And you can see that all the time. You see people who just. Their thyroid looks so much better when you give them some progesterone.
- [42:16]
B
Oh, yeah. And it also helps with T4, a T3 conversion, which I often forget the progesterone component, because I go through the whole list of what raises reverse T3. Okay, high insulin and estrogen dominance. And, well, usually in the case of estrogen dominance, there's low progesterone. So that can be the. The sister component to that. Like, we can say low progesterone also increases reverse T3 or at least impairs that conversion of T4 to T3. Yeah.
- [42:43]
A
Yeah.
- [42:43]
C
So it's. It's like a. A. What's a triple hitter, you know?
- [42:47]
B
Yep.
- [42:48]
C
That's why people have to come and see us, because we know what's going
- [42:52]
B
on and so many don't. I mean, you. And I see this all the time with these. And I've. I've bitched about it on this podcast before. There are boatloads of functional, integrative.do. whatever term they want to use to promote themselves and market to the public who don't have a clue about thyroid and hormones. Like, no clue.
- [43:14]
A
Yeah.
- [43:15]
C
And the thing that you always see. I know you said this too, because I listen to your podcasts, but, you know, the. The normal range for thyroid. Oh, you're fine. You're fine. Or I TSH or whatever. And, you know, you really do see, you know, people come and come to. To us, people like us, and they feel so much better on thyroid meds because it does so much. I mean, not to mention that if your thyroid's not working, you're not detoxing estrogen either. So you. Now you have that whole problem too. And then you're not. There's more to it, too. So you. If you don't have enough thyroid hormone, you don't make enough stomach acid. If you don't make enough stomach acid, then you end up with gut dysbiosis. And then you can create a whole scenario in your gut where you recycle estrogen because of something called beta glucuronidase. So that's a whole thing. There's all these connections involved. And for me, I always say to my. My patients, when they come see me, if we can get your thyroid fixed first, that's going to help with everything else. That's like the biggest linchpin of all of this. I'm sure you'd agree with that.
- [44:22]
B
Oh, yeah, yeah. And I think, you know, the other thing that we see is people coming to us where maybe they're working with someone who says, well, I'll treat your thyroid, but I won't treat your hormones. Or these hormone popup clinics that go, well, I'll throw you some hormones, just the same ones, over and over without really even measuring you. But I. Oh, we don't treat thyroid. Just everything that you said proves they have to be looked out together. They do.
- [44:49]
C
Yeah.
- [44:50]
B
So if your doctor is not looking. If your practitioner is not looking at both thyroid and hormones, and they don't know this like the back of their hand, you gotta just run. It's time to get a new doctor because you will be in this cycle of, well, I'm taking all these thyroid hormones and I'm just not getting better. While you're on progesterone. No. Right. Is anyone addressing your low testosterone? No. Is anyone addressing your estrogen dominance or low estrogen?
- [45:17]
C
No.
- [45:18]
B
So it, it just makes sense. You have to do it all together.
- [45:22]
A
You do.
- [45:23]
C
And you have to also look at the gut, too. That's also really important as well. Yep. So you cannot fix the gut or some of these issues with the gut where you have estrogen detox symptoms if you don't treat the thyroid because you then can't digest well if your thyroid's not optimized. So, yeah.
- [45:39]
B
So many layers.
- [45:41]
A
So many layers.
- [45:42]
C
Yeah.
- [45:42]
B
So with progesterone, I'm not sure. I'm. I'm trying to decide which, which path to go down because I have so many questions for you. So with progesterone, do you have a favorite. Do you have a favorite delivery method? So we know that there's oral, there's topical. I don't even know if there's. Are people still using troches or sticking the pellets in for progesterone nowadays? Like, what's your favorite delivery method?
