Guidance for 36-year-old female, labs included.

[Charger]

Below are labs for my sister who is in her mid-30s. I am trying to assist her with optimizing her health/hormones. I'm less versed on what the optimal levels for women are and would be interested in advice from other women and the usual reputable posters (@haidut, @Hans, etc.) as far as possible supplementation and dosages. I'm comfortable recommending a D3 supplement for her obviously low levels, but not when it comes to the hormonal stuff like progesterone.

Few notes:
• She was on Lexapro for a year or so, recently came off.
• Has continued to gain weight over the years and is distressed by it, she gained more while on Lexapro.
• Started recently taking Semaglutide to help lose weight. This is one factor where I'd be hesitant to recommend something like thyroid because I'm unaware of the potential interactions. It will be diffiicult to get her to drop it as she has all her faith put into it as the solution.
• She's talked of her low libido, obviously low energy levels, and has mentioned her memory getting worse.

Her complaints such as libido and memory are familiar to me from a few years ago and I've made strides in those areas since finding RPF and would hopefully like to do the same for her as much as I can. I can't expect her to go full OJ and liver but she is willing to try things, any advice is appreciated.

 

[Hans]

Below are labs for my sister who is in her mid-30s. I am trying to assist her with optimizing her health/hormones. I'm less versed on what the optimal levels for women are and would be interested in advice from other women and the usual reputable posters (@haidut, @Hans, etc.) as far as possible supplementation and dosages. I'm comfortable recommending a D3 supplement for her obviously low levels, but not when it comes to the hormonal stuff like progesterone.

Few notes:
• She was on Lexapro for a year or so, recently came off.
• Has continued to gain weight over the years and is distressed by it, she gained more while on Lexapro.
• Started recently taking Semaglutide to help lose weight. This is one factor where I'd be hesitant to recommend something like thyroid because I'm unaware of the potential interactions. It will be diffiicult to get her to drop it as she has all her faith put into it as the solution.
• She's talked of her low libido, obviously low energy levels, and has mentioned her memory getting worse.

Her complaints such as libido and memory are familiar to me from a few years ago and I've made strides in those areas since finding RPF and would hopefully like to do the same for her as much as I can. I can't expect her to go full OJ and liver but she is willing to try things, any advice is appreciated.


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It will work the same with women as men. Fix nutrition and lifestyle. It's that simple. But much more difficult to do as women are usually a lot more picky, etc.

 

[chrstn4o]

Below are labs for my sister who is in her mid-30s. I am trying to assist her with optimizing her health/hormones. I'm less versed on what the optimal levels for women are and would be interested in advice from other women and the usual reputable posters (@haidut, @Hans, etc.) as far as possible supplementation and dosages. I'm comfortable recommending a D3 supplement for her obviously low levels, but not when it comes to the hormonal stuff like progesterone.

Few notes:
• She was on Lexapro for a year or so, recently came off.
• Has continued to gain weight over the years and is distressed by it, she gained more while on Lexapro.
• Started recently taking Semaglutide to help lose weight. This is one factor where I'd be hesitant to recommend something like thyroid because I'm unaware of the potential interactions. It will be diffiicult to get her to drop it as she has all her faith put into it as the solution.
• She's talked of her low libido, obviously low energy levels, and has mentioned her memory getting worse.

Her complaints such as libido and memory are familiar to me from a few years ago and I've made strides in those areas since finding RPF and would hopefully like to do the same for her as much as I can. I can't expect her to go full OJ and liver but she is willing to try things, any advice is appreciated.


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How is her gut function? If not optimal I would work on that as a matter of priority and focus on reducing toxic exposures, detox support with supplements and shedding existing toxic burden with sauna etc. Very often if you improve gut and liver function a lot of symptoms melt away. Oh, yes, and a bunch of liver flushes - that is an absolute game changer. Works well for my female clients that have stubborn weight, brain fog type issues, and fatigue (which is very common). But the trick is to not rush any this, rather gradually dial it up while cleaning up the diet and environment. Hope this helps.

 

[peter88]

Getting daily sun exposure should be at the top of the list.

 

[mostlylurking]

Below are labs for my sister who is in her mid-30s. I am trying to assist her with optimizing her health/hormones. I'm less versed on what the optimal levels for women are and would be interested in advice from other women and the usual reputable posters (@haidut, @Hans, etc.) as far as possible supplementation and dosages. I'm comfortable recommending a D3 supplement for her obviously low levels, but not when it comes to the hormonal stuff like progesterone.

