Ideal post-menopausal estrogen level?

Alzheimer's, cardiovascular, and other chronic diseases; biomarkers, lifestyle, supplements, drugs, and health care.
User avatar
Gilgamesh
Contributor
Contributor
Posts: 1711
Joined: Sat Oct 26, 2013 11:31 am
Location: Northeast US mostly
Contact:

Re: Ideal post-menopausal estrogen level?

Post by Gilgamesh »

Hey friends,

Just came across this cool -- and potentially important -- paper in pursuing a totally different matter:

Accelerated Cell Aging in Female APOE-ε4 Carriers: Implications for Hormone Therapy Use

I don't know enough about HT in women (or in men, for that matter) to know how to advise my ε4-carrier women relatives, but I'd love to hear what our experts think about it.

GB
User avatar
Stavia
Contributor
Contributor
Posts: 5255
Joined: Tue Apr 29, 2014 6:47 pm
Location: Middle Earth

Re: Ideal post-menopausal estrogen level?

Post by Stavia »

Nice find G. This follows on the first paper (suggesting telomere protection in e4s) that prompted Lily to persue HRT, a very small sample then IIRC. Nice to see it reproduced in a bigger sample.
Lucy5
Contributor
Contributor
Posts: 480
Joined: Sat Oct 03, 2015 10:52 am
Location: Colorado

Re: Ideal post-menopausal estrogen level?

Post by Lucy5 »

Great post GB...thank you for looking out for those of us struggling w/the HRT choice!

I decided to go on HRT a number of years ago despite the cancer concerns (so prevalent in my family). When I first read about the possible reduction in cellular aging for Apoe4s, I used that as an argument with my GP as a reason to continue. Also, concerning for me was the argument that there is a "window" in which beginning HRT is effective (tho not so current where that analysis stands now). My doc seems more concerned with breast cancer. My view and debate with him is: I at least have a shot at surviving breast cancer should I get it; the odds at surviving LOAD (not to mention my risk as a 4/4) is dismal to say the least. For me, this study ends the debate. If I was a 3/4, I might feel differently, not sure.

The real question for me at this point is the best HRT protocol. Flying blind on that for now...
Silverlining
Senior Contributor
Senior Contributor
Posts: 366
Joined: Wed Oct 30, 2013 4:14 am

Re: Ideal post-menopausal estrogen level?

Post by Silverlining »

Julie...have you resolved your HRT and estradiol levels challenge? For me, the struggle is ongoing. My baseline estradiol was 18.9 three months ago. Since then, I've been on estradiol/estriol as follows

Biest cream 2ml (80% estriol, 20% estradiol)
Biest cream 4ml (80% estriol, 20% estradiol)
Biest cream 4ml (70% estriol, 30% estradiol)

This week I pulled another estradiol lab and it's FALLEN to 14.5. I'm still quite symptomatic with hot flashes night and day (not to mention several other unpleasant meno symptoms). So the new script this week will be Biest 4ml (50% estriol, 50% estradiol).

I'm freaking out because I feel like I'm the one deciding all of this and I don't know what the hell I'm doing! Each month, I get on the phone with the compounding pharmacy and they basically do what I ask. I have no idea why my levels are falling. I'm wondering if the patch would be better? If anyone has answers, please share them! Meanwhile, I'll just keep on with the blind leading the blind....

On another really nasty note...I pulled an NMR and it is SO horrible, much worse than ever before. I'm assuming hormones are responsible? Apparently, I'm now a walking high risk stroke/MI candidate. I guess though, that it takes time for these numbers to actually result in an adverse event, so I need to figure these things out sooner rather than later. Sure feels overwhelming, but I know I'm preaching to the choir!
User avatar
Julie G
Mod
Mod
Posts: 9187
Joined: Sat Oct 26, 2013 6:36 pm

Re: Ideal post-menopausal estrogen level?

Post by Julie G »

(((Silver))) You know I've been there. Honey, the cream (by itself) just isn't working. YES, move on to a patch. You may need to use both- I do. This is a critical period for your brain and overall health. I suspect that some thin women simply have a hard time absorbing estradiol.

Although Dr. Bredesen has recommended I get levels up to 80, my gyn has set a more realistic goal for me of 50 that honors my practice of CR. I'm set to re-test soon. I've moved my high dose patch (0.1 mg) to a fattier part of my body and am using Estrace cream (TV route.) I think my levels are up as evidenced by breast tenderness, etc. IF not, my gyn is actually considering a second patch. I would love to hear from others who've successfully raised levels. It's clearly not easy for some of us.

Circ, you also have/had PCOS? As I recall from Drs. Lisa Mosconi & Stephen Cunnane (discussed at our NYC conference) that presents a similar risk factor for reduced cerebral glucose as having an E4 as evidenced by PET-FDG imaging :shock:
User avatar
KatieS
Senior Contributor
Senior Contributor
Posts: 1224
Joined: Wed Mar 05, 2014 1:45 pm

Re: Ideal post-menopausal estrogen level?

