Hoosierfan

Thanks all for the good info. Had a good appt w/ my OBGYN today and he suggested I try Necon .5 / 35, and take it continuously (no "dummy pills") so that we even out my hormone levels and my cycle stops. Here's his theory....that I have such high peaks of estrogen (given my genetic issues that make me estrogen dominant) and then "crash" to a low level before my period, that it is directly connected to my bp tanking -- estrogen does bind and make florinef more effective, so his theory is that when I started florinef therapy 2 years ago, my adrenals started to downshift their aldosterone production. No problem except when I've tried to reduce the florinef and I have low bps right before my period....since there is so much less estrogen at that time in my cycle, the florinef is less effective. (I also get really severe PMDD because I'm coming from such a high estrogen level to low). So, the two choices seem to be either adjust my florinef around my cycle, or try and even out the hormones so they are at the same levels all the time. The first is counterproductive to my long term goal to be off florinef (I'm usually not on it), and the second hits two birds with one stone -- PMDD and the low bp. Going to meet with my integrative doc tomorrow to go over my OB's suggestions, because I don't want to upset the apple cart. But if this makes things better.....

I should also note that right now the only thing my holistic doc has me doing to counteract the high estrogen is eating cruciferous veges every day, eating whey protein, and taking a supplement called methylguard (basically a whole lot of Bs) that is supposed to help my body process through the excess. But, even with these measures I still had a lot of lows and lightheadedness right around days 19 - 25 of my cycle, which is when I get my estrogen peaks.

Fire, thanks for the articles...taking these to my docs tomorrow. And squirrel, thank you to. Now I get it, estrogen = more NOx = more vasodialation. In my case, b/c I'm estrogen dominant, my bp goes down and the florinef just isn't enough to counteract it. So, it seems like progesterone only pill is the way to go and maybe regulate my cycle. I have a couple of books on hormone health and am reading them this morning -- seems like natural progesterone compounded is the way to go. But they talk about it as a supplement, not as a way of stopping your cycle. Hmmmm.... I have appointments with my OB tomorrow and my holistic doc on Thursday, so I will report back on what they tell me about estrogen, progesterone, stopping my cycle, options, etc. so that everyone can have this information. Thanks again, this board is invaluable!!!

I posted this on another thread and didn't get a response, so hopefully some one will chime in so that I can have an effective doctor's appointment later this week.... Ok, I need a kindergarten explanation of this. Is estrogen a vasodialator or vasoconstrictor or neither? And the same for progesterone? My hormone tests just came back and I am off the charts estrogen dominant, and a little low on progesterone. My bp tends to tank right around when my estrogen peaks and continues until my period. So, my thought was that estrogen was a vasodialator and that the best treatment for me was the progesterone only pill ---- but then when I research it seems it is the other way around (estrogen is a vasoconstrictor and progesterone a vasodialator). I'm totally confused!!!! I'm meeting with my OB and my holistic doc to go over my test results next week and I was inclined to say "hey, let's try and stop my cycle with the mini pill or MIrena," but now I'm confused -- would this make my bp LOWER?? I have NMH -- hypotension -- not POTS -- so if we do anything with my cycle I need something that will bump me up. Thanks all!!!!

My holistic doc and PCP have suggested that I wear compression stockings to help with the hypotension around my period (and as I've gotten off Ativan.....long story, but it has sent my CNS into a tailspin!). I have a Jobst 15-20 mm/Hg pair (waist high) and I used to find that they helped a bit, but now it seems like they are not helping at all (I've worn them the past few days and still hovering at 95/55 -- grrrrrr). Wondering if maybe I should step up to 20-30 pair??? I've only been diagnosed as having NMH, hypotension -- not POTS or as having pooling problems. So, I don't know if I should just bite the bullet and buy a pair of higher stockings. For those that have tried the various strengths, do you see a big difference?? I should also say that I've had these pair for about 6 months, wearing them 3-4 days a month -- it may be that they are just wearing out, so I did order a couple of new 15-20 pair yesterday. Just wondering if I should step it up. Really would prefer not to raise my meds (florinef, etc). Thanks, all!!