- [46:07]
C
Oh, usually don't do pellets with the progesterone, but you can do troches for progesterone. And that's kind of nice because some of it gets absorbed in your mouth, like through your skin tissue. It's almost like you get both the. You get both the oral progesterone and some of the transdermal, but through your mucosal tissue, but I don't normally do it like that. So you know that I do the rhythmic dosing. Yep. And rhythmic dosing was pioneered by T S Wiley, so anybody's really interested in learning more, you should read her books called Sex, Lies and Menopause. An amazing, amazing book. And also there's an organization called the Women's Hormone Network, and that's WomenShadow Network. Dot I think it's. Com. Anyway, the two of them, they. They've got. I like that delivery method, and it's all transdermal. You know, there's a lot of controversy around what the best delivery method is, to be honest. But the way I do it is I do rhythmic dosing with transdermal estrogen and progesterone, and sometimes I'll rhythmically dose progesterone oral with it if somebody's not absorbing the progesterone or their endometrial lining is getting too thick because it's not working so well transdermally. But I do it transdermally, and then I'll do static dosing. And usually women do that because they don't want to bleed or they just don't want to spend the money on compounded creams. So I do that. I'll do a patch and a pill. And that's generally the. The two methods that I. That I like to use. And of course, I have a preference for the rhythmic because that's on what I'm on. And most women feel. I mean, everybody's different. But I've had some women who are doing static and they change to rhythmic and they just feel so much better. And we can talk about that when you're ready. I'm not sure if that's part of the question.
- [47:54]
B
I know we can definitely move into the rhythmic. And so I want to. I want to put a disclaimer here. You have to work with someone who is trained in rhythmic dosing.
- [48:06]
C
Yes.
- [48:06]
B
Period.
- [48:08]
C
Way to do that would be. The two places to go to find someone trained would be to go. You can go to the wileyprotocol.com they have a list of providers there. And the womenshormone network.com they do something called physiologic restoration. There's a list of providers there, too, and I'm a provider on both of those.
- [48:27]
B
So.
- [48:27]
C
Yes, but you do have to work with someone who knows what they're doing. And most. And those two methods, or those two places that I just mentioned, they all have pharmacies that specifically specialize in Making these compounds.
- [48:41]
B
Okay, so rhythmic dosing is what compared to static dosing? Let's just start with the. The basics.
- [48:49]
C
All right, well, I'll start with static. Cause that's really easy to explain. So static is. It's the same amount of estrogen and progesterone delivered every day, you know, throughout your cycle. There's no change. So usually a patch would. Maybe a.05 patch and 200 milligrams of progesterone taken every single day. And that's it. That's so easy. Right? That's all it is. Now, rhythmic dosing is matching your own cycle. So it's peak dose of. So you only use estrogen. You use estrogen the whole time, all 28 days of a cycle. And on. So. And then on day 12 is the highest dose of estrogen, which is what it would be normally.
- [49:33]
B
Okay. Estrogen kickback and how to overcome it. This is from a patient of mine, and we. We talked about it one morning, and she's like, you know what? I want you to ask Carol this. I said, okay. So she wants to know, what is this estrogen kickback and how do you overcome it? If it's real, when you start taking progesterone and increasing the dose of progesterone. She said, I'd also love to know if there is a dose of progesterone that is considered to be too high.
- [50:02]
A
Okay. So the estrogen kickback is a term that I think started at the Estrogen Dominance support group on Facebook. I think that's the etiology. Okay. Anyway, they were recognizing, and I did a podcast with them early on, and that's exactly what they're experiencing. The low doses of progesterone were making them feel worse. And so I went on and said, you have to have enough progesterone to overcome that. So they started calling it the kickback phenomenon. You get more estrogen activity when you're already loaded with estrogen activity. Okay, so that's kind of nice. I've seen it described in the medical literature recently. They called it progesterone inversion, allopregnalone inversion. Instead of a Gaussian curve like this for absorption, it goes the other direction. It's flipped. So the high doses get you relief, and the low doses get you misery. So I called it biphasic. One thing I wrote to a researcher who didn't answer me yet. I'm going to have to go after him because it has a dual nature at the low doses and the high doses. So that's important. To recognize that you need to get yourself at a dose higher. So all the estrogen excess and the kickback symptoms are gone. And it's a real shame. A lot of women might get prescribed some progesterone and their doctor's saying, oh, see you in three months.
- [51:39]
C
Yeah.
