Comments on: Hormone Testing http://www.custommedicine.com.au/blog/2008/02/20/41/ These articles involve various new treatments involving complementary medicine by Dr Michael Serafin Ph.D. Wed, 04 Mar 2009 02:30:17 +1100 http://wordpress.org/?v=2.8.4 hourly 1 By: Dr Michael Serafin http://www.custommedicine.com.au/blog/2008/02/20/41/comment-page-1/#comment-24302 Dr Michael Serafin Tue, 17 Jun 2008 01:00:31 +0000 http://www.custommedicine.com.au/blog/2008/02/20/41/#comment-24302 Peter The problem with relying on serum analysis for detecting transdermal progesterone is that it is a fundamentally flawed methodology and will never be able to demonstrate suitable serum levels. The reason for this is due to the fact that when progesterone is absorbed into the blood stream from the skin it binds to red blood cell membranes in order to minimize unfavorable interactions between the fat loving progesterone molecule with the aqueous (water) serum phase (remember oil and water do not mix!). When a patient goes for a serum blood test the blood sample is centrifuged before it is analyzed to remove all red blood cells, along with any progesterone attached to them. Therefore serum analysis cannot possibly accurately measure transdermal progesterone if most of it is being thrown out before being tested for. This phenomenon is not observed to such a degree with oral progesterone due to the fact that once absorbed it initially enters the liver (the reason why it has such poor bioavailability - 10 to 15%) where it is attached to the Sex Hormone Binding Globulin (SHBG). This protein then allows progesterone to remain in serum by minimizing the unfavorable interactions mentioned above and thus will show up in serum analysis. Therefore we cannot rely on serum testing to verify the validity of transdermal progesterone. Secondly, serum analysis only detects hormone levels in serum. It does not reflect hormone levels inside the cells where they are actually active. Therefore I cannot understand why so much emphasis has been placed on serum testing to the detriment of other methods. Saliva and urine tests both show that transdermal progesterone does indeed raise progesterone levels. The level achieved obviously depends on the dose and rate of absorption. I however usually adjust the dose until I obtain a reading within an optimal target range. I feel that the validity of both these methods of analysis has been well proven and thus more accurately reflect the true level of transdermally absorbed progesterone. Finally over the last 10 years or so I have been involved with 1000's of women using transdermal progesterone. Our saliva/urine testing almost always shows improved progesterone levels not to mention the fact there is a great improvement in the patients symptoms - which is what it is all about! Peter
The problem with relying on serum analysis for detecting transdermal progesterone is that it is a fundamentally flawed methodology and will never be able to demonstrate suitable serum levels. The reason for this is due to the fact that when progesterone is absorbed into the blood stream from the skin it binds to red blood cell membranes in order to minimize unfavorable interactions between the fat loving progesterone molecule with the aqueous (water) serum phase (remember oil and water do not mix!). When a patient goes for a serum blood test the blood sample is centrifuged before it is analyzed to remove all red blood cells, along with any progesterone attached to them. Therefore serum analysis cannot possibly accurately measure transdermal progesterone if most of it is being thrown out before being tested for. This phenomenon is not observed to such a degree with oral progesterone due to the fact that once absorbed it initially enters the liver (the reason why it has such poor bioavailability – 10 to 15%) where it is attached to the Sex Hormone Binding Globulin (SHBG). This protein then allows progesterone to remain in serum by minimizing the unfavorable interactions mentioned above and thus will show up in serum analysis. Therefore we cannot rely on serum testing to verify the validity of transdermal progesterone. Secondly, serum analysis only detects hormone levels in serum. It does not reflect hormone levels inside the cells where they are actually active. Therefore I cannot understand why so much emphasis has been placed on serum testing to the detriment of other methods. Saliva and urine tests both show that transdermal progesterone does indeed raise progesterone levels. The level achieved obviously depends on the dose and rate of absorption. I however usually adjust the dose until I obtain a reading within an optimal target range. I feel that the validity of both these methods of analysis has been well proven and thus more accurately reflect the true level of transdermally absorbed progesterone. Finally over the last 10 years or so I have been involved with 1000’s of women using transdermal progesterone. Our saliva/urine testing almost always shows improved progesterone levels not to mention the fact there is a great improvement in the patients symptoms – which is what it is all about!