I'm still struggling with my bp tanking before my period -- it seems that it is hormonal related and we are trying to correct that, but in the meantime I thought I would try and add some licorice root to my repertoire. (I'd rather not increase my florinef b/c it gives me headaches). I'm curious how much people take to find it effective....Rama, anyone?? My whole foods store only carries 450 mg capsules. I've tried 1 per day the last couple of weeks and don't see a difference, so I'm wondering if that's just too little. As always, thanks for the input!!!

Ok, I need a kindergarten explanation of this. Is estrogen a vasodialator or vasoconstrictor or neither? And the same for progesterone? My hormone tests just came back and I am off the charts estrogen dominant, and a little low on progesterone. My bp tends to tank right around when my estrogen peaks and continues until my period. So, my thought was that estrogen was a vasodialator and that the best treatment for me was the progesterone only pill ---- but then when I research it seems it is the other way around (estrogen is a vasoconstrictor and progesterone a vasodialator). I'm totally confused!!!! I'm meeting with my OB and my holistic doc to go over my test results next week and I was inclined to say "hey, let's try and stop my cycle with the mini pill or MIrena," but now I'm confused -- would this make my bp LOWER?? I have NMH -- hypotension -- not POTS -- so if we do anything with my cycle I need something that will bump me up. Thanks all!!!!

Yeah, its a "detoxification" issue. I doubt that a GP would be familiar with it, and maybe not even a Gyno or an Endo -- I started seeing an Endo the same time I got in with my functional / holistic medicine doc, and when I told him about the detoxification testing my doc was doing to look at hormones, he looked at me like I had 5 heads. But, maybe some more sophisticated Endo's might be familiar with it (I've since dumped that Endo). I'll try and simplify it, but basically your body produces estrogen (and any natural substance) and it has to go through 2 phases of detoxification -- first phase is where the estrogen gets oxygen added to it (this is where you hear the term "free radicals" or "antioxidants"), and then in Phase II your body produces enzymes that break down the estrogens. There are several different types of estrogens. The genetic tests can show you if you produce the necessary substances to convert the estrogens into the estrogen + O, and then convert the estrogen + O in a form where the body gets rid of it. In my case, I don't get some of the estrogens past Phase I (so I have high estrogens), and then I ALSO lack the enzyme that converts them past Phase II (so I end up with a lot of oxygenated estrogens running around). So I get a double whammy, b/c both are not good to have. The specific tests my functional medicine doc ran were from Genova Diagnostics -- first was a detoxification profile, which gives you the base genetic info. Second was an "Essential Estrogens" test, which shows all the different types of estrogens in my system and was a one day urine test. Now we are running a Rhythm Test -- which shows all your hormone levels (estrogen, progesterone, testosterone) over a 30 day period. PM me if you want and I can send you the graphs my doc gave me from the test results -- it's a little complicated!!!

This is the testing that I'm doing with my integrative / functional medicine doc right now and Lyn is right on. Cholesterol is the beginning point. In my case, my tests so far show that I am estrogen dominant, and then I have a genetic defect where my body doesn't detoxify the estrogen correctly -- if you will, the estrogen gets "stuck" at high levels in my body b/c I don't produce the enzymes that break it down and get rid of it. So far, what my holistic doc has me doing (until we get the full cycle test completed) is: (1) eating 1 c. of cruciferous veges a day; (2) eating a serving of whey protein per day; and (3) taking Methylguard (a supplement of Bs). The veges, protein and Bs are precursors to, and help my body produce, the enzyme that is lacking. So, ahead of starting any hormones, this is another avenue to discuss with your doc. I've been doing it for a month now and I can't say I see any improvement yet, but I'm also in the midst of Ativan withdrawal (eeeeek!), so even if it was helping I wouldn't notice. I should know more and can report back more in the next couple of cycles.

Diamond, I just saw also that you are on Klonopin -- know that benzos interfere with your hormone levels. I was on Klonopin awhile back and when I tapered it, my period was reactive to that tapering. I was put on Ativan earlier this year (BAD mistake), and my PMS symptoms just got worse -- from a little fatigue and a headache to being debilitated for up to a week. I'm off of it now, and hoping I'll see some improvement, but as I said my doc is looking into my levels just the same.