- [51:39]
A
And with themselves three months of torture. They're doing their best and that's, that's really not good for that patient. It's very bad for their body to keep them in this hyper. Now you've exacerbated the problem with the low dose progesterone. You should stay there, get out of
- [51:57]
B
there, get out of that low dose state. Well, I'm actually thinking back to. I might have shared this on our last podcast. I forget my experience with oral estrogen in my 30s now, I had PCOS and I couldn't even tell you what dose I was given of oral compounded progesterone. And my thought is, now hearing you speak right now, my thought is the reason why I gained weight, which they were like, no, no, no, that can't happen, that's impossible. Like, no, I gained 10 pounds like in two weeks. I'm thinking that because I was already in an estrogen dominant progesterone deficiency state with pcos, that low dose, most likely of progesterone that they gave me was so low that it basically made me estrogen dominant.
- [52:43]
A
Yeah, yeah, even worse. Yeah, even worse. And then there's the question of can you use too much progesterone? So in my mind you have to get beyond the amount of progesterone that is in the third trimester of pregnancy, which is impossible to get to those levels when you never. We never can. I've seen some labs now going from 50 to 550 nanograms per deciliter during a pregnancy. If you were to load yourself up on, well, progesterone capsules. Let's say we did have a letter from a doctor during fertility work with 600mg oral capsules, divided doses. He got up to 40, 20 to 30 is considered really good luteal. We hardly ever see that. Right? Yeah, you can swim in that. And that. I say that goes for men too. The male fetus was exposed to huge amounts of progesterone and did not hurt them a bit. And then on top of this, men are really being tortured by lack of progesterone too. They're being given a drug called finasteride. If you look at Wikipedia, which has one good thing they have is they put structures if you look at the structure for finasteride, you look at the progesterone structure, they're practically the same. But we, we choose to give men a drug that has caused suicide and loss of sexual interest and loss of such sexual function, and that's okay, but we have to be afraid of progesterone. That's really scary.
- [54:21]
B
Yeah, no, I, that. I agree with you. I totally agree with you. So is there piggybacking on that answer? Is there a minimal level of progesterone that we want to see at day 19 to 22? I mean, I would, I would think. No, there's no minimum minimal. We don't want you minimal.
- [54:38]
A
The only reason for testing there is, is to find out if somebody's ovulated or not. So. So, for example, today I talked to a woman. She was, she was in that window. Her progesterone was one point. And I said, so I can conclude from that number that you didn't ovulate that month. So your progesterone that you should have a nice big wave of is simply not there for you. That's. That's what those numbers can tell you.
- [55:06]
B
Now, if we're, if you're testing a woman who is postmenopausal, you just test any day, then, I mean, there's no way to tell, you know, when a certain. But. But that woman's hormones are still fluctuating, fluctuating throughout the month. We just don't know where she is in that fluctuation.
- [55:25]
A
Right. Well, there's some natural fluctuation all the time. That's another danger of getting a number from a lab five minutes later. It could be just something else if you checked it again. So then you make a big clinical decision on it, and it's totally wrong. Like, what percentage of the time you spend this higher this time might be a better, better indicator, but we can't measure that. No, postmenopausal, I don't see a reason for initial testing. You know that progesterone's down. You know, testosterone's down, you know, estrogen's down. So start building accordingly, restoring the hormones, getting rid of the symptoms. Then if you want to recheck, like, one thing to recheck is like, what if they had a lot of estrogen hanging around? Like I said, you can get somebody pretty comfortable with months of progesterone, but it's because they've got a lot of estrogen hanging on. So then you may make a decision to work on this estrogen piece.
- [56:23]
B
Yeah. No, exactly. And it always comes back to asking that patient how they feel. Like, how do you feel? Because we can look at a number all day long, but if you're like, well, I'm still anxious, I'm not sleeping, you know. Yeah, having hot flashes. Let's do some progesterone. Exactly. Now there's been some controversy in our, we'll say in our world with a very well known big name guy doctor that's come out lately with some pretty crazy stuff around hormones and is starting to discredit himself. But regardless, Ms. Sandy here brings in this question. Dr. Mercola claims topical progesterone converts into something unusable. And the best way to take it is transmucosal, massaged into the gums and a vitamin E base. Which way is best?
