Dr. Raymond Peat's Books



They are thin and easy to carry around, at least..:)

If you are hoping for authoritative tomes that would once and for all put to rest your doubts regarding Dr. Peat's views, don't buy his books.

Buy them if you are on the market for more skepticism.

I must admit, I had expected books published by a publishing house specialized in scientific works, texts with a clear structure, fully edited and with a comprehensive index. I was hoping that Ray Peat's books will further my knowledge and enlighten me on the topics that his articles and radio interventions had only touched upon.

Alas, there is (let's say "almost") nothing in the books that you couldn't have found on the net already if you followed the excellent collections put together by his followers which include articles, radio shows and even published emails.

The books are self-published collections of articles.

The most developed of them is called "From PMS to Menopause. Female Hormones in Context". 189 pages ending with the following note:

 

Added to the artisanal publishing, this rather aggressive promotion of Progest-E places a serious question mark over the book's contents. I cannot see a good reason not to name Dr. Peat's patented product here and I honestly do not see why Dr. Peat does not name it as well, since he so obviously refers to it in the note above. Is this name omission business intended to not make the entire book appear like a "companion" to Progest-E? Be that as it may, even without the name of the patented product, the book still reads like an extensive effort to persuade Progest-E users that the progesterone product they bought is good for them and to persuade readers that the mysteriously unnamed but obviously referred to Progest-E should be bought and used.

 

It is all about context, right?

 

I did read the book carefully. I underlined many things. Sometimes, these were just interesting tidbits I did not know. For instance, the fact that "a male runner's estrogen is often doubled after a race" or that "Estrogen and insulin lower blood sugar, progesterone and thyroid sustain it". Sometimes, I noted snippets of speculation that sound pretty cool, stuff I tend to believe in or that I have seen elsewhere information about: "Antibodies to joint material are found after even a mechanical or thermal injury to the joint; twisting cartilage makes it antigenic; autoimmune disease is probably nothing very special" but I would stop underlining when things went off in directions I didn't find convincing, like the estrogen-demonization pathway, very present in the book. The above sentence goes on with: "estrogen is now known to be responsible for many forms of it, including osteoarthritis".

 

But many times I underlined things that were unsubstantiated in a major way. Key elements of the "progesterone is good for women" theory are left hanging, simply things we should trust Ray Peat on.

 

For instance, on page 68, there is this paragraph that had me pull my hair in frustration (my reactions are in red):  

"Progesterone and DHEA are the precursors for the other more specialized steroid hormones, including cortisol, aldosterone (sodium retaining hormone), estrogen and testosterone. The formation of these other hormones is tightly regulated (by what?), so that taking a precursor will correct a deficiency (but why would that unnamed "regulatory authority" ever allow a deficiency to begin with?) of the specialized hormone, but will not create an excess (if 'it' allowed it to be deficient, how can we trust 'it' that it will a) increase b) not overly increase the deficient hormone?). At least in the case of progesterone (why suddenly ditch the other precursors, then? Are they less likely to be properly used by the unnamed "regulatory authority" and if so, why?), an excess tends to balance or neutralize an excess of the specialized hormone, so it has been described as having anti-androgenic, anti-estrogen, anti-aldosterone and anti-cortisol functions (I find it so easy to believe all this, especially that it totally contradicts my own horrible experience of attempted progesterone supplementation!)".  

WHAT? Is that IT? I mean, the paragraph above establishes a whole universe and places progesterone on a position that is incredibly powerful, a god among hormones. No reference is given, however, Ray Peat merrily goes on to other things. That is often the feeling I get reading his books and/or articles: he drops bombs and then pretends nothing has happened and keeps on gathering pretty flowers and spreading references/explanations for THOSE!

 

Even so, I believe that the paragraph unequivocally implies that, should someone be in need of estrogen, the supplemental progesterone, its precursor, might just oblige. However, although half the book is about how estrogen is the work of the devil, this obvious pathway is never explored and the idea that women who are low in estrogen should not touch progesterone is never even mentioned, not a fleeting remark, nada! Besides, what a can of worms that is, given how a woman's hormones fluctuate throughout most of her adult life.

 

Besides the variations on the "progesterone=good/estrogen=bad" theme, the book is also replete with the usual believable advice Dr. Peat has extended for a long time and for which he has gathered his current following.  Sunlight, red light, coconut oil, saturated fat, the benefits of milk and OJ, the malediction of PUFAs are all there.  Honestly, were it not for the hormonal exaggerations, I would recommend it to my friends.

 

However, tall tales of progesterone wondrousness had me roll my eyes too many times in regret that Dr. Peat ever embarked on his progesterone-worship journey. Too many formulations like "I suspect", "probably", "seems to be", "appears", "from my observations", "x suggests y" "indicate that" we are not on solid scientific ground.