Diamondcut, I'm looking into this issue right now with my holistic doc -- going through cycle hormone testing. We've already done a snapshot test and discovered that my estrogen levels are high; now we are looking at the whole cycle. I don't have POTS, but NMH, and my symptoms get really bad right the same time yours do -- headaches,dizziness, bp tanks, fatigue, etc. I'll keep you posted on what my doc recommends and if you try the progesterone and have some success with it, let me know!

Janet, do keep us posted. I don't have POTS, just NMH, but my bp tanks just before my period and a couple days into my cycle. And the moodiness, hot flashes, crushing fatigue and lightheadedness is putting me in bed. So, my holistic doc is really concerned that my cycle is taking such a toll on me. We're in the testing phase right now, so I'll keep you posted on what my doc has said as well, and maybe we can exchange ideas, etc.

Read that rosemary may help up bp, and also licorice root powder (which I know several on this forum use anyway). Thoughts? I'm already on florinef...tried to get off a couple of times earlier this year and crashed....ugh. Long story.

Thanks for all the feedback on this post; it really helps. Curious if anyone who responded went through comprehensive hormone testing BEFORE the hyster or the hormone treatment. My holistic doc and I are working on two -- one was a snapshot estrogen test (pee in a cup one day a month), the other one is looking at all my hormone levels over my cycle.

Thanks, Sue. I hate beets anyway so that one is out to begin with!!!! I've also seen garlic and pomegranate juice as no - nos; but stil haven't seen anything that I should INclude.

My holistic doc who I have been seeing for the last couple of months is trying to improve some issues through my diet, most importantly getting in more leafy greens and cruciferous veges -- since I have picky eaters in the house and am not one to sit down to a bit kale salad, I've decided to start investing in juicing..... There are a few threads on here lauding the benefits of juicing, and that plus internet research has led me to be THOROUGHLY CONFUSED!! I have NMH (not POTS), but in general I want to try and include ingredients in my juice that will RAISE my bp, not risk lowering it. (of course, all of the juicing books have recipes for hypertension, but not hypotension.....rrrrrggggg!!!). So for those who have juiced (and in particular green juiced), can you give me an idea of ingredients (veges, fruits and herbs) to include and those to avoid? Don't want to make my hypotension worse!!!

I'd like to know as well, since I haven't had a response to my hormone question posted earlier this week!!! I don't have POTS, just NMH, but doc thinks that my symptoms are worse around my period b/c of excess estrogen. We joke about pushing me into earlier menopause, but that might be on the table if it would be effective!!!

It's been awhile since I've posted, mostly because the last 3-4 months have been really rough on me (long story, but Pdoc stuck me on Ativan and it's been a nightmare being on and getting off) In any event, I'm seeing my holistic doctor who is looking for a cause as to why my marginal bp (usually 100/60) tanks and I get hypotensive right before my period (say, 4 or so days before until about 2 days into my cycle), along with other horrible pms symptoms. Has anyone here who is hypotensive (or prone to episodes) been treated with hormones (either for the hypotension directly or independently) and what have been your results? So far testing has shown that I am high in various estrogen levels, so my holistic doc is wondering whether the higher estrogen may cause hypotension. We've just done a snapshot (i.e. 1 day) test; we're working on the 30 day cycle test right now. Any input / knowledge that the ladies could help with would be greatly appreciated!!

Hi all -- just got a call from the endocrinology office I had an appointment with in late July and they are moving UP my appointment to next week (shocker!). My chief purpose for the visit is to get a handle on what is going on with me hormonally and endocrine (read: adrenal) wise, and why it's been so hard for me to get off the Florinef (after using it for almost 18 months now). And hopefully some suggestions on how we can taper and WHETHER we can taper. Never been to an endo before, so what should I be asking and are there any tests I should insist on? My integrative doc just ran an adrenal cortex stress profile (saliva) so we are awaiting the results of those.