Few notes:
• She was on Lexapro for a year or so, recently came off.
• Has continued to gain weight over the years and is distressed by it, she gained more while on Lexapro.
• Started recently taking Semaglutide to help lose weight. This is one factor where I'd be hesitant to recommend something like thyroid because I'm unaware of the potential interactions. It will be diffiicult to get her to drop it as she has all her faith put into it as the solution.
• She's talked of her low libido, obviously low energy levels, and has mentioned her memory getting worse.

Her complaints such as libido and memory are familiar to me from a few years ago and I've made strides in those areas since finding RPF and would hopefully like to do the same for her as much as I can. I can't expect her to go full OJ and liver but she is willing to try things, any advice is appreciated.


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Vitamin D level is in the ditch. Supplementation is important. Ray Peat advised me to take 10,000 i.u. of D3 daily when my D was at 36. I've been doing that for 3 years now and my D level is very good now. My D had been below normal for many years. I take this sublingual drop.

https://www.toxinless.com/kmud-161118-vitamin-d.mp3

The female hormone tests can be confusing because things are different depending upon the cycle. Here are three Ray Peat interviews about progesterone and estrogen that are very informative:

• Politics & Science: Progesterone Part 1
• Politics & Science: Progesterone Part 2
• Politics & Science: Progesterone Part 3

I do remember that Peat said that a healthy female would have progesterone100 times higher than estrogen, except when the estrogen spikes for a few hours to inflame the uterus for implantation. The three interviews above have very helpful information.

According to the test results, the total cholesterol is low; it needs to be above 200. Cholesterol is protective.

Cholesterol, longevity, intelligence, and health.

Ray Peat

raypeat.com

The Truth about Low Cholesterol – Functional Performance Systems (FPS)

Here's a radio show with Ray Peat about cholesterol:

https://www.toxinless.com/kmud-081201-cholesterol-is-an-important-molecule.mp3

The TSH is above 1 so is too high. Although the T3 is at 27, it is considered low and would be better if it was pushing the top of the "normal" range. The test isn't calibrated correctly so it can be confusing to understand.

Thyroid: Therapies, Confusion, and Fraud

Ray Peat

raypeat.com

Low vitamin D negatively affects the thyroid. Supplementing D would be beneficial.

Vitamin D Deficiency and Its Association with Thyroid Disease

Vitamin D deficiency is a global health problem, its role as an immune modulator has been recently emphasized. The evidence is increasingly pointing towards vitamin D significant role in reducing the incidence of autoimmune diseases. However, at this ...

www.ncbi.nlm.nih.gov

Thyroid function also needs thiamine; a thiamine deficiency will negatively affect thyroid function.

Thiamine and Hashimoto's thyroiditis: a report of three cases - PubMed

As the administration of thiamine led to a partial or complete regression of the fatigue and related disorders, it is reasonable to infer that the administration of large quantities of thiamine restores thiamine-dependent processes. The mild thiamine deficiency suggested by fatigue and related...

pubmed.ncbi.nlm.nih.gov

 

[mostlylurking]

Few notes:
• She was on Lexapro for a year or so, recently came off.
• Has continued to gain weight over the years and is distressed by it, she gained more while on Lexapro.
• Started recently taking Semaglutide to help lose weight. This is one factor where I'd be hesitant to recommend something like thyroid because I'm unaware of the potential interactions. It will be diffiicult to get her to drop it as she has all her faith put into it as the solution.
• She's talked of her low libido, obviously low energy levels, and has mentioned her memory getting worse.

Her complaints such as libido and memory are familiar to me from a few years ago and I've made strides in those areas since finding RPF and would hopefully like to do the same for her as much as I can. I can't expect her to go full OJ and liver but she is willing to try things, any advice is appreciated.

Lexapro is an SSRI. That means it increases serotonin by blocking its breakdown (reuptake). Serotonin is not the "happy hormone". My own experience was that the high serotonin continued to be a big problem for me for years after stopping SSRIs and resolved when I began high dosing thiamine hcl.

Serotonin Syndrome and Thiamine: Is There a Connection? - Hormones Matter

A mild deficiency of thiamine is responsible for the large number of the polysymptomatic illnesses reported.

www.hormonesmatter.com

Many pharmaceutical drugs block thiamine function. There is an ongoing study regarding Lexapro and thiamine but the results aren't in yet. If it is blocking thiamine function in order to stop the reuptake of serotonin in the brain, this would be problematic. Thiamine is needed to clear serotonin from the brain.

