Our 3rd annual meet-up will piggyback on the LowCarb USA conference in San Diego, CA, August 3-6.

Hormone Replacement Therapy E4 Women

Insights and discussion from the cutting edge with reference to journal articles and other research papers.
User avatar
Stavia
Mod
Mod
Posts: 3939
Joined: Tue Apr 29, 2014 6:47 pm
Location: Middle Earth

Re: Hormone Replacement Therapy E4 Women

Postby Stavia » Tue Jan 13, 2015 7:10 pm

circular wrote:Perchance is there a big histamine burst during a hot flash?


don't think so, I think its neuronally mediated vasodilatation, not histamine mediated.

PhillyFree
Contributor
Contributor
Posts: 50
Joined: Sun Nov 03, 2013 4:03 pm
Location: Silicon Valley CA USA

Re: Hormone Replacement Therapy E4 Women

Postby PhillyFree » Wed Jan 14, 2015 1:39 am

The SPECT scans such as used by Dr. Daniel Amen http://www.amenclinics.com have a lot to do with blood flow,
circulation, which would point up not only the importance of some minimally effective level of estrogen (and complementary
micronized progesterone), but also exercise, yoga downward dog, weed pulling, inversions and slant boards...?
There are Dr. Amen lectures with SPECT images on YouTube. He has several books as well.

User avatar
Stavia
Mod
Mod
Posts: 3939
Joined: Tue Apr 29, 2014 6:47 pm
Location: Middle Earth

Postby Stavia » Sat Feb 28, 2015 5:09 pm

Back to HRT ladies : Lily has said Dr Trutt is aiming for estradiol levels of 50 to 75 your units.
Anyone else have any other targets?
Im now on a whole 50mcg estradiol patch and feeling ok. Was on half for a month and now a whole. Micronised progesterone 100mg 25 days.

User avatar
KatieS
Mod
Mod
Posts: 986
Joined: Wed Mar 05, 2014 1:45 pm

Re: Hormone Replacement Therapy E4 Women

Postby KatieS » Sat Feb 28, 2015 5:55 pm

Stavia, Glad to hear you're feeling better with the titrated dose upwards. Some protein bind the estrogen, so the dose adjustment is so individual.

User avatar
Stavia
Mod
Mod
Posts: 3939
Joined: Tue Apr 29, 2014 6:47 pm
Location: Middle Earth

Postby Stavia » Sat Feb 28, 2015 8:41 pm

Kitano, so the method of determining dose is basically how I feel?

circular
Contributor
Contributor
Posts: 3244
Joined: Sun Nov 03, 2013 10:43 am

Re: Hormone Replacement Therapy E4 Women

Postby circular » Wed Mar 18, 2015 2:14 pm

Okay, so can anyone save me 20+ pages of reading here and help me zero in on what might be "optimal" menopausal levels for women of the following? I know Dr. Bredesen wants to optimize them, and participants in his study can't divulge the target, so I guess if anyone has a clue -- outside of his study, or what their belief was pre-study -- whether "optimal" might mean high end of range or mid-range that would be helpful. Assuming it wouldn't be low end. I'm actually probably still going through meno which my numbers seem to reflect but it's almost a year.

I am:

Testosterone Total LC/MS = 52 ng/dL
Testosterone Free, Direct S = .2 ng/dL

Thyroxine (T4) Free, Direct, S = 1.29 ng/dL

Cortisol = 6.6 ug/dL

Estradiol = 108.1 pg/mL
Estriol = < 0.1 ng/mL

Progesterone = .6 ng/mL
ApoE 3/4 > Thanks in advance for any responses made to my posts.

PhillyFree
Contributor
Contributor
Posts: 50
Joined: Sun Nov 03, 2013 4:03 pm
Location: Silicon Valley CA USA

Re: Hormone Replacement Therapy E4 Women

Postby PhillyFree » Wed Mar 18, 2015 6:41 pm

Post-menopausal reference ranges as used by
Life Extension Fndn http://www.lef.org

•Estradiol: (<5.0 – 54.72 pg/mL)

•Progesterone: (0.1 – 0.8 ng/mL)

•DHEA-S: (10 – 190 ug/dL)

•Testosterone:
Total: (6.0 – 82.0 ng/dL)
Free: (0.03 – 1.55 pg/mL)

--------------------------------------------------------------------------------
from globalrph.com

