Can You Get Too Much Progesterone?

For today's posting, I want to relate a personal story. I hope that you will further trust your body, your symptoms and 'how you feel'. Be your own best patient advocate when you are discussing options with your doctor or nurse practitioner.

A personal story

Some six months into my surgically induced menopause, I began to feel like a hypochondriac for the first time in my life. I had located a local doctor who agreed to prescribe natural HRT and I was in great anticipation of significant results. Instead, I began experiencing unusual joint stiffness and pain, mobility problems, and swelling of my wrists, hands and feet. This was a problem that worsened by the day.

When I developed tendonitis in my dominant hand, my physician did not see a hormone connection, but rather saw the situation as 'repetitive stress'. She prescribed an anti-inflammatory cream, then anti-inflammatory capsules, then referred me to a chiropractor for deep heat treatments and acupuncture. Soon both hands were affected, and the swelling began to worsen. All the while, any small amount of relief from the pain was very short-lived. Then there was a great deal of discomfort with an Achilles tendon in one foot. Had I suddenly developed fibromyalgia or some strange type of arthritis? Why did it feel as though my joints and tendons were staging some sort of revolt? I had to wonder about the hormone connection.

In my case, natural hormone replacement therapy preceded the onset of these joint/muscle/tendon problems. My physician had prescribed a very strong progesterone cream, which I had been using twice a day, for some three months. I had noticed weight gain, sleepiness, swelling in my hands and fingers, and when the tendonitis/carpal tunnel set in, I asked repeatedly if the hormone treatment might be causing some of the discomfort. One day, after another session of acupuncture for the pain and swelling, I asked the question again. This time, the technician remarked that pregnant women often get similar symptoms, such as carpal tunnel, and that the problems usually resolve after childbirth. Aha! Since pregnant women have very high levels of circulating progesterone, I was beginning to put the pieces together. Hormone imbalance was the culprit once again.

Now, in case you are misinterpreting my story as some sort of attack on progesterone cream, let me offer reassurance. I have personally done a great deal of investigation into progesterone cream, both over-the-counter versions and stronger prescription versions. I still believe that it is extremely beneficial for women, both before and after menopause. However, in my situation, excess progesterone became a problem. A small amount of women can actually experience a paradoxical response, where the treatment result is very opposite of what is expected. There are few known side effects when progesterone is administered in physiologic doses, amounts intended to mimic natural body production.

My body was giving many, many signals that an imbalance was getting worse. When my doctor would not listen, I decided to trust my instincts, my symptoms and my body. I promptly located another physician!

Soon, a consultation with a naturopathic doctor confirmed my suspicion about the high-dose progesterone cream. I then located a new doctor, who specializes in natural hormones and anti-aging medicine. He prescribed a compounded lozenge which contains a much smaller amount of progesterone, tailored to my specific needs, along with DHEA and some other complementary hormones. The carpal tunnel has slowly resolved as a result of the new treatment.

Why do I share this story? In retrospect, I find this chain of events very instructive. Natural hormone replacement therapy, in my opinion, is more art than science.

In order to achieve health and wellness, we must learn to trust ourselves and listen to what our body is trying to tell us. In spite of the challenges, natural hormone replacement therapy is still my choice. Stress, diet, age, environmental exposures (xenoestrogens) and body type all have an impact on hormone levels. Each woman is unique and her doctor must see her as such.

I have read many accounts of women having to switch doctors several times as they navigate through the natural HRT jungle. It's part of the challenge--but well worth the effort.

Hypothyroid or Hypochondriac?

Today' post will be short and sweet. I ran across a fabulous article written by
Barbara Gerry, correspondent for the Seattle Spokesman-Review.

Those of us dealing with the strange and bizarre ailments, which accompany Fibromyalgia
and Chronic Fatigue Syndrome, will relate to Ms. Gerry. Dealing with our doctors can be very frustrating indeed! She puts into words what a lot of us have been thinking. You go, girl!


Here's a link to the story, via Mary Shomon's About.com Thyroid page:
http://thyroid.about.com/b/a/257425.htm

Dr. John C. Lowe and the link between thyroid function and fibromyalgia

Dr. John C. Lowe, of the Fibromyalgia Research Foundation, believes strongly that there is a link between fibromyalgia syndrome and thyroid malfunction.

According to his research, patients with 'marginally adequate metabolism', compounded by sudden or prolonged stressors, may be diagnosed with fibromyalgia or chronic fatigue. He contends that the symptoms are actually metabolic in nature and indicate hypothyroidism or a resistance to thyroid hormones.

What's the theory?

The stress-induced hormone cortisol, when elevated over a period of time, or as the result of a sudden trauma, has the ability to disrupt and suppress the thyroid system. According to Dr. Lowe, the resulting system-wide metabolic malfunction is the root of the fibromyalgia and chronic fatigue manifestations. This is a subtlety that many doctors and endocrinologists fail to take into account. If you want to delve into this theory further, Dr. Lowe has written a book entitled The Metabolic Treatment of Fibromyalgia. It is geared towards those in the medical profession, but you may want to buy yourself a copy. There are some very positive reader reviews on Amazon.com.

This theory of the onset following a trauma really makes sense to me personally.