Post by KatieS »

Silver, I so hoped that PAP would ameliorate these hormonal fluctuations, as PAP over time seemed to increase my sensitivity to insulin and estrogen. I agree with Julie's recommendation as I use the generic estradiol patch made by Sandoz (actually prefer this to the Vivelle as it sticks better on my skin) on my outer fatty buttock area to get that 20% increase absorption.
circular
Senior Contributor
Senior Contributor
Posts: 5565
Joined: Sun Nov 03, 2013 10:43 am

Re: Ideal post-menopausal estrogen level?

Post by circular »

I wonder what role the based used in the compounded HRTs plays. My first two compounders used Versabase which is quite "pure" and non-allergenic and absorbs well. My third didn't have that and used their cheapest on me. I had histamine reactions. I looked up ingredients and it had BHT and petroleum (if I recall right). It didn't feel like it absorbed well at all. I asked for Versabase as written in my prescription. They didn't carry it. They had something called HRT base. I got that while they ordered Versabase for me. The HRT base seemed fine as far as no reactions, but I'll be glad to have the Versabase back. I like it best.

The compounding pharm, when I told her I was reacting to her cheap money-saving base (not using those words ;) , was skeptical and said "there's nothing in it". I read her the ingredients from a website and told her I have mast cell issues and react when others wouldn't. She changed her tune pronto. Geesh. I'm getting tired of living in a fox hole (bless those actually doing so).

That's not to say the patch isn't warranted. My OB/GYN was comfortable with estradiol at 100 while Dr. Gundry said he likes it somewhere around 35 but seemed willing to defer to her (?). I'm thin but seem to be absorbing it. I put it on my inner thighs. A compounder said to use it where the skin is thin as opposed to over body fat (???).
ApoE 3/4 > Thanks in advance for any responses made to my posts.
circular
Senior Contributor
Senior Contributor
Posts: 5565
Joined: Sun Nov 03, 2013 10:43 am

Re: Ideal post-menopausal estrogen level?

Post by circular »

Juliegee wrote:Circ, you also have/had PCOS? As I recall from Drs. Lisa Mosconi & Stephen Cunnane (discussed at our NYC conference) that presents a similar risk factor for reduced cerebral glucose as having an E4 as evidenced by PET-FDG imaging :shock:
:shock: is right! Although I really didn't fit the PCOS clinical picture, my hormonal and symptom profile was similar enough, and there was no better explanation, that in the PCOS basket I went. Many years later I found out it was gluten causing the irregular cycles when I went completely off gluten and the PCOS med (Metformin) at the same time. Regular periods from that point forward.

Gluten being one of, if not the, big kahunas in the lectin world, this fits Dr. Gundry's theory (see his Diet Evolution book) about plants evolving lectins to wreak havoc in their animal predators and keep them from gobbling their babies (seeds). This extreme version would be a lectin's ability disrupt the predator's reproductive system to stop their survival altogether. While I can't site firm science to support this theory, I find it interesting.

So we have PCOS involving insulin resistance, which could dovetail with cerebral hypometabolism of glucose, and also PCOS possibly involving lectin sensitivity, at least in some. Given the symptom overlap between carb intolerance/PCOS and lectin-gluten intolerance/PCOS, and given what you say about PCOS and brain hypometabolism of glucose, I'm wondering how lectins may also play a role in brain hypometabolism of glucose (in sensitive people)! When Dr. Gundry saw the Framingham data showing thin women with high adiponectin having higher dementia rates, as a cardiologist he envisioned the lectins damaging the brain vessels. (That's the part he communicated to me.) I'm thinking the inflammation involved exerts broader insults. Does brain inflammation also lead to hypometabolism of glucose?

Sorry to stray so from post-menopausal estrogen levels. Move this elsewhere if you wish.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
circular
Senior Contributor
Senior Contributor
Posts: 5565
Joined: Sun Nov 03, 2013 10:43 am

Re: Ideal post-menopausal estrogen level?

Post by circular »

Would be good to see a study of E4 rates in women with PCOS dx.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
Jean
Contributor
Contributor
Posts: 80
Joined: Sun Mar 22, 2015 2:22 pm
Location: Colorado, Front Range

Re: Ideal post-menopausal estrogen level?

Post by Jean »

Silverlining I can relate to what you're going through. I hope you can move to the patch too. I'm sure I didn't know what the hell I was doing until something worked for me with HRT. I've been on it 15 yrs. and landed with the patch after trying oral methods, including other types of estrogens for a few years.

Julie, I'm glad you're aiming for lower estrodial for you!

I judged HRT success by how I felt and how my body reacted. I noted that when I reached an estrodial level of 88 in 2005, I felt fat and my breasts hurt, and I think my mood suffered too. At that time I was with a doctor that aimed for higher levels. I felt better at levels between 48 and 70, and my Pharmacist friend and tutor was concerned since my estrone (bad circulating estrogen) was too high (84) in 2005. Last year at an estrodial level of 67, my estrone was 42.

The .5 patch worked well for me from 2009-2014. Then night sweats, and sleep problems led me to try .75 in 2014 which is working well for me now. My estrodial levels were at 66 in 2014 and 67 in September of 2015. However, when I moved my patch to my butt, my recent November estrodial test showed a drop to 48. So I'm going to return the patch to my abdomen. I hope my levels return to the 60's since I tolerated that level well.

However, on the scream side, my thyroid TSH just keeps rising. I do have other test results too, but not enough. ---for another thre
Post Reply