Bio Identical Hormone Replacement Therapy

Started in the first Year of Fibromyalgia

"Protection and Healing"

The sad thing about being sick is that too few doctors will check your hormone levels.   In 2008, My OBGYN recognized my problem just with a quick discussion.  He initially only focused on estrogen and progesterone, but that was a start.  Thank goodness for his frankness.

Hormone levels can be severely impacted by inflammation.  LDN reduced my inflammation and increased hormone levels immediately.

It is likely that LDN and hormone supplements are BOTH increasing hormones in the body, so there is some overlap in the function.  This explains why I lived well with higher hormone supplements and no LDN until 2013.

Since MANY things affect thyroid levels, hormones will vary with diet and hormone supplements.

Thyroid Fix:  For the purpose of this post, let's assume your thyroid levels are at least in normal range.  My normal TSH turned out to be around 1.0 to eliminate Fibromyalgia pain.  That's just me.  A typical endocrinologist would say that is too low.  They might stop supplementing when the TSH is much higher.  Higher TSH doesn't work for me.

I have also heard that high T4 is important for Riboflavin conversion to an active form -- this drives several metabolic cycles within our body that drive key functions.  (See MTHFR.net and Dr. Ben Lynch for more information.)  Low T4 has also been linked to cancer.

My Thyroid Hormone supplement is Natural Desiccated Thyroid (T4, T3, T2) and is considered bioidentical.  I added some T4 with Tyrosine to move my Free T4 level into the midrange of normal.

Another source recommended the following tests with the thyroid panel:

TSH, Free T4, Free T3, Reverse T3, Total T3.

Estrogen, progesterone, testosterone, DHEA, FSH, LH, Cortisol, Vitamin D, Blood Sugar, Insulin and HA1C.

Cholesterol testing can be helpful as mine is always abnormal when my thyroid hormones are low.

I test for Prolactin too since I am using Risperdal.

So, if the thyroid hormone is high enough, your body functions better.  I continue all my bioidentical hormones at the same level since starting LDN.

Bio-IDENTICAL HORMONES

Estrogen:  Estradial was very low after menopause.  I have been using daily bioidentical topical gel (about the size of a sunflower seed)  to avoid any impact to digestion.   Prescribed by OBGYN.  Confirmed by hormone specialists.  Reconfirmed by OBGYN in 2015.  No need to supplement with any other form of estrogen.

Progesterone:  I use bioidentical topical, and OTC.   I use this at night to help with sleep.  Amount to use was determined by OBGYN.  Confirmed by hormone specialists.  Reconfirmed by OBGYN in 2015.

Testosterone:  I use a bioidentical topical prescribed by OBGYN.  This was added when I tested near zero.  This can be affected by other drugs.  My fibromyalgia pain medicine may have been impacting this.  Testosterone is a key to healing and well being.    Check out the Wikipedia page.  Several 2014 studies support testosterone as preventative for rheumatic autoimmune disease.  Testosterone also helps with inflammation.  It is FDA approved for men, so I use a large pump, but only dispense a small pea sized amount.  I found a generic version for $300 at Walmart.  Reconfirmed by OBGYN in 2015.

Pregnenolone:   I added this in 2013, years after the other three above to help with skin dryness.  I used a dab topically for two years.  I now use 20 mg Pregnenolone pill daily.  This is OTC.  No one recommended this, I was just experimenting and found it to work well.  A recent visit with an OBGYN in 2015 confirmed this dosage for adrenal fatigue.  All my skin problems disappeared when I added this hormone.

I have heard that the Pregnenolone supplementation is dangerous because you don't know what pathway pregnenalone will follow when it converts to other hormones in the body.   However, one doctor speculated that I was hypo-pituitary, so my body is not signaling to make enough hormones.  I used a sex steroids flowchart from Genova Diagnostics to estimate the impact.  Since it had an immediate effect on improving my skin (that was looking like a 90 year old's), and had NO other visible side effects, I have kept using this.

Prolactin:   Risperdal stimulates the production of this.  I can use as little as .25 mg Risperdal to improve sleep and reduce food reactions.  Prolactin is an immune modulator.  At 1.0 mg Risperdal, I do not have any significant ADD symptoms, so I believe it is also helping to manage inflammation.
Very high levels of prolactin seem to cause other autoimmune diseases.

My OBGYN told me that my liver should filter any excess hormones.  I take a day off hormones on Sunday to "clear hormone receptors".  I usually have a hot flash during that day off.

It is possible that the LDN is improving my body's ability to produce hormones since 
-- I don't see as much difference on my HRT day off -- (I don't do hormones on Sunday to clear receptors)
-- I had many higher libido-related responses to LDN
-- I have much better energy throughout the day, possibly a link to cortisol cycle improvement
-- LDN may be helping with thyroid hormones that drive the metabolism and make the body work more efficiently

Some functional medicine practitioners warn against HRT, but they are not usually working with peri or postmenopausal women.  Others say it is the only safe way to move into our postmenopausal years as many diseases correlate to these low hormone years.  See my 2015 post on the Medscape article that correlates MANY autoimmune diseases to low hormone levels.  I can only say what is working for me.  I plan to stay on Bio-HRT.

UPDATE:  I have since learned that low progesterone will hamper thyroid hormones.  As the progesterone falls during exposure to toxins and menopause, your thyroid hormones will not work as well.  My internal medicine doctor at the time did not check any of my hormone levels.  Some of my thyroid problems were resolved with adequate T4/T3 and progesterone.

AUTOIMMUNE UPDATE:  My recent PUBMED searches on sex hormone replacement and autoimmune is showing that low hormones (including testosterone) are related to autoimmune disease.

Non-thyroid supplementation costs me about $1.00 per day.  My thyroid co-pay is about .25 cents per day.

The bioidentical hormones were working so well that I may have never moved on to LDN.  This year I had an intestinal infection while the endocrinologist was lowering my thyroid supplement by 40%!  That combination sent me to an autoimmune flare full of symptoms, and I knew I had to do something.  Now I know that LDN was a logical next step for all autoimmune.

Most people cannot even tell I have any health challenges at all.  That makes me smile. :-)