 

I will end this review with another one of Ray Peat's optimistic speculations, one that might entice you to take advantage of the summer season better, instead of embarking on unsafe hormonal supplementation. I don't know about you, but I'd rather be cured (or harmed) by some good old sun exposure than by rubbing on my skin powerful substances recognized as carcinogenic by the scientific community and labeled as such by the authorities: 

"I suspect that light on the skin directly increases the skin's production of steroids, without depending on other organs. Different steroids probably involve different frequencies of light, but orange and red light seem to be important frequencies."

T4 Trials & Tribulations

Ten days ago I treated myself to yet another round of blood tests.

TSH shot up to 2.88 from 0.11, so definitely 25 mcg is too little daily T4 supplementation for me. If 50 mcg was too much, then I guess I need 37.5? I’ll be cutting up pills every night then. Fine.

Magnesium was at the bottom of the acceptable range and calcium was at the top! That’s got to be bad news, right? Maybe that plays a role in the return of my pain and tiredness?

Estrogen doubled yet again. Progesterone increased as well, four times the amount I had when I wrote the “Perfect Ten Progesterone” posting,  however, it is now only twice as much as my estrogen, from ten times the amount. So that’s another piece of bad news.

Anti-TPO’s are falling again, 611 from over 700 (so, still a heck of a lot, they should be below 6!), so moderately good news there, although… I’m not even sure I should bother checking them anymore.

The CA-125 (an ovarian cancer marker) is higher than last year, 45 instead of <35.  I don’t like seeing it progress, needless to say, the more so as my estrogen is rising as well, steadily, if you catch my drift…

Total cholesterol at an all time high: 225, with an LDL of 67. So, still good ratio, but it was 190 five weeks ago… Vacationing in Eastern Europe increases cholesterol, who knew…

For the first time, I did Free T4, Free T3, Total T4, Total T3 and TSH, like so:

The real downer was Total T4, which was under the lower limit! Not by a whole lot, but still! What was that supposed to mean? Lab proof of hypothyroidism?  Or was my body adjusting to the lower dose of supplementation? I can't wait to check it again and to talk to someone about this.

Well, on the other hand, I just read today "Levothyroxine And Lung Cancer In Females: The Importance Of Oxidative Stress", by Umberto Cornelli, Gianni Belcaro, Martino Recchia and Annarosa Finco a very credible study suggesting that too much T4 can cause serious issues as well and that one cannot monitor its amounts carefully enough. I see lots of people living with undetectable TSH levels and that cannot be right either. Inducing hyperthyroidism iatrogenically apparently can cause lung cancer in women.

"During the therapy with LT4 even at the steady state condition a peak of the hormone is evident a couple of hours after the administration and may cause a temporary condition of hyperthyroidism and a further increase of oxidative stress.

Oxidative stress is well documented in hypothyroidism [22-24] and is even worsened through treatment with LT4 [1,2]. The difference between the two conditions is that, in case of hypothyroidisms, oxidative stress is due to the reduction of AO [4], whereas, after the LT4 treatment it stems from overproduction of ROS from mitochondria [5,6].

A very simple method that can be used to measure oxidative stress is related to hydroperoxides content in plasma which is considered a very reliable test compared to other common methods since it shows very limited coefficient of variation [25].

An inverse association with fruit and vegetables consumption and lung cancer recently has been documented recently in the EPIC study for 50 to 59 age group, without an effect on specific histological subtypes [26]."

 So I should start measuring the hydroperoxide levels as well while I fiddle with this dangerous stuff. Also, increase antioxidants intake. I am not so sure about vegetables, finding clean veggies is an ordeal in itself.  I will look into supplements.

How to decrease calcium and estrogen and increase progesterone, magnesium and T4, make CA-125 and Anti-TPOs go away and be happy?

That’s all I’d like to know.

P.S. on August 17, 2013: Actually, the above sounds outdated. Just an old Peatian "reflex".  I no longer believe progesterone is good and estrogen is bad, so I take that back.  I will stop caring about the progesterone/estrogen ratio and worry instead about the level of hydroperoxide in my blood. It sounds like a fair trade-off..:)

Plus, the study I mention gave me a nightmare last night. So maybe I should withdraw a bit from worrying about these things altogether, like the doctor said. Just find the time and organize another seaside session...

P.P.S. I just came across a study that supports my decision to stop considering progesterone such a good guy, a study linking it to the emission of hydrogen peroxide: "Progesterone increases skeletal muscle mitochondrial H2O2 emission in nonmenopausal women". Yep. :( And guess what, estrogen is counteracting it, according to the authors. That makes progesterone less than a hypothyroid woman's best friend, because it promotes oxidative stress. Taking this one step further: maybe it was an excess of my natural progesterone which launched the H2O2 destructive festival which may have brought about my Hashimoto's.


