You certainly are on a lot of hormones – thyroid, estrogen, progesterone, testosterone and oxytocin. I don’t know your full history with lab results and haven’t done an exam, but my question is: “Why isn’t your body able to make what’s necessary?”; and “If your body is making what’s necessary, why do you still have so many symptoms?”. Of course, there are cases where bHRT is warranted…
As far as the TSH, 3.5 is within normal limits based on the labs I see and use. A good range for TSH is 1.8-3.0, but regardless, prescribing thyroid hormone based on symptoms and a TSH of 3.5 is a bit much in my opinion. It doesn’t sound like the cause of your thyroid imbalance has been determined.
That said, has the cause(s) of any of your imbalances been determined? Have you simply been prescribed hormones because of your gender, age symptoms, and hormone lab values? I understand that hormones can help and be necessary and get people out of a crisis… That said, I’m not saying the wrong treatment was given, I don’t know the whole story.

I’m not familiar with using massage oil for hot flashes or adrenal fatigue. And even if they do provide some help, the cause of your hot flashes and/or adrenal fatigue is certainly not a lack of being massaged with a particular oil. Again, it’s great if it helps, but it really sounds as if you need to figure out what’s causing the issues that are surfacing.

As far needing to increase the dose to maintain symptom relief – I’ve seen that be the case, but it won’t always work in the long run. I’ve seen it mostly with thyroid, testosterone and progesterone replacement. However, one can’t simply increase these doses forever. Somewhere along the line the person reaches a tipping point and increasing the dose doesn’t help. The reason for this is because the underlying issues were never dealt with.
In cases similar to yours, I’d be searching for some causes to these symptoms and wouldn’t be comfortable with a physician prescribing (many) hormones simply because the levels are low (and/or because of age, gender, and symptoms).

I hope this helps,
Dr. Rob D’Aquila

First, you should wait and see what the results show and then decide if you’re comfortable and able to implement his treatment plan.

Issues with weight loss could be related to cortisol or thyroid hormones. Also, with the history of PCOS, you may elevated testosterone and blood sugar imbalances.

See my most recent article on this topic by clicking here: http://robdaquila.com/2012/04/23/blood-sugar-imbalances-can-alter-estrogen-and-testosterone-levels/

Good luck,
Dr. Rob D’Aquila

HRT should not be disrupting your sleep. It sounds like you need to dig a little deeper and also get your hormone levels checked.

Also, sometimes the thyroid is the culprit with being overly emotional and crying for no apparent reason.

Take care,
Dr. Rob D’Aquila

I started seeing a natural doctor, Dr. Cushing. He is great and has opened my eyes to alternatives. I am 45 years young and its been challenging to lose weight for a long time. I was diagnosed with PCOS around 18 years old or so… Anyway, I have been trying to lose weight for about a year now and I lost around 25 but I keep gaining 10 or so back. I cut down on the “bad” carbs (white rice, pasta etc). I have not eaten red meat since 85 and just stopped eating chicken 2 months ago (I was just tired of it).

I met with Dr. Cushing and he said that based on our conversations he feels that my hormones have something to do with it so he ordered a saliva test. Now, I am anxious because I dont want to take any type of synthetic or bio-identical hormones. His choice is neither of those by the way. Im assuming he will treat whatever it is naturally. I just dont know what that may be…how or what he will do. Im just frustrated….

Any ideas or suggestions?

I have been lost and confused about what to do about peri-menopause symptons, the worse being overly emotional and basically crying for 3-4 days for no real reason.

I thought I would try NHRT and since starting it 10 days ago I have been totally exhausted, mainly because I just can not get to sleep. I am not a good sleeper but this is not normal for me.

Does NHRT do this as I thought progesterone helped with sleep.

Now I feel flattened and not sure where to turn.

Thanks

Jude

You’re welcome.
Your endo is clearly focused on pathology and not functional medicine, as so many endos and MDs are in general.
And your endo recommended an anti-depressant??? On what grounds? Have he measured that you’re low in serotonin or norepinephrine? I wonder why that’s suitable without a diagnosis of clinical depression (and presumably no lab testing) however functional adrenal fatigue is not. Adrenal fatigue can at least be measured via saliva – although there probably isn’t a standard diagnosis code for the insurance companies and medical profession, and so it is ignored. The questions above are rhetorical…

Blood levels of cortisol (especially one sample) is about as useful as a screen door in a submarine – UNLESS there is pathology. Again, saliva is the way to go when it comes to functional adrenal issues (4 samples throughout one day). He probably doesn’t see any need for saliva because he is not familiar with it and doesn’t know how to interpret it. Bear in mind that I am in no way mocking your endo. I’m sure he’s smarter and more experienced than me. It’s just that we do two different things – function vs. pathology.