- [57:16]
A
What he actually said in that article was that progesterone in a cream converted to allopregnanolone irrevocably, it wouldn't go backwards. And that might be true. It actually, actually might be true. That's how you, you want it. Aloe is more, much more potent at the GABA receptor than progesterone is. Also, it may be that his transmucosal form does the same thing. He offered no proof that it did. I talked to Dr. Frank Nort at Rhine lab after that. I said, could we be measuring aloe? He said it's not really worth it because it doesn't show up very much in the urine. So it's already been converted yet to something else. So we can't, can't get a handle on it. I thought it'd be cool too. You could, you know, test people for this. How drowsy you're going to be. If you could have a couple tests dose and check their urine, but not going to work.
- [58:11]
B
Okay, so. But there's nothing wrong with transdermal progesterone.
- [58:16]
A
No.
- [58:17]
B
Okay.
- [58:17]
A
Not at all. And really transmucosal is also a skin like thing. It's a little bit different secretions, but you are still like theoretically transdermal. So he's telling you one transdermal doesn't work, the other one does.
- [58:33]
B
Yeah, I was thinking, I mean, it's still kind of a crapshoot. Basically. If you're rubbing it on your gums, you don't know if maybe you produce excess saliva. Maybe there's something in your saliva that counteract. I mean, we don't know. Are you rubbing it in the right way?
- [58:44]
A
Yeah, you swallow a bunch and it's oral. You really can't tell But I will say this seems to be better absorbed. Should transmucosely eat in the mouth like. Or the vaginal rectal area. When women do have problems with absorption, sometimes that helps to switch to that.
- [59:00]
B
Now on that note, are there any risks or even benefits to taking progesterone vaginally or she. She says rectally, which I've never heard of that way of. Of delivery, but vaginally versus taking it orally or using a cream, or is it just really more kind of individualized Per. Per each one. Each person.
- [59:26]
A
It's individualized. And you can get better absorption vaginally and rectally. So for those who are having trouble with absorption in the other, in the creams or the oral, it's. It's an alternative that might work. Okay.
- [59:41]
B
Yeah. So if they're not feeling better. I wasn't. I'm not going to say if we don't see the number climb because we can't rely on that. If that person is not feeling a change and improvement in symptoms, then maybe change the delivery method. Okay. Okay. Now why is it that we do not use estrogen? At least if you're being treated properly, let me say that do not use estrogen alone or unopposed, meaning you have to have progesterone on board. Why is that? Can you expand on that?
- [60:12]
A
Okay. The. The activity is so intertwined, but it doesn't even make sense. The biggest amount of sex hormones that your body makes is progesterone. Secondly, it's testosterone. Estrogen's at the very bottom. Yet we've like, in our medical culture, we made it like the most important thing. And it isn't. You don't do well without the progesterone support. The estrogen doesn't work as well postmenopausally. I used to see women getting loaded up on estrogen, trying vainly to get relief from hot flashes and anxiety and stuff and just using more and more estrogen. The doctors really. And no relief. No relief. The higher they go. It's still the problem. I even met a woman who. She would steal perm red from the pharmacist counter. Used to be a fast mover. She'd just grab it because she needed to load up in her mind.
- [61:14]
B
Yeah.
- [61:14]
A
To get some relief. Or maybe she did. There are circumstances that they're seeing happen. We've given estrogen too much importance in the scheme of things. And it doesn't really drop in most women till menopause. And what's happening in the peri years, which is not in most of the medical literature, but Jerry Lynn Prior publishes We have the highest estrogens of our whole lifetime. So you're taking a high estrogen time of life, telling you we'll give you some estrogen to solve your progesterone deficiency symptoms. It's craziness going on and this high estrogen is saying, oh, you need to protect your bones. This again comes from Ray Pete, and I don't have his references. He said high estrogen increases parathyroid hormone. High estrogen, low thyroid situation. It's usually the same thing. And you can actually Prolactin. Did I say parathyroid? Prolactin. High prolactin levels. Unless there's a tumor, it's from this imbalance of hormones and it will come down with progesterone. If you leave yourself with high prolactin, then parathyroid hormone goes up and sucks calcium from your bones, increases the calcium in your bloodstream. So this theoretical. You need estrogen for your bones. Estrogen only. You're actually making more people osteoporotic with the estrogen only. So I. I think it's a very dangerous situation.
- [62:53]
B
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