Hormone Replacement Therapy E4 Women

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Julie G
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Re: Hormone Replacement Therapy E4 Women

Post by Julie G »

Good find, Susan! It's worth noting that bio-identical hormones were used in this one. We're seeing a positive cognitive trend in the small number of studies using bHRT. We need more like this to demonstrate that the inconsistencies found in the Women's Health Initiative studies were due to synthetic hormone use.
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Re: Hormone Replacement Therapy E4 Women

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Julie and Stavia

I have a question on HRT. Do you have definitive research sites, that show HRT for APOE 3/3 women have positive cognitive effects for a 60 year old women? Been down a million rabbit holes in the last 4 years and have hit this one in the past. Just recently started looking again and realize the studies are all over the map. I do not see two studies in a row with all variables being equal; that come to the same conclusion.

In fact seeing brain atrophy in some, cognitive decline in some, harmless in some, no effect either way in some; but not seeing any studies that are very conclusive stating cognition improved or brain size increased. I understand that it is individual in some women, I understand the "critical window theory", even though that is very debatable as well, (as to when that is open or closed). I am not lazy, just thought you guys or any body else can point me directly to any studies.

In fact wondering if DR. B has any, or what influenced his thinking on this for his post menopause patients. He actually wants estrogen levels fairly high. APOE4, I can find some , still vague, but some evidence, for 3's none. Of course I understand that hormonal regulation is critical for general health as well as brain health; but is bio identical HRT really beneficial. I did not question this in the past, but really starting to wonder where it lies in the spectrum of brain health.

This is being asked / questioned in light of the fact that not all women have OBVIOUS issues after menopause. You all know the negative issues, fatigue, night sweats, sleep issues, dryness, etc. But what if your Estrogen was low and you did not have any of those issues? Should you then go back later and add HRT because of cognitive issues only? Now I also recognize that not everything has to present as a physiological symptom. There could be changes affecting the body that are less subtle and do not manifest until later. But I really think the question has to be asked....

Thanks Frank and Sandy
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Julie G
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Re: Hormone Replacement Therapy E4 Women

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Hi Frank & Sandy. The reason that the info is all over the place is because synthetic hormones have yielded inconsistent results (sometimes negative) re. cognition. Dr. Ann Hathaway does a great job of separating out bioidentical HRT evidence which consistently yields positive results. That said, we need more studies. Here's an excellent primer on HRT & Cognition compiled by Dr. Ann Hathaway. Here you can see her speak at our recent meet-up. (We had some technical issues, but you can get the gist of the info.)
But what if your Estrogen was low and you did not have any of those issues? Should you then go back later and add HRT because of cognitive issues only? Now I also recognize that not everything has to present as a physiological symptom. There could be changes affecting the body that are less subtle and do not manifest until later. But I really think the question has to be asked....
Dr. Bredesen and Dr. Hathaway will say overwhelmingly- YES... even much older than age 60. When symptoms of cognitive decline are present, they believe the evidence is strong enough to throw everything at it- especially bHRT for women.
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Stavia
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Re: Hormone Replacement Therapy E4 Women

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Frank I agree with Julie. The different cleavage of the APP protein with and without oestrogen nailed it for me.
Have a look at the evidence on her slides - the few studies there are, are not only e4s.

I've just had this very conversation with my best friend. The possible risk of breast cancer is small, if at all present with oestradiol transdermally. Breast cancer 5yr survival is currently 99% with localised small breast cancer. So even if there is a small increase in breast cancer with HRT, the mortality increase is gotta be a fraction of that.
Just my 2 cents worth.

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circular
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Re: Hormone Replacement Therapy E4 Women

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Is the estradiol patch bioidentical? I assume so. What would I ask for, what drug name, for the patch? Or what is the right bioidentical vaginal one to ask for. I try not to boss my doctors around too much, so if I could give mine a choice :lol: Sorry it's probably in the thread. I'd like use one of my caregiver thread-reading waivers if possible.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Stavia
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Re: Hormone Replacement Therapy E4 Women

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17 beta estradiol Circ

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SusanJ
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Re: Hormone Replacement Therapy E4 Women

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circ, Vivelle is one brand name, and Sandoz makes a generic that is very inexpensive and as (I think) Katie noted, it stays on better. So you could just say you'd like something like Vivelle or it's generic and see what they are comfortable with. My doc had no problem in me suggesting this.
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Re: Hormone Replacement Therapy E4 Women

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Thank you doc Stavia and "doc" Julie. Made Julie honorary doc. LOL. Been hitting the information (all 93 slides and looking up references) you guys suggested. Already impressed with the amount of referencing DR. Hathaway supplies. I like that she does not only include rat studies and has a fine mix of good studies. Turning point for me Stavia is the cleavage as well. I also like her chart (albeit not hard science) but a great reference as to the ratio values of estradiol to progesterone. I also agree that breast cancer risks are low.

I will get to part two of my inquiry after some meetings today. Of course I have more questions, haha, you girls did not think I was going to let you off the hook without more ????????? LOLOL

Mahalo Frank
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Re: Hormone Replacement Therapy E4 Women

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Thanks Stavia and Susan, I may make the change. One thing holding me back is that the OB/GYN who started me on bios about five years ago had 18 year's experience with them, and she recommended BiEst compounded cream for its estriol component. It's 1/2 estradiol (my levels are good) and the other half estrio. So I wonder what it was that excited her about estriol, and I do recall her excitement. Does anyone know anything about estriol? TIA
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Stavia
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Re: Hormone Replacement Therapy E4 Women

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Circ dunno. Have a look thru my slides on Anne Hathaways presentation at San Diego

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