Progesterone and LH levels?

macchiatto

@Dragonwolf, @KnitOrMiss or anyone else who's knowledgeable about these things, I'd love a second opinion on my lab work.

Last week I saw my gyn for my long-overdue "annual." Told him I suspected low progesterone (besides having PCOS, I've been having 5 days of spotting before every cycle, I had an early m/c about 3 years ago and I've been having major insomnia for several months. For my sister, this turned out to be related to low progesterone. I am also wondering if I've developed a luteal phase defect). He did a lot of blood work.

When I picked it up today, the nurse said it was all normal but I'm not convinced. Progesterone was 2.2ng/mL and LH was 5.5 m[iU]/ml. It gives the reference ranges for different parts of your cycle. I'm not 100% positive where I was at but since starting keto last year my cycles have mostly been 28-34 days. The blood work was done on CD18 and I believe I ovulated CD22. (I do chart to avoid, but I've been doing it so long I only go by CM most cycles so I'm not temping to confirm ovulation really happened.)

What do you think about my levels? Would you try to do further follow-up even though the nurse said they were normal? I'm really wondering if progesterone supplementation would help. My sister said to avoid the synthetic kind anyway ... are there OTC supps that would be worth trying or should I not mess with those?

Reference range for progesterone for premenopausal females:
Follicular 0.1-1.4 ng/mL
Luteal 3.3-25.6 ng/mL (I think this is where I was, right? Unless it was anov. Or if it was 3-4 days pre-ovulation was I maybe not quite in the luteal phase yet?)
Mid-luteal 4.4-28.0 ng/mL

LH for premenopausal females
Follicular phase 1.9-12.5 m[iU]/mL
Mid-cycle peak 8.7-76.3 (Think I was here, but maybe not since it was several days pre-O?)
Luteal Phase 0.5-16.9

On the bright side, my non-fasted glucose (2 hrs after eating) was 95 and insulin was 12.3 so those look good. TSH, testosterone, etc., all looked to be w/in the normal range too.

KnitOrMiss

@stacicali - Didn't you have a chart that might help answer some of this?

Luteal phase begins AFTER ovulation, so you would have been before luteal phase, as far as numbers. So, the did LH, but not FSH? My understanding was those two were always run together... That was the first thing that seemed odd to me. Mine weren't run this time, despite my doc requesting them, looks like it was an incomplete mark as received on the fax or something... My progesterone wasn't run either. It was frustrating, as I was wanting a better picture than the last time, when they only did the estradiol and testosterone, etc.

I can tell you that when I was low in progesterone (like my test didn't even show 0 level, regardless of phase), supplementing bioidentical progesterone cream did not help - as I had an underlying adrenal depletion/dysfunction, and so my adrenaline and cortisol were lacking enough that my body kept stealing any progesterone I gave it. And when I took it, I felt pregnant EVERY SINGLE CYCLE. Morning sickness, cramping, whole body soreness, all of it - every single month, but without ovulation or pregnancy. It was pure he-L-L. We were trying to conceive at the time, and it was just a heart-wrenching every single time. And with no real relief of symptoms.

That being said, your progesterone test seems pretty close to what mine was 2 years ago, but I honestly don't know if that's good, bad, ugly, or what. Seems low, but I've no idea where I was in my cycle at that time... The last tests run though were supposedly good, but ???

So, before I'd agree to any treatment of any kind, I'd get the whole picture, and I forget which other tests it suggests for adrenal function, but there are several.

@macchiatto - You are diabetic, correct? I don't know the best range for PP numbers, but 95 seems low to me. I though the 100-110 range was normal? I don't remember, as my ranges always feel to normal before. As for insulin, 12.3 seems high, but I'm assuming that it is non-fasted, too?

I know when mine (fasted) was a 9, before it came down to a 7, my PCP about had a heart attack because it was too high. I feel best between 5.5-7.5, really, from what I've been able to tell, though it is a very dynamic number, and there isn't a good way to get an average of it, etc. And I have not seen any charts on PP numbers for insulin, etc.

On the TSH, I would just ask what your number is... Optimal ranges have it as below a 2.0 uIU/mL or mIU/L. Most lab tests still say anywhere from 3.5-6.5 can be considered normal, but optimal ranges per most functional or naturopath doctors are 0.5-1.5... I got told I was normal at 4.65, and I was anything but. Even now, I'm hovering over a 2, and the lower I get, the better I feel, and I can always tell when things bump back up a bit, as I start feeling more run down, etc.

B12, D3, Folate, and Ferritin are also crucial to female whole health, so if those numbers weren't run, if you need any follow up stuff done, I'd request those, too. I'm trying to remember what else, but my results are a mess at this point... Hopefully someone else will chime in soon.

Alliwan

What was the range for your insulin test? The one they run on me is 0-24 is normal range, for fasting insulin levels. So a 12.3 would be a good thing. But they might have different ranges on different tests or different testing facilities.