]]> By: Peter Gal http://www.custommedicine.com.au/blog/2008/02/20/41/comment-page-1/#comment-24301 Peter Gal Tue, 17 Jun 2008 00:01:57 +0000 http://www.custommedicine.com.au/blog/2008/02/20/41/#comment-24301 I think transdermal progesterone is left with a quandry which needs explanation to a level satisfactory to convince the research scientists - not necessarily doctors at this stage, I believe baby steps are acceptable initially: 1) The vast majority of research papers which validate the therapeutic benefits for progesterone do so by comparing the improved clinical symptoms to the serum levels of progesterone, not the saliva levels of progesterone. 2) Until transdermal progesterone raises the serum level of progesterone to the same levels as were achieved by the research scientists who validated the therapeutic benefits of progesterone, therefore transdermal progesterone cannot justifiably lay claim to achieve the same therapeutic benefits as are achieved by an increase in serum progesterone. 3) I see no possible logical basis by which the transdermal progesterone researchers can lay claim to the same therapeutic benefits as have been previously associated with increased levels of serum progesterone, until the transdermal progesterone is demonstrated to increase the serum levels of progesterone. 4) Therefore the transdermal progesterone researchers must lay claim to their own therapeutic benefits for humans (not mice, sorry) after they first demonstrate that an increase in salivary progesterone is linked to a therapeutic benefit, AND that a reduction of salivary progesterone is linked to a therapeutic decline. It is not sufficient to demonstrate only one of these relationships. When the dosages and measurements of such studies are published in peer reviewed journals, AND repeated by at least two independent parties (all results on which we are going to base a therapy must be repeatable), then the corresponding transdermal progesterone dosages and salivary measurements as used by the researchers, are the ones we should observe. I have not been able to find any peer-reviewed research papers which demonstrate the above. I give you all the benefit of my doubt and I believe that you have all found the research papers which demonstrate these relationships. Well done. Perhaps one day I might find them too. I think transdermal progesterone is left with a quandry which needs explanation to a level satisfactory to convince the research scientists – not necessarily doctors at this stage, I believe baby steps are acceptable initially:

1) The vast majority of research papers which validate the therapeutic benefits for progesterone do so by comparing the improved clinical symptoms to the serum levels of progesterone, not the saliva levels of progesterone.

2) Until transdermal progesterone raises the serum level of progesterone to the same levels as were achieved by the research scientists who validated the therapeutic benefits of progesterone, therefore transdermal progesterone cannot justifiably lay claim to achieve the same therapeutic benefits as are achieved by an increase in serum progesterone.

3) I see no possible logical basis by which the transdermal progesterone researchers can lay claim to the same therapeutic benefits as have been previously associated with increased levels of serum progesterone, until the transdermal progesterone is demonstrated to increase the serum levels of progesterone.

4) Therefore the transdermal progesterone researchers must lay claim to their own therapeutic benefits for humans (not mice, sorry) after they first demonstrate that an increase in salivary progesterone is linked to a therapeutic benefit, AND that a reduction of salivary progesterone is linked to a therapeutic decline. It is not sufficient to demonstrate only one of these relationships.

When the dosages and measurements of such studies are published in peer reviewed journals, AND repeated by at least two independent parties (all results on which we are going to base a therapy must be repeatable), then the corresponding transdermal progesterone dosages and salivary measurements as used by the researchers, are the ones we should observe.

I have not been able to find any peer-reviewed research papers which demonstrate the above.

I give you all the benefit of my doubt and I believe that you have all found the research papers which demonstrate these relationships. Well done. Perhaps one day I might find them too.

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