sex lies and menopause

[Laurs]

Hi @dani, thank you for sharing your knowledge, very interesting. I have several friends who have started hormonal replacement therapy (estradiol), and have done some research on it, especially since the C’s confirmed that hormone replacement therapy is generally a good idea (session of 6th July 2024).

I came across this interview of Dr. Mercola with Kashif Khan of 6th August 2023. He is the founder and CEO of The DNA Company (I understand that he is not a medical doctor), and he wrote a book ‘The DNA Way.’

According to Mercola, Khan is quite knowledgeable in the area of endotoxin and mycotoxin, which can play an important role in many chronic degenerative diseases, and estrogen excess, which can produce symptoms identical to endotoxin. I would be interested in your opinion about what he has to say, especially since he strongly recommends avoiding estrogen replacement therapy as most women are prescribed estradiol, typically, which he says converts into 4-hydroxy estrogen, a cancer fuel. Also, what is your opinion about his suggestion to take pregnenolone instead? Here are some excerpts from the transcription of the interview:

Khan explains:

While estrogen replacement therapy is all the rage, this strategy is likely doing far more harm than good. I strongly recommend avoiding estrogen replacement therapy, even bioidentical, organic estrogen replacement therapy. You can go on other forms of hormone therapy, but not estrogen.

[Estrogen] is certainly one of our biggest toxic threats today, especially given that you have to think of it contextually. Our context today is not grandma's context. [Due to] the hormone disruption and estrogen mimics we're dealing with [today], you already have too much, and you’re adding more through hormone replacement therapy or birth control pills.

So, we're already in a context where it's a threat, so you have to pay attention to it. The layers you have to look at are dominance. So, what do I make? Am I more androgenized, am I more estrogenized? And you can predict that through the genes that metabolize each step of the cascade ... progesterone to testosterone, to estrogen. What do I do in each one of those steps?

Many women — and men, by the way — are estrogen-dominant and just produce way too much. It's [due to] a conversion of CYP19A1 to testosterone and estrogen. That's why aromatase-inhibitor inhibitors work well, because you are just flowing the gene expression down in that one location, and all of a sudden, you have more free flowing testosterone.

By the way, there are three pathways that your estrogens convert into, potentially, before you clear them, and these metabolites are 2-, 4- and 16-hydroxy estrogen. 2-hydroxy estrogen is the good clean stuff you want. 4- and 16-hydroxy estrogen are toxic.

… But these two metabolites, the 4 and 16 [are] highly inflammatory, [and] we know all chronic conditions are rooted in inflammation. For men, the 16-hydroxy pathway is closely connected to testicular cancer. In the androgen pathway, dihydrotestosterone fuels prostate cancer."

To detox estrogen, the same detox pathways used for other toxins also apply here, such as the glutathione pathway, antioxidation, superoxide dismutase and COMT, which is the tail end of methylation. COMT, in particular, is really important for clearing toxic estrogens, whereas glucuronidation deals with some of the androgen toxins.

"If you take a hormone therapy and look at this cascade, what are most women getting? They're getting estradiol, typically, which converts into 4-hydroxy estrogen, which is a cancer fuel.

…Keep in mind, in menopause you don't have a menstrual cycle anymore, so you're not clearing that toxin. It just gets stored in fat. That's what your body does with it, which is why you have inflammation in the breast. That's where you have a lot of fat as a woman.

How to Measure Estrogen Excess

There are two ways to measure or gauge potential estrogen excess. One is to look at your genetics to understand how you metabolize estrogen. The other is to take a standard DUTCH test, which is commonly used to monitor patients on hormone replacement therapy.

Unfortunately, many doctors are not trained on interpreting metabolites. They're looking at estrogen alone, not understanding that there are genes that metabolize and turn the estrogen into different things.

I'm not opposed to all hormone replacement therapy. The master precursor hormone, though, is pregnenolone. That is the base hormone that converts to all others, and it’s unlikely to aromatize. The ideal administration route is once a day in a cacao butter suppository. DHEA, which is a male hormone, at 5 to 10 mg can also be added.

… DHEA can easily aromatize and can form estrogen, which is not a good thing, so you need to be careful about using too much. Those are two base hormones that people can use rather safely. You can also use progesterone, which is anti-estrogen.

Estrogen, aside from increasing intracellular calcium concentration, is also antimetabolic, as it slows down your metabolic rate and inhibits your thyroid function, both of which are bad news. It’s toxic to your body in most cases. It is likely only second to excess LA intake as a factor that increases your risk of cancer.

You do need it sometimes, certainly for reproductive purposes and for wound healing, but most of the time you have more than enough to fill those roles, and it's just an excess, especially with all the xenoestrogens we're exposed to in the food supply.

FWIW, I also include this article from another Menopause thread, about the many, many different symptoms women deal with, which reveals a lack of comprehensive understanding among health care providers and women themselves, so by all means, dani, please do write that book !