I'll put in my 2 cents even though I don't have POTS, just NMH (neurally mediated hypotension). I take Effexor XR -- important to note that it is a SNRI, not SSRI (N stands for norepinephrine). I've been on it for about 5 years and it has really helped keep my bp up, and also keep my bp regular. Interestingly, I'm just starting to learn WHY the Effexor is effective now that I've started seen an Integrative / Functional medicine doctor. Here's what he told me about what's going on with the microbiology: (1) Serotonin, in general, keeps your vascular system more regulated so that it fluctuates less (read -- constriction and dilation are less dramatic); (2) Serotonin in your blood causes your adrenals to produce more aldosterone (i.e. the stuff florinef mimics), so higher bp cause you are retaining more salt, fluids; (3) Norepinephrine can be a vasoconstrictor (again = higher bp); (4) norephinephrine is a catacholamine, which is a group of substances produced by your adrenal glands...one of the important functions of catecholamines is to help the body dispose of natural substances it produces, like estrogen...less norepinephrine can equal excess estrogen in the body, which can lead low bp, depression and anxiety. This last one is one thing they are specifically looking at with me since my bp has significant fluctuations at the same time in my cycle....

We did talk diet briefly, but he was more interested in why I've been having such trouble adjusting to meds, why I've been unable to taper the florinef, and why my cycle throws a kink into everything. We'll get around to diet, I'm sure, but for now he's worried about the "bigger" issues that are impacting my functionality in serious ways.

Happy to report that my appointment with the integrative / functional medicine doctor on Thursday was really productive. He was actually interested in getting at the source of my symptoms, rather than just treating the symptoms themselves. So, he's trying to figure out why I have NMH in the first place. Looking at possible enzyme deficiencies (that might result in me not breaking down excess bodily substances, like estrogen...too high estrogen = low bp) and possibly adrenal issues (basically that 17 months on florinef plus all the other stuff going on has done in my adrenal system, so no longer producing either aldosterone or catecholamines; and apparently catecholamines are crucial in ridding the body of excess estrogen, so again, if low on those, estrogen too high = low bp and really low bp before my period). Going through some testing over the next couple of weeks..... He had a couple of recommendations until we get the testing done, 1 c. of cruciferous veges per day to take care of the enzyme deficiency. He also recommended 400 mg of magnesium glutamate (b/c I've been on PPIs for awhile). So, took the magnesium the last three days and my bp has been REALLY low (down from avg of 105, to this morning 91/53, my danger zone). Got on here and google and discovered the magnesium can lower bp (oooooooppppppsss, not good for me). So, guess I'm ditching that supplement!! I assume you guys would agree that the mag might have caused the low readings???

Hi all. I'm due for my first appointment with an integrative health doctor on Thursday, and I'm pouring over my records of the last year trying to put some of the pieces of the puzzle together for him. I'm trying to explain the source of jitteriness that I have -- basically feels like someone plugged me into a low voltage wire, and so its like I constantly don't know what my blood pressure, etc. might do. Really hard to explain -- almost like the "shakes." My Pdoc has more than once dismissed it as "anxiety," but I know what anxiety feels like -- this is more physiological. And, it seems to have started when I started to taper from .1 of the Florinef in January. At different doses the jitteriness has been better or worse, but it all seems to have started then. And, it gets worse around my cycle. Could Florinef be the culprit (i.e. too little)? I know when I go UP on Florinef, I get the same sensation (x100) for a couple of days but then it calms down. This is almost the reverse, but is constant. My PCP seems to think my florinef dose is ok because my bp has been doing fine on my current dose (most often 100/60 - 105/65), and was even ok around my cycle this month (yes!). But I'm wondering if that is a good measure to go by or if this jitteriness I'm getting could be that my aldosterone and / or cortisol levels are off......any thoughts, input?! Thanks, as always

Thanks, Issie. I was just thinking that in addition to the list of the meds I take that they asked for, that I'd give them the schedule I take them on (seems like every hour I'm taking something), but then I thought that was overkill.....now that you mention it it may not be overkill cause who knows how all these little things interact!!!

Getting in to see a complementary / integrative doc in a week and a half (yeah!) to try and get a better handle on the following: (1) My NMH and the root cause (serotonin deficiency, adrenal deficiency, other) and the "kink" that my menstrual cycle adds into the whole thing; (2) why I'm so darn sensitive to meds and why I can't seem to taper off florinef or SSRIs (florinef being of concern for the moment) (3) ongoing tummy upset and alternative ways to address (taking prilosec and carafate now, but still bothering me after 6 weeks) (4) best way to manage daily headaches caused by florinef if we can't get off or have to take a Looooooooooong time for me to get off (meaning the next year or more). Any suggestions on how to make the best of this appointment, what tests to ask for, what to take with me? My first appointment is 90 minutes (woah!), so there's a lot of time to discuss....