*Cortisol, serum
AM: (4.3 - 22.4 µg/dL) (8 am, since cortisol drops off rapidly after 8 am moving toward 12 Noon)
PM: (3.1-16.7 µg/dL)

*TSH (0.3 - 3.04 mIU/L) (Note: I'd rather see it under 2.0, closer to 1.0 if hypothyroid and taking thyroid meds)
free-T4 (0.8 - 1.8 ng/L)
free-T3 (2.3- 4.2 pg/mL)

PhillyFree
Contributor
Contributor
Posts: 50
Joined: Sun Nov 03, 2013 4:03 pm
Location: Silicon Valley CA USA

Re: Hormone Replacement Therapy E4 Women

Postby PhillyFree » Wed Mar 18, 2015 6:57 pm

Circular,
Your testosterone and progesterone are midrange and as espected in postmeno,
estradiol is high for postmeno. This makes you "estrogen-dominant" (i.e. low progesterone in relation to estrogen).
I'd retest at 2 years fully postmeno (no periods for a year is considered at full menopause).
Get DHEA-S next time also.

Key SNPs on SHBG gene (sex hormone binding globulin) influences how much free hormone you end up with
out of serum testosterone and estrogen testing. Wildtype - normal expected free hormone forthcoming, heterozygous
reduces expected free hormone by 15%, homozygous variant reduces expected free hormone by 30% -- something to
take into consideration when evaluating needs for HRT. Check your 23andme or promethease for SHBG.

free T4 is normal, but thyroid was not adequately tested. Next time, get TSH, free T4 and free T3, possibly even two
Hashimoto's antibodies if you suspect hypothyroid, since 90% of hypoT today is caused by Hashimoto's autoimmune thyroiditis,
which in turn is often fueled by eating gluten and dairy.
Very, very few people need to test for reverse-T3, which is the body's defense against catabolism, seen
in persons with very high cortisol or taking glucocorticoid meds or very low cortisol (like Addison's) -- this is probably not you.

Serum cortisol is mostly bound hormone. Needs to be tested at 8 am as cortisol levels drop off rapidly after that
heading toward 12Noon. Unless cortisol was tested around 7:30-8:30 am, I'd consider the result meaningless.
Directions for "morning" cortisol are just too vague, owing to diurnal cortisol rhythms. Consider getting a 24 hr diurnal
saliva test for cortisol from ZRT labs, 4 snapshots during 24 hrs, also known as an ASI (adrenal stress index) test. Can get
this direct to consumer at e.g. mymedlab.com

circular
Contributor
Contributor
Posts: 3244
Joined: Sun Nov 03, 2013 10:43 am

Re: Hormone Replacement Therapy E4 Women

Postby circular » Thu Mar 19, 2015 10:25 am

PhillyFree thanks for all that. I didn't think to see what LE might say. I'd expect they'd be going for some version of "optimal". I haven't known whether lab ranges are considered optimal.

Thanks for noting the estrogen dominance. It seems my estrogen is out of sync in general. I have the problem of not being able to take progesterone due to the laxity effects, so I have to check my uterine lining every so often, which is really no issue at this juncture. But I know estrogen dominance isn't desirable, although I wonder if it would it be less of an issue when the estrogen is bioidentical? What symptoms to look for?

I'll be doing much more complete testing when Dr. Bredesen's people call me for the out-of-study review. This one was just to see where the main hormones I'm supplementing are before renewing the scripts. I did ZRT four cortisol some years back and was low morning/high evening. I should do theirs again. Thanks.

There are a bunch of SHBG rs#s listed. Which do I look at, and which is the normal value and which the variant?

Many many thanks!
ApoE 3/4 > Thanks in advance for any responses made to my posts.

rep
Contributor
Contributor
Posts: 310
Joined: Tue Oct 14, 2014 1:33 am

Documentation for Window of Opportunity for Starting HRT - Urgent

Postby rep » Wed Jun 03, 2015 6:43 pm

I need a link to a study that provides info on the "window of opportunity" for starting HRT to prevent dementia.

I've heard that it is a ten year window. Is that 10 years after last period?

I would like documentation for my doctor for an appointment for tomorrow. It's critical. Thanks much.

Also - did any of you have breakthrough bleeding when beginning HRT then have it go away?
Is bleeding in the beginning common?
Thanks.


Return to “Science and Research”

Who is online

Users browsing this forum: No registered users and 1 guest