Indeed any type of surgery can be traumatic in a physical sense. A hysterectomy, especially one that includes removal of one or both ovaries can be traumatic emotionally. Within months of my hysterectomy, I was experiencing nearly all of the symptoms of fibromyalgia, which I accepted as part of sudden menopause. Most everything that I read substantiated this belief and I was resigned to accept my new stiff and aching body! Thankfully, in my case, a caring nurse practitioner allowed me to try a very small dose of Armour thyroid medication over a period of a few weeks. As I reported in a previous post, this improved the severity of my symptoms and I am now taking the medication daily. Of course, this is by no means scientific proof and is merely my personal experience. However, it sure looks like more than coincidence in my situation.

Be sure to check out The Fibromyalgia Research Foundation web site and print some things off to take along on your next doctor's visit. If you have a physician who is open-minded, they will be glad you did.

Mary J. Shomon, author of Living Well With Chronic Fatigue Sydrome and Fibromyalgia

Patient advocate and writer Mary Shomon has written several wonderful books centered around the topics of thyroid dysfunction, metabolic disorders, autoimmune disease and weight loss. I love her informational page on About.com. Mary is not a medical doctor, but began researching these issues passionately as a result of being diagnosed with Hashimoto's Disease in 1995. I can relate to her frustration in not being able to find solid, hopeful answers through traditional medical channels. Shortly after my hysterectomy, I had so much information swimming around in my head...and books and articles piled on my desk...that I felt compelled to creat a natural women's health website devoted to menopause. View it here, if you are interested in some other menopause topics. But, I digress...

Right on target for today's post is her book written in 2004, entitled Living Well With Chronic Fatigue Syndrome and Fibromyalgia. As it turns out, many of the symptoms of menopause-- brain fog, weight gain, difficulty sleeping and joint/muscle pain all over the body--are also symptoms of a slow thyroid (hypothyroid). So is there a connection between menopause and thyroid dysfunction? A lot of experts out there are saying YES. In my own personal health struggles, this makes a lot of sense.

After reading what Ms. Shomon had to say, and digging into various other articles and alternative health books, I asked my nurse practitioner to consider the possibility of sub-clinical hypothryoidism. What does this mean? Well, when I went to a yearly physical about a year after my hysterectomy, the doctor ordered the routine blood tests. The results showed my thyroid function to be in the normal range. Problem is, that range may not be normal for me, nor for a lot of other women! There are numerous experts and medical practitioners who accept the premise that some of us may feel better and function better at a different number. Thankfully, my nurse practitioner agreed to allow a trial period on a very small dose of thyroid medication (Armour). I am far from feeling 100% again, but I can't tell you how amazed I am at the difference from then to now. It has helped my brain fog and the water weight gain for sure. Time will tell what other positive changes will occur.

I could go on and on, but will stop for now! We will pick up this topic again soon. In the meantime, check out these tremendous books:

Fibromyalgia Syndrome and Menopause

Hello and welcome to my blog. I am in menopause due to a hysterectomy three years ago. I was 38 years old... and WHAM!

Sudden menopause.

Hot flashes, memory problems, weight gain and unusual joint and muscle pain. My best friend had a hysterectomy in her early thirties. Same thing with her, only the joint and muscle pain is profound. So I'm wondering what the link is between menopause, hormone changes and the misery of fibromyalgia. Turns out there are a lot of theories. I will work on posting them here over the next few months. Let me issue a disclaimer: I am not a medical professional. This blog is not intended to diagnose, treat, cure or take the place of your medical doctor's advice. And, please don't post comments trying to diagnose, treat or cure... Sorry, that's the rules.

Okay, that said, let's jump into the nitty gritty of this fibromyalgia/fatigue thing.

I look forward to getting your input.

Definition:
Fibromyalgia is a syndrome (set of symptoms) characterized first by diffuse muscular and joint pain, with no particular origin or identifiable cause, accompanied by fatigue and compromised immune system function. The most identifiable characteristic of fibromyalgia is that sufferers have "tender points"--up to eighteen points on the body that are unusually tender and painful.

Symptoms include burning, stabbing pain in the back, neck, shoulders and back of the head, fatigue, stiffness, which is usually worse in the morning, headaches, unrelenting insomnia, anxiety, heart palpitations, impaired coordination and memory problems. Some sufferers also report bouts of anxiety, depression, dizziness and dry eyes/mouth.

Fibromyalgia is closely related to Chronic Fatigue Syndrome, which manifests with similar symptoms. CFS's primary symptom is profound fatigue; muscle and joint pain is secondary. The two disorders are often misdiagnosed and are sometimes difficult to differentiate from one another.

Just last week, I ran across a fascinating story about Martin Pall, Ph.D. He has written a brand new book, linked here: Explaining 'Unexplained Illnesses': Disease Paradigm for Chronic Fatigue Syndrome, Multiple Chemical Sensitivity, Fibromyalgia, Post-Traumatic Stress Disorder, and Gulf War Syndrome

What is the theory?

Dr. Pall, who is has a Ph.D. in biochemistry, has concluded that a potent oxidant compound, peroxynitrite, may be the culprit in a number of diseases and syndromes. He has worked in collaboration with the supplement manufacturer, Allergy Research Group, to create a specific line of anti-oxidant nutritional formulations to assist in down-regulating the oxidation response.

If you care to wade through a very technical article, here is one of interest, regarding Dr. Pall's
biochemical theory of Chronic Fatigue and Fibromyalgia:

http://www.ei-resource.org/Articles/cfs-art12.asp

Until next time...best regards.