I am not sure about the 95 for blood sugar if you are diabetic. Last time they ran my 2 hour blood sugar test mine was 89 and they were happy with it. So i dont know if its different if you are diabetic.

Id have to dig out my old paperwork from late 2014 when I had my LH and FSH run. I am with @KnitOrMiss. I am not sure why your FSH wasnt run at the same time, that's odd. But your LH numbers look ok for a Follicular phase.

Your progesterone is odd. You are too high for the Follicular phase and too low for the Luteal phase. Mine was low last time it was tested so I used progesterone cream after ovulation and it helped, but I dont have an adrenal issue.

Id have to go look for my paperwork. I had it run after my miscarriage but before my latest pregnancy and my son is now 8 months old, so it may take me awhile to find it. But it helped show my doctor and ob I needed progesterone help when I did get pregnant with my son.

macchiatto

Sorry I took so long to respond. I do appreciate your responses, @KnitOrMiss and @Alliwan.

You're both right; mental slip on my part! Yes, I would have been in the follicular phase, so my progesterone does actually seem a bit high for that but low for luteal. That means my LH is normal, which is interesting since my luteal phases seem short now. Not sure what to make of that. I've tried Progessence Plus (from Young Living) at my sister's suggestion to see if it might help with insomnia. I'm not sure if it's making a difference; sleep has been better, but I'm also taking 2 Benadryl and a melatonin TR every single night!

I am finally due to see my new PCP for an annual physical later this month so I plan to talk to her about this, too.

@KnitOrMiss you're remembering correctly that I have diabetes concerns, but not actually diabetes. Both parents, both grandmothers and one sister all have Type 2 diabetes. I had prediabetes and high triglycerides about 4-5 years ago but I went on a low carb diet, lost about 10% of my body weight and managed to reverse the prediabetes and drop my tri's down to 52. That's definitely something that motivates me to keep weight down and carbs somewhat low b/c I don't want to re-develop that! (My BMI was in the normal range when I found out I had prediabetes, but my dad and his mom are/were both slim diabetics. I always have disproportionate belly fat at any weight and I know that can be related.)

And yes, the insulin was non-fasted, too.

KnitOrMiss

carbsyndrome.com/is-your-brain-two-quarts-low/

Have you looked into this? I know that since you follow a low carb diet, not all of this may apply, but I've found massively improved sleep quality by taking 5-htp with cofactors at night...

Melatonin never worked well for me. I did okay with L-Theanine, which to my understanding - is the one that helps you stay asleep - melatonin helps you fall asleep...but it was expensive alone. There is a decently priced formula here that has both...

Since the high trigs and some of the other factors, especially with being a slim diabetic, it really makes me wonder about the thyroid side of things... Recent info has me rethinking a lot I thought I knew about IR, PCOS, hypothyroidism, and such...how they all relate.

macchiatto

@KnitOrMiss thanks for the link. Interesting info; I hadn't come across that before!
You know, I was trying 5-HTP for a little while and thought it might be helping a little but forgot to re-order when I ran out. What are cofactors? Is there a certain brand you'd recommend?

The melatonin time release seems to be helping more with staying asleep. I had tried some other supplements. The benadryl+ melatonin TR seems to be working pretty well most of the time; it just makes it harder to wake up in the mornings so I'd love to be able to wean off it eventually! (I'd love to figure out if there's an underlying cause that's treatable.)

Interesting about thyroid. My numbers have always seemed to be in the normal range but I've heard sometimes that can be misleading.

KnitOrMiss

@macchiatto

Doctor's Best brand has one with the cofactors, which I think are B6 and C... I'm taking Nutricost brand at the moment, but I'm not sure whether I like it or not. Having the convenience of the cofactors is great... I tried getting them separately, but the doses weren't in sync...

There's a discussion going on in the LCD group at the moment, but I've recently uncovered some issues that are really making me question whether I've been misdiagnosed and actually have Hashimoto's Thyroiditis, as well as my insulin resistance being in some sort of auto-immune form, as well...

Optimal range for TSH is 0.5-1.5 uIU/mL or mIU/L.... Most lab ranges say up to 4 or even 6 is acceptable. My doc said that I should definitely be below 2, and he prefers around 1 with symptom relief...

Melatonin never worked for me, presumably because I was so deficient in vitamin D for a long time that my circadian rhythm was in chaos... But my understanding is that for best use, you should get the brightest light or sunlight you can for 15 minutes upon waking, again in the lunch hours 12-3 pm, and this will allow your body to naturally taper to a decrease in cortisol to taper as melatonin naturally increases, etc.

macchiatto

Thanks for the info!
I'll go look for the discussion in the LCD group. I hope you're able to get an accurate Dx!!

stacicali

Sorry that I'm just now chiming in. I find it frustrating when doctors (or nurses) don't even ask you where you were in your cycle when the blood work is drawn, so I try to double check their findings. Here are 2 sites I've used:

http://www.fertilityplus.com/faq/hormonelevels.html#female

http://www.parenting.com/fertility/ovulation/day-day-guide-to-your-reproductive-cycle