• Has continued to gain weight over the years and is distressed by it, she gained more while on Lexapro.

I gained 25 pounds in 25 days when I took Bactrim antibiotic. Bactrim blocks thiamine function and thiamine is required for oxidative metabolism. So instead of burning the food for fuel, my body packed all of it in as fat. I regained my health via high dose thiamine hcl; however I did not lose the weight until I started taking 90mg of niacinamide 4Xday. I then lost 35 pounds in 3-4 months without changing my diet. I did do light exercises daily.

Semaglutid

Semaglutide Side Effects: Common, Severe, Long Term

Warning​

Oral route (Tablet)
Warning: Risk of Thyroid C-Cell Tumors In rodents, semaglutide causes thyroid C-cell tumors. It is unknown whether semaglutide causes thyroid C-cell tumors, including medullary thyroid carcinoma (MTC), in humans as the human relevance of semaglutide-induced rodent thyroid C-cell tumors has not been determined.Semaglutide is contraindicated in patients with a personal or family history of MTC or in patients with Multiple Endocrine Neoplasia syndrome type 2 (MEN 2). Counsel patients regarding the potential risk of MTC and symptoms of thyroid tumors

-end paste-

This drug is billed as a way to lower blood sugar in type 2 diabetes. Thiamine normalizes blood sugar and diabetics are deficient in thiamine. Thiamine also helps thyroid function and liver function and pancreas function. Choosing to stop the Semaglutide and instead looking into thiamine and thyroid supplementation could be beneficial.

• She's talked of her low libido, obviously low energy levels, and has mentioned her memory getting worse.

These are symptoms of poor energy creation at the cellular level = poor oxidative metabolism. Two things that are required for good oxidative metabolism are good thyroid function and good thiamine status.

Mitochondria and mortality

New descriptive sentence from the article here

raypeat.com

How Can Something As Simple as Thiamine Cause So Many Problems? - Hormones Matter

Is thiamine deficiency too simple to explain the devastating nature of the systemic adverse reactions to some vaccines and medications?

www.hormonesmatter.com

Thiamine and the Energy To Heal - Hormones Matter

Returning back to having the energy to heal, if thiamine is instrumental in making energy, thiamine then is instrumental to healing.

www.hormonesmatter.com

Beyond Deficiency: Using Thiamine as a Metabolic Stimulant - Hormones Matter

Thiamine is functioning as a metabolic stimulant to restore energy metabolism inhibited by factors unrelated to nutritional status.

www.hormonesmatter.com

 

[Charger]

Thanks for the advice so far.

She will start supplementing D3 today, and I have suggested she make an effort to get more sunshine. She's starting at 5,000IU a day.
I had ordered her a B1 test and apparently didn't get a result back, I may recommend her take 300mg thiamine a day as that is what I take and feel good on it.
I am considering ordering her Progesterone and letting her assess how she feels at low doses. Her SHBG seems pretty low, much lower than mine, and assume maybe this could be indicative of both low thyroid and/or low progesterone.
I would like to get her to try thyroid but told her I'm not comfortable while she's on Semaglutide. She's pretty high on it, not even sure how she heard about it as I don't keep up with the mainstream fads anymore.

 

[mostlylurking]

I had ordered her a B1 test and apparently didn't get a result back, I may recommend her take 300mg thiamine a day as that is what I take and feel good on it.

B1 tests are notoriously unreliable. Here's some information about testing B1:

Thiamine Deficiency Testing: Understanding the Labs - Hormones Matter

Understanding thiamine deficiency and the lab testing methods most appropriate for detecting abnormal thiamine chemistry.

www.hormonesmatter.com

Simply taking some and evaluating the response can be very helpful. However, don't assume that what works for you will work for her. 300mg of thiamine hcl seems to be a reasonable starting place. Thiamine hcl is absorbed in the small intestine and is known to have an inefficient absorption rate; if the gut is not in good shape, the absorption rate would be worse. The recommended way to take it is to split the dose in half, take half in the morning, before lunch and the other half by 3:00pm. Taking thiamine late in the day can mess with your sleep. Always take it with plain water, never with anything with juice as the sugar will cancel the effect.