Hormone Replacement Therapy E4 Women

Insights and discussion from the cutting edge with reference to journal articles and other research papers.
circular
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Re: Hormone Replacement Therapy E4 Women

Postby circular » Mon Dec 22, 2014 12:47 pm

Interesting new study. Although they seem to miss the possibility that contradictory results as to HRT and cognitive benefit in women may have to do with ApoE status, it still provides some good food for thought:

"Just for Her? Study of Women’s Biology Offers New Therapeutic Angle"

http://www.alzforum.org/news/conference ... utic-angle

I find this bit about allopregnanolone personally disturbing since I can't take progesterone, but may be encouraging to women who can:

"This neurosteroid metabolite of progesterone triggers the birth of new neurons, curbs amyloid deposition, and preserves cognition."

Dr. Bredesen measures pregnanolone. I wonder how that's different from allop...

And here's something to suggest why progesterone helps with anxiety http://www.ncbi.nlm.nih.gov/pubmed/23348009
ApoE 3/4 > Thanks in advance for any responses made to my posts.

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Re: Hormone Replacement Therapy E4 Women

Postby alysson » Mon Dec 22, 2014 2:05 pm

Sandraz, Stavia, and Kitano, thanks for your comments. Much appreciated.

Yes, I imagine the study testing will include these hormones, but as Stavia pointed out, hormones do fluctuate during perimenopause, so a single snapshot in time might be of limited value. I will be patient and trust that if they believe I need HRT based on testing, age, and symptoms, they'll let me know. And I imagine they might actually suggest a specific dose and brand.

It is good to hear that sleep for the two of you improved with HRT.

I also have a problem with low DHEA. Earlier this year, I had been taking 5 mg of DHEA per day, but saliva testing showed my DHEA was near zero, as was my testosterone. So my doctor suggested I increase my dose, up to 25 mg per day. I went with 15 mg. After a few months, I was retested and my DHEA and testosterone were way high. My doctor said stop all DHEA for two months. Now I'm doing one week on, one week off, of 15 mg of DHEA per day, per the recommendation of my alternative healthcare provider.

For now, I'll just do my best to be patient (not one of my virtues). :)
ApoE 4/4

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Re: Hormone Replacement Therapy E4 Women

Postby LillyBritches » Mon Dec 22, 2014 9:46 pm

Stavia wrote:Lily honey, oestrogen suppresses fSH and LH so they have to be low on hrt if the dose is enough. Hes splitting hairs, you " arent in menopause" cos youre taking hrt, youre not making the oestrogen yourself...I dont understand what hes saying....
Lilbunny, units!!! I feel like G but I wanna compare pls. My oestrogen level is now 150, its perfect apparantly. However I am spotting so will have to fo cyclical with periods. Meh its ok.


Hey, girl I agree with you to a certain extent. And that extent is this: my FSH has always been low, even before I began HRT and before he began testing my estrogen/estradiol levels. My FSH has been consistently low even when my menses ceased. My FSH was low when my body wasn't really producing any estradiol (pre-HRT); my estradiol at that time tested at only 11 units (3 pg/ml). My FSH was still low after a few months on HRT; at that time, my estradiol tested at only 110 units (30 pg/ml). I don't think that's enough supplemental estrogen to suppress FSH levels.

Speaking of menses...guess who visited TODAY? Just in time for Christmas. :lol: This, after almost a week OFF ESTRADIOL. And after Auntie had been on "sabbatical" for a lllllooooonnnnngggg time. Long time.

Dr. Trutt and I emailed about it today - he said to wait two more days before restrating my estradiol (at a lower dose) and to also DC my progesterone for two days. Also said my body just might not want estradiol at 257 units (70 pg/ml). Sigh.

I'm telling you - my body wants me to spawn. Pffffttt. Girlfriend's gonna wait FOREVER. Cuz these eggs ain't gonna hatch. ;)
I'm just a oily slick in a windup world with a nervous tick.

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Postby Stavia » Tue Dec 23, 2014 2:17 am

Hmmm...fertile vampire genes? Baby vampire Lillianes trying to take over your pituitary?
Wow.

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Postby LillyBritches » Wed Dec 24, 2014 2:52 am

Stavia wrote:Hmmm...fertile vampire genes? Baby vampire Lillianes trying to take over your pituitary?
Wow.


Yep. Just call me Delta. ;)
I'm just a oily slick in a windup world with a nervous tick.

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Re: Hormone Replacement Therapy E4 Women

Postby Julie G » Wed Dec 24, 2014 9:24 pm

Stavia, you ARE a SciFi chick :lol:

I've noticed something odd regarding serum hormone levels and wondered if anyone else was having a similar experience...I've been using the same bio-identical Minivelle estradiol patch since April, .075mg. My first round of testing revealed a serum level of 47. My second round, on the same exact dosage, showed a level of 27. Huh? :shock:

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Postby Stavia » Thu Dec 25, 2014 1:19 am

Different time of test in relation to drug trough level? Different skin thickness ie site varied thus absorption varied?

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Re: Hormone Replacement Therapy E4 Women

Postby KatieS » Thu Dec 25, 2014 7:34 am

Julie, where do you apply the patch? Somewhere I read that the patch has 20% increased absorption over fat, then a skinny abdomen, so once I changed to the side of my buttock, I did feel a mild boost.(http://www.ncbi.nlm.nih.gov/pubmed/10993035)

Looks as if the buttock only provides less variation in the dose:
"The relative standard deviation of each pharmacokinetic parameter after application to the abdomen averaged 50 percent, which is indicative of the considerable intersubject variability associated with transdermal drug delivery. The relative standard deviation of each pharmacokinetic parameter after application to the buttock was lower than that after application to the abdomen (for example, for Cmax 39 percent versus 62 percent, and for Cavg 35 percent versus 48 percent)."
scroll down to the pharmacokinetics:http://www.drugs.com/pro/estradiol-patch.html
Note how the levels fall, so be sure and have the same timing to correctly compare levels.

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Re: Hormone Replacement Therapy E4 Women

Postby Julie G » Thu Dec 25, 2014 8:27 am

Intriguing, Stavia. Tell me more about how serum levels change throughout the day. Could that really explan a 20 pg/mL drop?

I've been placing the patch on my lower abdomen, near ovaries, and switching sides- very little fat there. I had NO idea that fat aided in the drug delivery, Kit- eye opening- and an easy change, However, since my weight & patch placement has remained stable throughout both testing periods, that still doesn't explain my decreased absorption.

Puzzled :?

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Re: Hormone Replacement Therapy E4 Women

Postby KatieS » Thu Dec 25, 2014 8:49 am

When I switched to the upper outer buttocks, I covered the patch with a thin strip of paper tape, especially since I swim or sweat so much, it helps keep the patch from slipping off.

Julie, do you consume soy-based products that could boost your levels? Likely you still have some ovarian output of estrogen that factors into your levels.

At 62, my doctor refuses to even measure my levels, since he will not respond by altering the ultra-low dose. I don't think we know what level is considered optimal for women in their 60s.


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