Update on P:E2 ratios. Thank you Dr Peatfield

Hi after much research in the quest for answers I finally came across an article by Dr Raymond Peatfield. I have no idea how to add a link here but a google search should bring it up should anyone else out there be interested in the relationship between progesterone deficiency/ estrogen dominance and hypothyroid. Would be most helpful to those of us who dont have Hashis and are searching for answers as Progesterone deficiency is the most common cause of hypothyroidism after Hashimotos. In the article he explains the importance of vit d, cholesterol and liver health to produce progesterone especially after menopause and how its all interconnected with fibroids etc. I have read quite a few articles that suggest fibroids are caused by a lack of vit d. He also says that once hypothyroidism is treated natural progesterone levels will increase and improve health over all. As we should be aware how important progesterone is to female and male health. Progesterone lowers blood pressure, lowers cortisol levels, reduces anxiety and promotes regular cell death to prevent cancer as well as promoting proper thyroid function. So I will be continuing low dose natural progesterone supplimentation until my levo increases enough to help out natural production even though my doc tells me at my age I dont need it! Well I suppose just like everything else we have discovered how little they really know! Xx

10 Replies

Am confused - do you mean Dr Ray Peat or Dr Barry - Durrant-Peatfield ??

Is this is what you were referring to:-


To copy a link you go to the top of the page and highlight the http or https line then ctrl C (which means you have copied the link). Then go to where you wish to place it and Click Contrl V and it should pop into place.

A similar article that I have read in past. I will try to find it again. Im confused now too must be Ray Peat?

This is another and I'll give you a link which contains all his articles.



This is the only link that makes some sense and I've been trying to use it to calculate my own Pg/E2 ratio as I think I'm oestrogen dominant. You can use it for blood or saliva results.


Pg/E2 Ratio

Blood spot or serum example: a patient has E2 = 100 pg/mL and Pg = 20 ng/mL. The Pg units are first converted to pg/mL before calculating the ratio: 1 ng/mL is equivalent to 1000 pg/mL. Therefore, the ratio is 20 ng/mL x 1000 = 20,000 pg/mL Pg, divided by 100 pg/mL E2:

20 x 1000/100 = 200

It also describes how to interpret the result. However, its probably easier to speak to a professional.

Hi thanks for that. Im so confused by the whole thing. I have calculated mine and I get 10:1 Different for me I suppose as I have hit menopause. Ive tried speaking to so called proffessionals but they are not willing to commit to answers. They are not used to women asking these questions. Im supposed to be satisfied that im menopausal! I have read so many things about levels. The problem im having is what they call hormonal dump. My levels are falling all the time which causes a dump of estrogen. When this happens it triggers an adrennalin rush that can last a few days and then i start bleeding. Ive ended up in A&E a few times because of heart rate going bananas. Ive told them its hormonal but then they look at me as if im stupid. Last time i was rushed to hospital in an ambulance and given the full heart attack treatment. After a few hours in hospital on a monitor etc i went to toilet and discovered i was bleeding. I told them and all they said was oh how odd? Can none of them put 2 and 2 together? Im getting a private scan tomorrow to check my womb lining. X


When I tried to calculate mine I think it came to 68. I'm in my late 30s so I'm assuming this is high oestrogen dominance. Your experience sounds very frightening I hope you're alright.

I think you may have to speak to a private doctor as the NHS trained doctors are out of their depth here. Hence the puzzled reactions. How did your scan go? Hopefully the outcome will be good but you may need bio identical hormone treatment. I may need Progesterone cream and somebody also mentioned DHEA but if you're menopausal then a different approach may be required.

Good news on the scan yesterday. My womb lining has reduced to 3.6mm last year it was 10. So I can only presume i did the right thing using the progesterone cream? Its always difficult making such decissions as when I was in my 40's I had heavy bleeding it was then i used the cream and it worked well to control the bleeding but the doc said stop using it, it could cause fibroids. Well i stopped using it and at 50 i got fibroids! Never had any sign of them and then they started growing after i stopped the cream. They have shrunk to half the size now, biggest one being 7cm at its worst. I was dissapointed that they havent shrunk any since last year but they confirmed my womb is still shrinking as have my ovaries. My womb was the size of a 5 month pregnancy a few years ago. Im hoping that the combination of the levo and the progesterone helps sort my problems out but Ive only been on 25mcg for 4 weeks. Cant wait to get my 6 week blood test to see if there is any difference. X

So Progesterone cream makes the lining thinner. I really didn't know how exactly it worked. Most doctors don't know and don't believe in it either. If its not manufactured by Big Pharma they will dismiss it and I expect when you told them about getting fibroids again they must have dismissed it.

Gosh I'd heard about people having massive fibroids but only as a rare thing. Your oestrogen dominance must have been even worse than mine before menopause. All the best with your 6 week blood test. Let us all know how you get on. Well done!

No it doesnt make the lining thinner its a bit more complicated than that. It controls or reduces the estrogen dominance. When you stop ovulating or if your not ovulating every cycle thats when the trouble starts. Your progesterone levels drop but in perimenopause your estrogen continues to be high. I think at your age you need a ratio of 300-500:1 on the progesterone. Mine needs to be 100:1 to be well. So if your ratio is off the estrogen dominance causes the womb lining to build up. The progesterone keeps it stable and in check and when the progesterone drops the lining sheds. If you dont have enough progesterone during your cycle the womb lining just keeps going and gets thicker. Thats why the heavy periods etc because eventually it will break down. So if I hadnt used the progesterone for 3 weeks out of 4 my womb lining would have continued to grow. My progesterone is too low so really im still in an estrogen dominant state but now my estrogen levels are too low to cause a build up but the fibroids havent shrunk enough due to being estrogen dominant. Hope you are following what i mean. Its easier to draw a diagram than to describe it. So big problem is at my age my ovaries not producing progesterone therefore my adrenals should take over but i also have low cholesterol. Ur body manufactures progesterone from vit d and cholesterol. Other problem being if cortisol is low bodyg steals progesterone to make cortisol so cortisol level up thyroid level down, u with me? So this is big problem its all interconnected. If one part of the puzzle is wrong then the whole thing is out of balance. So need to get progesterone levels up to conteract all the bad effects. Hope that helps xx

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