 

[Nienna]

I continually wake up around 3:00 a.m. and can't go back to sleep, and I wake up every hour and a half.

Have you been checked for sleep apnea? Because that does sound like someone who has it. If you have sleep apnea, getting a CPAP machine and using it will make a world of difference. I have sleep apnea and the CPAP machine has made of huge difference for me.

fwiw

 

[Mari]

Thank you @dani for sharing and helping!

....A replacement of both estradiol and estriol provides the best protection. ....

....is common for people to start supplements they do not need, and then cause problems in their own health

My question would be, how do I know when to start with patches/cream/...? I´m 43 now and I don´t think I have pre-menopause symptoms pronounced - yet (or I assign them to PMS) - but I understood from reading around that at one point estrogen starts dropping very quickly and usually women start with replacement when it is already down; so when it is already (too) late... You see what I mean?
What do you think?
I haven´t done thyroid test, I only had a general check-up around 6 months ago and from the bloodwork doctor said she concludes that thyroid levels are optimal.

I continually wake up around 3:00 a.m. and can't go back to sleep

For how long now? I woke up at 3:00 this week already twice, this night included; I had a weird dream in both cases, I woke up, and couldn´t sleep until 6:00. Many people in How are you feeling? thread reported the same.
It might be apnea as Nienna suggests, or might be general "vibe" that is doing rounds around the globe.

 

[Chu]

Thank you @dani for all that information! It's super interesting (and thanks @Laurs for those quotes too!).

I'd be very interested in what you have to say about perimenopause as well.

For those interested, so far I've found these podcasts very interesting, and many of the symptoms match mine:

Her website has more information: The Menopause Library | HRT, Education & Wellbeing | Balance

I still have to find the right "cocktail", based on what you wrote about progesterone and testosterone. Any knowledge you can share is super welcome. Hormones are complicated!

 

[Mrs. Peel]

Have you been checked for sleep apnea?

Yes but it was over a decade ago.

 

[dani]

Should reverse T3 be 10 or lower to be optimal? Should T3 cytomel liothyronine be used to lower reverse T3 that is above 10?

reverse T3 should be between 10-20 to be optimal. Reverse T3 measures how adequately your body is able to convert inactive T4 into active T3. T3 supplements alone are very short acting, so a combination therapy with T3/T4 is best. T3 alone will have big spikes and troughs which isn't ideal. You should be able to normalize your Free T3 with a combination medication. Supplementation with iodine, if your levels or low (or if you are unable to check your iodine levels), selenium, and folic acid are helpful as well.

 

[dani]

Chu and Mrs. Peel, I will get you both individualized recommendations later to today after work. I am in the US central time zone fyi. Chu, the most common necessary replacement in perimenopause is progesterone. Mrs. Peel, your cortisol is most likely responsible for your poor sleep along with your low estrogen and progesterone. Cortisol should be tested via saliva ONLY (you can use dried urine as well but not blood.) It is the standard of care even among traditional allopathic doctors to use salivary tests for cortisol. Lars, you mentioned mold above which is similar to Lyme's Disease which is a biotoxin disease and can lead to CIRS (Chronic Inflammatory Response Syndrome) which is very debilitating. Up to 20 percent of the population suffer from this. It is a multi system failure. Symptoms include poor sleep, weight gain refractory to any exercise/diet modifications, depression/anxiety or a sense of not feeling well, gut issues, muscle aches or pains, etc. Again, I will give more info later. This is a hard one to treat and takes a year to recover from, but it is 100 percent treatable. The treatment of perimenopausal symptoms differs a little bit from postmenopause so I will address that later today. Mrs. Peel, I would recommend adrenal adaptogens as a start. Ashwaganda is included as well as other ancient herbs. It should not have a bad effect on you as a group as opposed to taking Ashwaganda alone.

 

[Yas]

I just want to say thank you, dani, for sharing your knowledge here!

Hormones are indeed very hard to understand. We can understand the basics of what they are supposed to do and learn a bit about their interactions with one another but it is precisely there where it becomes hard to know exactly how to work with them without causing more harm than good: in their interactions with one another, and with every other body system and function. They are so important! That's why every bit of knowledge you can share is very valuable so that we can understand this a bit better.

 

[Mari]

Thank you @dani for all that information! It's super interesting (and thanks @Laurs for those quotes too!).

I'd be very interested in what you have to say about perimenopause as well.

For those interested, so far I've found these podcasts very interesting, and many of the symptoms match mine:

Her website has more information: The Menopause Library | HRT, Education & Wellbeing | Balance

I still have to find the right "cocktail", based on what you wrote about progesterone and testosterone. Any knowledge you can share is super welcome. Hormones are complicated!

Thank you for sharing Chu!

Just watched the videos, very fascinating.

