Ideal post-menopausal estrogen level?

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Julie G
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Ideal post-menopausal estrogen level?

Postby Julie G » Wed Oct 14, 2015 12:39 pm

I'm struggling with this one...and I realize there are no easy answers- partially because we're on the forefront of a movement to manipulate biomarkers to optimize cognition and health and partially because there have never been long term BHRT studies.

Dr. Bredesen recommends post-menopausal estrogen levels around 80 and up for the presumed cognitive benefit. I think Lilly's anti-aging doc has similar goals (?) Dr. Gundry, on the other hand, wants our population to have levels between 30-40 for the presumed cardiac/longevity benefit. I see many GYNs recommend post-menopausal levels between 40-50 for optimal bone health. I share all of these goals: cognition, longevity and healthy bones...but am confused with such mixed advice. :shock:

Since I've been practicing CR, my levels have dropped to 39 despite heavy supplementation (.1mg Minivelle & Estrace cream,) but I've been feeling really good- healthy and strong. No menopausal symptoms and my cognition is fairly sharp- for me. I've been slowly trying to eek levels up by using more Estrace cream and by placing my patch atop body fat (symptoms indicate levels are rising) but I feel bleh- bloated, sluggish, and tired. I felt cognitively sharper and overall more energetic with my lower levels.

Is anyone else struggling with this? My guess is that my mild practice of caloric restriction is down regulating my hormones and heavier supplementation may be counterproductive. I'd appreciate any insights.

Kit, I know your Mom supplements. Have you ever tested her levels? Given her longevity, I'm guessing they're lowish...

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KatieS
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Re: Ideal post-menopausal estrogen level?

Postby KatieS » Wed Oct 14, 2015 1:33 pm

Julie, my mom had endometrial hyperplasia requiring a hysterectomy in her later 50s, so I suspect her levels were high. Even now, she is on three times the dose patch I use. If I use a bit more than my 0.0125 estradiol patch, I experience breast tenderness. This alarms me, since I had a SNP unlike my mom, for a 3-fold breast cancer increase with HRT (likely to be synthetic progesterone-related in the small French study part of the original postings on HRT), so I'm just content with my suboptimal dosing and not having to deal with postmenopausal bleeding or frequents US. Bones tend to be protected even with a 0.017 the ultra-low dose patch. Possibly with age, the patch absorption level is diminished, or mine is increased with exercise.

Neither one of us have had our levels checked. When I was in my early 30s, my level was 30, feeling very athletically competitive, as were most of the women in this study which included a Bone CT (I was 175, most others were much lower, 130). Two years later, after less training, my level rose to 180. Two subsequent bone density scans have confirmed better than average density. Bones tend to be protected even with a 0.017 the ultra-low dose patch.

The estradiol levels fluctuate and maybe don't reflect free, unbound estrogen. I would go with your own body's feedback, because feeling sluggish (slightly depressed?) affects that neurochemistry link to AD. My mom is probably the most depression-resistant person I've ever known.

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Re: Ideal post-menopausal estrogen level?

Postby Stavia » Wed Oct 14, 2015 4:28 pm

I'm onto my second gynae now cos first one moving. Second gynae says she feels its hopeless to go with blood levels as the absorption is so variable with transdermal route and she goes by symptoms and tries to have the lowest dose that fix symptoms as she feels the breast cancer thing is dose dependent.
Sigh.
Too complicated

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Re: Ideal post-menopausal estrogen level?

Postby Stavia » Wed Oct 14, 2015 4:29 pm

Kitano are you meaning 12.5 micrograms estradiol?

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Re: Ideal post-menopausal estrogen level?

Postby KatieS » Wed Oct 14, 2015 6:13 pm

Stavia, my halved patch is supposed to absorb 0.0125 mg per day, but contains 0.195mg of estradiol. When I was in my 50s, I used double this dose (& had bleeding!), so now I'm satisfied with this ultra-low dose.

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Re: Ideal post-menopausal estrogen level?

Postby Jean » Wed Oct 14, 2015 7:10 pm

Julie, have you been tested since you've put the patch in a different place that's causing high estrogen symptoms? When I was supplementing at a high dosage like yours, my numbers quickly shot up into the 80's and I felt much like you do now. Did you move it away from your abdomen? Your .1 dose seems high, but I understand where you are trying to go with that.

My level is currently at 67 and it seems like a good level for me. However, I also felt fine at 47 and 60 when I was younger. I gained weight and was just not me if the numbers when the numbers creeped up. I have levels spanning 15 years and tell myself that by this time I think I know how I should feel on the correct dose for me. For years, .5 (half of yours) was just fine. My level was 66 in 2014. When I increased it to .75mg last year, it only went up 1 point.

However, now I'm dealing with the gland that controls the hormones (thyroid) and struggling with progesterone to estrogen ratios, which my current doctor completely discounts? So I don't know where I am hormone health wise. But I'm betting one size doesn't fit all - ever.