 

Whose Hormones Are These?!?

        I just came back from my doctor’s office. 

        The news is intriguing. 

        Luckily, I will see Dr. Coculescu (”the Great”) soon enough. I hope he can explain these developments and advise me accordingly.

        Three weeks have passed since my previous lab tests. My TSH was a nice 1.9, down from 5.21, under 50 mcg of T4 for a few weeks. I was entertaining hopes of going up to 75 mcg of T4 (Levothyrox), an amount not exaggerated for a Hashimoto’s patient of my size. My doctor had opposed the idea (see previous post), although she had wondered about the accuracy of the tests, thinking that they showed too little TSH for such a small amount of supplementation. 

         Lucky me that she didn’t increase my T4 dose, because even continuing with the 50 mcg for these extra three weeks, my TSH is now at a bewildering 0.11!  My T4 is higher than it has ever been, bordering the upper acceptable limit.  Again, lucky me that “mymexicandrugstore” didn’t deliver my T3 on time — I would have headed for a thyroid storm, without a doubt, with T3 supplementation on top of what my body is already producing!

        I didn’t check T3 this time around, but I’d be curious about the TPO antibodies, because, unless they are really high, marking another episode of thyroid destruction and subsequent hormonal flooding, I am not sure what to make of this! 

         Is my thyroid increasing its function of its own accord? Is the Peat diet working wonders on me, with some delays? Am I possessed by a higher metabolic self? 

        The latter option would be in sync with another surprise: a high estrogen level, ten times higher than three weeks ago. I didn’t check progesterone, but I doubt it went 10 times higher as well, so as to keep the Peat favored ratio… But who knows, after all, who would have guessed the thyroid development? 

        Cholesterol is down, but it was never bothersome. Vitamin D3 is hovering on the lower admissible range, so my doctor offered 100.000 units of supplementation — that is how they like to do it in France, with vials of potent liquid stuff, called “Uvedose”. When I was in Cannes last year, I bought them without a prescription from a pharmacy. In Alsace, no such luck.

        She also directed me to decrease my T4 supplements to 25 mcg… 

        I am wondering if my recent hair loss was connected to the exaggeratedly low TSH, rather than the Synthroid type medication or some previous hypothyroid moments that were never captured on lab results.
 
       I could have sworn I would never again see that level of estrogen, let alone that TSH or the T4, but here we go… Maybe with the increased amount of calories, came increased titers of hormones, across the board. Could it be that my body is waking up? Restarting? With all the good and the bad hormonal developments? So...
 
       IS PEAT RIGHT?

Perfect 10 Progesterone & Other Curious Findings

I finished reading Dr. Raymond Peat’s book “From PMS to Menopause. Female Hormones In Context” and I am now (re)reading the articles collected in "Nutrition For Women". I will soon write review those. For now, I will just comment on my test results.

In his book, Ray Peat recommends a ratio from five to ten times more progesterone than estrogen in serum levels. He does, on several occasions, mention the possibility of progesterone’s turning into “other hormones”, but he never takes this idea to its full consequence, namely, natural progesterone's possible final transformation into Public Enemy No. 1, estrogen. I think that, sooner or later, he should address this, because it is an important part of the hormonal equation, one that has not received the necessary focus up to now.

Drum rolls, please, as my progesterone levels were exactly TEN TIMES the amount of my estrogen, many weeks after my short Progest-E experiment, when I felt things had returned back to normal. Not five, not six, not seven... Perfect 10 me! 

(So, well, I was right all along, and those who tried to tell me my symptoms stemmed from a potential “liver issue” better learn that their imaginary knowledge of how hormones can affect one would be best not shared out there. Also, if a woman describes previously non-existent symptoms of estrogen and cortisol spikes after taking natural progesterone, you can believe her, although Dr. Peat and other proponents of natural progesterone never explicitly discuss the possibility.)

I also had good levels of DHEAs. I am sorry I didn't check my pregnenolone, I forgot, but I soon will.

Now, for the thyroid part of my labs: despite supplementation of 50 mcg of T4 for almost a month, my levels of T3 and T4 are only slightly changed. That is, T3 decreased a tiny bit, but it was already in mid-range, from 2.55 to 2.43, in a range of 1.71-3.71 pg/ml. T4 went from 13.4 to 13.52 in a range of 12-22 pmol/l, so it’s still lagging towards the lower part of the admissible spectrum, Levothyroxine or no Levothyroxine. TSH was the only one that took a spectacular dive, from 5.21 to 1.90, on range of 0.21 to 4.60 mui/l. This made my GP happy, albeit a bit mistrusting of the Romanian labs, so I will repeat them here in two weeks or so. I wanted to move up to 75 mcg of T4, but she said that would not be warranted and that raising my metabolism was not what she had in mind, to begin with — just getting rid of the TSH, while settling in the thyroid range my body chooses, as long as that is within what is considered normal.