I also searched online if there is a possibility to get hormonal creams over the counter in Germany and it seems that here as well the situation is the same as everywhere else - prescription only.

 

[Gaby]

Knowing what path Mercola took recently, I would take his research with a grain of salt. Studies don't reflect his reservations, on the contrary.

There are a lot of educational videos at Home - DUTCH Test. True, they have a conflict of interest, but even they admit that their hormonal urine test reflects symptoms. Those who have long commuting or walks can listen to the videos. It's a learning curve, but it's doable. So that's the other option. Knowledge protects. Understanding what happens to your body and why and how it can variate will give you the tools to navigate your hormones at long-term.

 

[Jo Bugman]

Interesting I was reading this thread this morning and my fiancee was just prescribed a progesterone pill called Regulate to deal with her PCOS. It’s not exactly menopause but I was wondering if anyone has any experience with this pill or using progesterone to treat pcos? I’m cautious since the doctor described it as experimental.

I’m at work right now so I’d need to look into it once I have a moment.

 

[Mrs. Peel]

Mrs. Peel, your cortisol is most likely responsible for your poor sleep along with your low estrogen and progesterone. Cortisol should be tested via saliva ONLY (you can use dried urine as well but not blood.)

I had saliva testing way back when I went to a functional doctor once. It showed that my cortisol tended to rise in the evening instead of dropping.

Mrs. Peel, I would recommend adrenal adaptogens as a start. Ashwaganda is included as well as other ancient herbs. It should not have a bad effect on you as a group as opposed to taking Ashwaganda alone.

I have a supplement here called "Cortisol Health & Support 600" which contains B6, B12, Magnesium, Licorice root powder, eleuthero, Magnolia bark, ashwaganda root powder, rhodiola root extract, l-theanine Holy Basil powder, and phosphatidylserine. Says to take one a day with a meal, but not what time of day.

Should also mention my ferritin levels are high, always have been, doc checks them every six months and they go up or down a little. This time it was 326, last time 356. Tried donating blood to lower it, but afterward my blood pressure dropped so low I threw up and almost passed out. Normal blood pressure tends to run on the low side.

I'm also prediabetic, A1C is 5.8 and blood sugar tends toward the hypoglycemic end, which also may have something to do with the sleep issues. Sometimes when I wake up and can't go back to sleep, I'll get up and go eat something with protein and sometimes it helps me to go back to sleep.

 

[hlat]

Should also mention my ferritin levels are high, always have been, doc checks them every six months and they go up or down a little. This time it was 326, last time 356.

I think you need iron total to test your iron level. High ferritin can be a marker of inflammation instead of high iron.

 

[Mrs. Peel]

I think you need iron total to test your iron level. High ferritin can be a marker of inflammation instead of high iron.

Yes, that's what the doc said and probably true. The rest of the iron panel, all with normal range.

Iron Bind.Cap.(TIBC) 333 326 12/21/2023 ug/dL 250-450
UIBC 01 243 213 12/21/2023 ug/dL 118-369
Iron 01 90 113 12/21/2023 ug/dL 27-139
Iron Saturation 27

 

[dani]

Hormones in perimenopause. Ok the primary problem is perimenopause is progesterone deficiency. The first step is to start progesterone 100mg nightly on cycle days 14-25. If you are feeling better but not perfect, you can increase in steps up to 200mg nightly. Once your dose is stabilized, if you are feeling great on those days, but not the rest of the month, you can add 1/3 dose on days 4-13. Most women take 100-160mg and do great. Many add in days 4-13. Take it in the evening so it will help you sleep. You are best off taking it by pill form. Progesterone cream does not offer the same protection for breast cancer as oral does. Now, as perimenopause progresses, sometimes progesterone isn't enough. You can add biest estrogen cream 50estradiol/50estriol 1gm daily on days 1-25. In addition, you can add testosterone cream 1gm daily days 1-25. And you can add DHEA 5mg in the morning. I would start with progesterone. You can start DHEA as well at that time. If you are doing better and want to add it to days 4-12, add 1/3 dose on those days. I would have your hormones checked via a salivary test. Estradiol and testosterone are typically checked on cycle day 3. Progesterone needs to be checked around 7 days after ovulation or 7 days before your cycle starts. On a 28 day cycle, you would check it on day 21. If your cycle is longer say 35 days, you would check on on cycle day 28. Hope that makes sense. If your cycles are completely irregular, you can start progesterone at any time. You will typically have menses within a week from the last day you took progesterone. As your cycles normalize, you can then check your estradiol, estriol, and testosterone on cycle day 3 and your progesterone on cycle day 21. It doesn't have to be exactly those days, but close. Once you have your levels, you can adjust your doses. Low levels of vitamin C, B6, and zinc are also common with perimenopausal symptoms so adding them in as supplements is a good idea if you aren't already taking them in some form like a multivitamin.