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Re: Ideal post-menopausal estrogen level?

Postby Stavia » Wed Oct 14, 2015 8:08 pm

Kitano - that's half of the 25microgram a day patch right? You cut the smallest one in half? How do you know you can safely omit progesterone?

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Re: Ideal post-menopausal estrogen level?

Postby circular » Wed Oct 14, 2015 9:40 pm

Julie that was my thought, maybe you're estrogen dominant now with respect to your progesterone levels? I'm not sure what's an optimal ratio, but when you decide on a preferred estrogen target (let me know if you can sort that one out ;) ) then you'll want your progesterone in a preferred ratio.

Lately my estrogen hit 100 after getting on my old Biest formula after I tested at 5 and found out my BHRT wasn't Biest as supposed. At this time I had no symptoms, maybe because my progesterone was a touch above the high for postmenopausal (lab report .1-.8 ng/mL). I'm not targeting to be that high on both, I'm just trying to find my dosage groove. But like you really don't know my target.

Actually for some time I've wanted to get away from these creams and look into the bioidentical ones approved by the FDA. Every single doctor I talk to talks about the creams being unreliable in their dosing/absorption, but I'm not sure if they're just drinking Kool-Aid.

I mentioned Dr. Gundry likes levels 30-40, but I'm not sure that's his view specific to our population? I got the feeling it was in general, but ya, probably more cardio related.
ApoE 3/4 > Thanks in advance for any responses made to my posts.

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Re: Ideal post-menopausal estrogen level?

Postby Stavia » Wed Oct 14, 2015 9:53 pm

I've been on the patches for a while and have maybe 10 or 15 blood level tests. Always more than 12 hrs after I change a patch. I always put them in one of exactly two spots on my tummy symmetrically.
The oestradiol blood levels have been bouncing around a LOT. Between 100 and 300ish of my units. I don't think its KoolAid.

Its the same when we docs use fentanyl patches for terminal care. Terribly unpredictable and inconsistent.

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Re: Ideal post-menopausal estrogen level?

Postby Julie G » Thu Oct 15, 2015 10:06 am

Huge thanks to all for weighing in. I’ve been looking at this from all different angles and sort of have a plan for ME…for now. I’m convinced that this is yet another case of one-size-fits-all NOT applying to our population :?

First, thanks for sharing about your Mom, Kit. I was particularly interested in her POST-menopausal levels as I suspect she’s an excellent example of an E4 with longevity biomarkers. It sounds like you don’t have that information but given the relatively low dose of E2 that she takes, we can presume that they are lowish- 30’s maybe??? If you ever get her levels checked, please share. I suspect we can all learn something. Did she use HRT during the transition to menopause? Out of pure curiosity, I’d also love to know her IGF-1 level. I suspect that’s also low. She’s a remarkable example to us all and her health bodes very well for you.

Yes, I agree with you all that estrogen levels fluctuate with transdermal dosing, but testing still provides us with “something." The most reliable data is probably a combination of actual testing and symptoms. Based on that formula, I’m guessing my levels are currently in the low 50s and I feel BAD with a higher level. My breasts and belly are so swollen and bloated. I feel hungry all of the time. (Estrogen increases ghrelin.) And, did I mention the zit on my chin? I feel like I’m fourteen…in a bad way. I feel weighted down, sluggish, less cognitively sharp. It would be ludicrous for me to ignore this & keep trying to raise levels.

I suspect that my estrogen levels are as low as they are (despite supplementing) because of caloric restriction. Practitioners seem to have lower hormone levels, which is supposed to be a part of the benefit. There seem to be two schools of thought with the anti-aging philosophies. One is to try to normalize hormone levels with supplementation to match that of a younger person. Drs. Bredesen and Trutt seem to follow this school. The second philosophy is that of slowing down the systems within the body to slow down the aging process via caloric restriction. Dr. Gundry seems to follow this approach. (BTW, Circ, when I referred to Gundry’s advice for “our population” I simply meant post-menopausal women.) FWIW, I found this link (based on very limited non-human evidence) suggesting that caloric restricted women should NOT supplement estrogen: http://calorierestrictiondietplan.com/g ... -estrogen/ Sigh. Given my much greater propensity for cognitive decline, coupled with my history of severe hot flushes (low cerebral hypometabolism) following that advice probably isn’t a smart option for me.

Jean, excellent observation about the importance of ratios. Mine are all out of whack. My testosterone is fine at 1.4 pg/dL, but my progesterone is sky high at 6.1 ng/mL despite only taking 100 mg at night. I’m going to have to switch to a compounded version and cut my dose in half. I plan to keep my estrogen supplementation steady and NOT work on increasing levels. If my cognition worsens, I can work on up-regulating levels to help address the problem. Arbitrarily increasing them now, when I feel good, feels counterproductive to my strategy. Have I mentioned, I’m a work-in-progress? LOL. Huge thanks for the help, friends.


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