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Hormones
Hi
So a friend of mine- late 40s has some hormonal imbalances, she tested and her results look as follows:
Estradiol (ECLIA) <5.0
Progesterone (ECLIA) 0.1 ng/mL
Testosterone, total (ECLIA) <0.09 nmol/L
Of course along with that she has frequent hot flashes and inability to sleep well. She has been prescribed hormonal medication to help rebalance over a period of 2 months. But what recommendations/insight can I offer her. For the hot flashes I did see the tips in the symptoms dictionary.
Thanks
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3 Replies
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Hey ,
Estrogen and progesterone values go up and down through a woman’s cycle in her reproductive years. For example, values of progesterone in the first half of her cycle (pre-ovulation) can be very low (lower than 1 ng/ml) compared to the second half of her cycle where values peak above 5 ng/ml. For estrogen levels, the monthly dance looks a bit different, but there is an up-and-down rhythm as well that depends on the day of her cycle.
If your friend is still cycling, it would be helpful to know when these values were measured in her cycle. It would also be helpful to know in which units her Estradiol was measured and what reference ranges her laboratory uses.
Although labs can be helpful, labs are also a snapshot of what is going on. Symptoms can provide other clues. For example, sudden drops in estrogen can cause (via a cascade of reactions) hot flashes. Low progesterone can contribute to having hot flashes as well. At her age, her progesterone production has likely decreased and what the ovaries don’t produce, the adrenal gland has to pick up.
Progesterone can also be lower because of chronic stress. Poor sleep hygiene, chronic dieting and other stressors can cause the body to prioritize survival and lower progesterone production further as a consequence.
Remember that cortisol helps produce blood sugars in the absence of food. With low cortisol production (as a result of ongoing stress) it gets harder to stabilize blood sugars during the night. As a result, the body can produce a surge of adrenaline that might wake your friend up in the middle of the night causing hot flashes as well. In this case, having a small snack an hour before bed can help her until she addresses the reason for her low cortisol production.
Other things that can contribute to hot flashes:
• Having imbalances in thyroid hormone. Do you know if your friend has a hypo(or hyper) thyroid? For example, for women with a slow thyroid, it is harder to produce progesterone.
• Insulin resistance. Again, this ties into blood sugar regulation. In this case, having a diet of low-glycemic foods will help while improving her insulin sensitivity (for example by making her move more if she has a sedentary lifestyle. Just keep in mind that if chronic stress is at play, aggressive workouts might not be helping her at all)
• Is she drinking coffee? Or Alcohol? Reducing coffee and alcohol can reduce the amount of hot flashes.
• Does she eat a lot of spicy foods? Eating spicy foods can trigger hot flashes as well.You mentioned she is going to use hormonal medications. Is she already on them? And what medications is she going to use?
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Hi
Thank you for your response. Here are some answers to your questions or answers to fill in some gaps:
• No period since mid August
• No info on Insulin. She is under a lot of work stress and physically its all desk work but she does manage to hit the gym several times a week.
• Takes 25mg of euthyrox every morning (for Hashimotos- currently under control)
• Estradiol lab range is as follows:• Follicular phase 12.5v to 166 pg/mL
• Ovulation phase 85.8 to 498 pg/mL
• Luteal phase 43.8 to 211 pg/mL
• Postmenopuasal <5.00 to 54.7 pg/mL
• Medication prescribed as follows- will start now:[image0-2 copy.jpeg]Will pass on some tips in the meantime. Thanks -
Hey ,
If your friend’s main goal is to sleep better and reduce hot flashes, she is making some choices that could influence her symptoms. Keep in mind that hot flashes and sleep problems can have many different reasons. To see what works best or what influences her symptoms, keeping a journal will make things easier!
Her thyroid hormones are in balance, but Hashimoto’s is an autoimmune disease. With auto-immune issues, we often see some enhanced permeability of the gut lining (leaky gut). In these cases, the immune system can come in contact with undigested foods and can over time react more strongly to these foods. With autoimmune issues, it is quite common to have (hidden) food sensitivities and allergies which can contribute to her symptoms as well.
I’m quite sure you or your friend might find the guest expert call (on the 7th of December) with James White about food sensitivities quite interesting.
If she has allergies/food sensitivities, some gut healing might be a second logical step. Let me know if she is interested in taking the next steps so we can help her!If she still has complaints after adjusting to her current lifestyle choices and her medications exploring how her blood sugar regulation works could be helpful as well. Insulin resistance can worsen her symptoms and a fasting insulin measurement can help her to spot it. Of course, you could also make her aware of the signs and symptoms of insulin resistance (you can find them here and here) and see if she recognises herself in any of these. I have found with my clients that a fasting insulin test is more reliable though.
I hope she finds some relief and she is lucky to have you as a friend!
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