Ferritin at 55 is OK – TIBC and other RBC markers should be evaluated as well, however. If you are anemic in anyway, you can’t expect to get very well, because that would mean that your cells are deprived of “the most” important “nutrient” – oxygen.

I don’t recommend that anyone eat soy or gluten. Dairy is OK on a case by case basis in my opinion. However, when it comes to protein, I recommend meat, i.e. beef, fish, chicken, turkey, pork, lamb, eggs, etc.. Again, I can’t ever recall seeing a vegetarian with balanced blood sugar and healthy adrenals. And every time I see a patient in that state begin eating meat, they get better and never go back to being vegetarian because they feel so much better. I know it’s tricky with morals and just the thought of eating animals for some people. I’m just going with what I see and basing it on physiology.

I can’t say why you’ve had problems as a child despite eating meat. There are many reasons for blood sugar imbalances. And I’m certainly not suggesting that eating meat “fixes” blood sugar imbalances. I see plenty of people with blood sugar imbalances that eat meat – probably more, because I see more people who eat meat. However, I still rarely or never see people who don’t eat meat (or at least an adequate amount of protein) with healthy blood sugar. And what I’m saying is that from what I see, people that don’t eat meat don’t get enough protein – often because carbs are substituted for protein.

For all I know, you’re better off without meat. It could be something else driving your blood sugar issues, and low blood pressure issues (and presumed adrenal issues). Infections, nutrient deficiencies, emotional stress, and food sensitivities are just a few other issues that can adversely affect blood sugar. It’s very difficult for me to know what’s going on without seeing labwork and going by comments alone. I’m sure you understand.

I hope this helped at least somewhat.

Good luck with everything,
Dr. Rob D’Aquila

I can’t say that HRT is recommended because of the prolactinoma. Also, it sounds as if you have that under control by saying that the levels are only slightly increased.
Generally speaking I would agree with your endo in saying that you are not automatically a candidate for HRT simply because you are experiencing peri-menopausal symptoms.
My assumption, without seeing the entire picture (including labwork) would be that you need to get your general health in order. Those with weak adrenals tend to get the worst symptoms going into menopause. Based on your saying that you have “rather low blood pressure” and have been a vegetarian for 25 years leads me to believe that your adrenals aren’t up to par.
Also, I very rarely see vegetarians that don’t have adrenal stress. This is usually due to blood sugar imbalances caused by a lack of protein. I can’t say for sure, but that is what it sounds like.
If you were my patient, I’d have all your hormone levels (including adrenal) measured via a saliva test, in addition to extensive blood work and take it from there.

My best,
Dr. Rob D’Aquila

I’m 46 and I have a micro prolactinoma, which is since few months treated with some ayurvedic herbs and rosemary essential oil, because I couldn’t tolerate the side effects of Cabergoline anymore. My prolactin level is now only slightly increased. I also have a hypothyroidism, I’m taking 25 mg L-thyroxin. Since last summer I have strong peri menopausal symptoms and my period is very irregular, with skipped cycles and extremely strong PMS. I have no libido anymore, which is causing problems in my marriage,also the problems with the bladder after intercourse, which is totally new symptom for me. I have insomnia, strong mood swings, fatigue and sometimes anxiety plus depressive moods. I can’t recognized myself anymore. I’m already visiting a therapist, but it don’t really help me.
So I’m considering some form of (B)HRT to get some life quality back again. I’m vegetarian since 25 years, I drink no alcohol and no caffein, I’m slim, I have rather low blood pressure, I’m meditating, practicing yoga, trying to avoid sugar and processed food. I have varicose veins, but not bad.
Regarding to my endo as long I have my periods I don’t need any estrogen or progesterone. But my symptoms are making my life so very difficult at the moment, that I can’t just wait till I’m menopausal…
It’s in my case ( prolactinoma) a HRT recommended? I don’t know what I should change in my life style to get some improvement. In my country the BHRT is still not very known, but I would definitely prefer bio identical hormones. I took the birth control pill only as a young woman, for 3 months and I didn’t feel well on it.
What would you suggest me?
Thank you!
Diana