I can understand her wish to tamper with key metabolic things as little as possible. However, if I ever receive my T3 supplements (I ordered them online at mymexicandrugstore.mx), I will try to supplement a little bit of that and see how I feel.

For the bad news of the day, after one year of constant and considerable decline, my TPO antibodies rose again, from 535 to 731 (normal: below 5.61!) The TGO antibodies have decreased (could this be due to the Anatabloc supplementation?) and are now within acceptable limits — but they were never that high to begin with (from 4.25 to 3.52, they should be below 4.11.)

Anyway, I do feel better with this (loosely) Peatian diet and the little T4 I am taking. I have more zest for life, more energy and my circadian rhythms are excellent — at night, there is this magnificent tired feeling, like when I was a child and I would drop in the evening, brain foggy, muscles tired, to only wake up in the morning, refreshed and ready to take on a new day. This is in itself a superb achievement and might bring with it a lot of good.

Let me not forget my “pre-diabetic” story. It turns out one should never buy cheap blood sugar monitors. After so much worrying about it, the serum glucose lab test revealed a nice 84 in a range of 60 to 105 mg/dl. My home measurement that morning: over 110. So I stopped DIY-ing in this department. 

Heart: curiously high diastolic pressure, more often than not, and a puny pulse pressure.

You can see from the upper part of the graph above that I am trying my hardest to push my calories intake and my body reacts, by packing on pounds. I fight back by reducing calories, only to start again pushing my luck. I am curious if I changed anything after all this effort, if I went past 1600 calories a day while maintaining my weight -- I shall soon check on Cronometer. 

And finally, in the ears department: another infection, this time in the right ear. I took cyprofloxacine. The otolaryngologist said I should maybe consider a CT scan or an X-ray. I said no way. She insisted, maybe at least an ultrasound? I already did that and they found nothing, just some inflamed lymph nodes. She still seemed worried. I told her about my progesterone and pregnenolone supplementation and the ear pains and now the repetitive infections — she said she would not be surprised if those played a role, because the ears are lined with mucous tissue and they react to hormones.

Aspirin Will Cost Us In the Long Run. Low Estrogen/High Progesterone Exists!

The Peatian news of the day has to be Noah Buhayar's article on Bloomberg.com about aspirin becoming such a burden to the cost of healthcare... because it protects so many from cancer!

I have not started supplementing with aspirin. The idea that then I would have to add K2 to my regimen and balance these guys out is truly not something I look forward to (especially that both can do some damage, in the wrong dose, they are not harmless little substances).

***
Yesterday I started reading Dr. Sara Gottfried's "The Hormone Cure", because I had read the reviews and many raved about how well she explains their interplay.

I took her hormone quizz online and the results hit pretty much where I expected.  So, to all the women out there who think there is no such thing as progesterone dominance or women who are not in need of progesterone, because they would instantly turn it into the evil estrogen, check out my results:

High Cortisol.  It sounds like you are unlikely to have high cortisol at this point, which is great (...)

Low Thyroid.  There’s a good chance you are low in thyroid hormone (...)

Low Estrogen.  There’s a good chance you are low in estrogen (...)

Low Cortisol.  There’s a good chance you are low in cortisol. (...)

Low Progesterone.  You are unlikely to have low progesterone. Congratulations! (...)

High Estrogen.  You are unlikely to have estrogen dominance. (...)

High Androgens.  You are unlikely to have high androgens. (...)

For whatever this is worth, my recommendation for any woman out there considering hormone therapy is to take Dr. Gottfried's test or, better yet, to check your hormone levels before you decide you are "estrogen dominant" and start the "bioidentical hormone" supplementation, be it with pregnenolone or progesterone. Reading Ray Peat's and others' fabulous experiences is one thing, taking the decision to go that route on one's own is another.

Balance the time you spend on forums with time you spend with doctors or reading their books and using their free online resources. Just because you run on a discussion group into a woman who seems smart and knowledgeable and who did some things that worked for her and then she went out of her way to recommend them using Ray Peat's work and quoting his instructions to her as endorsements doesn't mean you have found YOUR answer! Nobody is evil in this equation, everyone is being super nice and tries to be helpful -- but hormone supplementation can have serious consequences and you need all the qualified, personalized help you can get when you do it.

I learned this the hard way, unfortunately!