Hi joziel, so much interesting information in your post. My god I don’t know how you deal with all those patches, I’d be really stressed out. There should be other options for women who need that amount of estradiol, other than sticking a million patches on!

I'm a work in progress here, I've recently increased my estradiol a bit, and I'm noticing improvements in many of my symptoms, which some of them were very similar to yours (pounding heart, fluttering heart, internal vibration, tingling hands/feet, dizziness etc). I'm a bit slow when it comes to increasing my dosage, I’m now on 3 sprays of Lenzetto a day (I switched from Oestrogel to Lenzetto a couple of months ago), but I've noticed a definite improvement doing 1 spray in the morning and 2 at night. This time around however I'm allowing a couple of months only to assess before another increase (before I’d wait much longer).
My last blood test, which I did on day 3 of my cycle (I think that's the best time?) showed 49,45pg/ml. Pg/ml is the measure labs do here in Spain, not pmol. But according to a conversion chart that should be about 182pmol. Here in Spain is more difficult than in the UK to find a doctor who's well-informed enough to prescribe HRT, fortunately I found a couple of them who are included in my health insurance plan, however they have limitations, like for example my current doctor told me 3 sprays of Lenzetto would be the maximum dose she prescribes. So if this is not enough for me I'll have to find another doctor willing to go for a higher dose (I'm already on the hunt for this).
As for progesterone, I also took the blood test on the same day, maybe I should've done another one on day 21 or so, specifically for progesterone. But this one shows 0,81pg/ml which is 2.97pmol. Not sure what the desirable range is. My doctor looked at all these results and said it's all fine, but I don't trust her judgment entirely, I've noticed every doctor has a different set of rules and info they go by, and may interpret results in completely different ways. For example she told me to take less vitamin D3 because I was at 77ng/ml, and I should be about 50, yet a different doctor last year told me up to 100 is optimal.
We don't have Tasso Randox testing here, however I'm sure there must be something equivalent, but I've not looked into it as I get all blood testing with health insurance, the only downside is a doctor has to request it. I'm very interested in the LC/MS progesterone tests, I'm gonna find out if this is something they do here. I suppose if you take progesterone vaginally, you don't get the sleepy side effects do you?
I watch Dr. Felice Gersh's videos too, and I like her approach a lot. I can tell you if I had the money I'd definitely have her as my doctor. I did see her in a few videos lately where she talks about this issue she sees with taking progesterone, one was an interview with someone, she explained in detail and it did make sense. What I understand is that when taken orally we absorb part of the progesterone and the rest is metabolized into something else, (I think allopregnanolone?) and I think the allopregnanolone then affects the GABA receptors which is what makes us sleepy.
Talking about allopregnanolone, this PEA palmitoylethanolamide supplement has become a life saver for me when it comes to sleep, during my 2 weeks off progesterone. I get deep sleep, about 7 hours nightly. If my stomach is empty I take 400mg and that's enough, if I've had a late dinner or have snacked something not long before bed and notice I still have food in my stomach then I'll take 600mg for the same effect. Palmitoylethanolamide increases levels of allopregnanolone, which is what makes it sleep-inducing. I myself wouldn't take it on the same nights when I take progesterone though, I don't know how they could interact with each other, but on the nights off I have no problem. However I'm still a bit worried about how all this allopregnanolone (from progesterone and from PEA) could potentially be habit forming, because of how its effects seem to be very similar to benzodiazepines (
https://pubmed.ncbi.nlm.nih.gov/9316828/). I need to find out more, but for now this is helping me a lot.
How very interesting what you've found out about vitamin A. In the same blood test I got 0.53mg/L of vitamin A, which is supposed to be normal but on the lower range, I wonder if you got your levels tested, and if you know what test is reliable for vitamin A. I eat/drink a fair bit of dairy every day, so I'm not sure I need supplementation, but I'm looking forward to hearing about your progress taking the 10.000IU's.
Oh just make sure it's not synthetic vit A, (I think the natural form is Retinyl Palmitate). But I guess you must know this already