Can I take BHRT with my coronary artery disease?

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TheBrain
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Re: Can I take BHRT with my coronary artery disease?

Postby TheBrain » Mon Feb 20, 2017 3:09 pm

circular wrote:Back again alysson. So the ADH/osmolality tests were part of the biotoxin labs Dr. Ackerley runs. I'm not sure if others have also had this included. She said she can't tell one way or the other whether I have CIRS because of my borderline labs. I gave a summary of my visit with her here.

We got the biotoxin labs covered (at least my insurance told me ahead that they almost certainly would and I haven't gotten a bill yet) using the chronic fatigue code. The other two codes used were for hypothyroidism and menopausal states for the hormones.

I explained to my primary care doc, and a new one at that, that I'd seen a chronic fatigue specialist but she wasn't covered by my insurance so couldn't run the labs. I gave the new doc the long requisitions from Dr. Ackerley. The new doc covered Dr. Ackerly's info (name etc) with her own and away we went. I'm still a little nervous a bill will show up for the more eccentric labs, but so far so good. I took a reference number from the two calls prior with my insurance where I was assured it would most likely be covered if my doctor thought I needed it...


circular, I imagine it's a bit disappointing to not know whether you have CIRS after all that testing. The good news is that you don't have results that clearly say that you do. But I wonder where you go from here. I did read your post about your visit with Dr. Ackerley, but I will re-read it to see if you wrote about what's next.

Thanks for those diagnosis codes. I've used all three before, so they wouldn't surprise my insurance company if I use them again.

I hope your insurance does, indeed, cover all the biotoxin labs. Good luck!

Do you tend to have low blood pressure? I think maybe the reason my osmolality is low is all the water I have to drink to get my morning, afternoon and evening supplements down. So now I find I have to up the electrolytes to keep up. I can't say I grasp it all that well yet.

I know what you mean about getting up to pee and that being followed by insomnia. That's what happened to me for years and still does occasionally. One thing I have noticed is that when it happens my hamstrings and hip flexors are tight. I don't feel they are tight until I get up to stretch them. I've found that these muscles need to be relaxed for me to drift off again in a short time. I do much better if before I go to bed I heat my hamstrings with a heating pad to get them relaxed (I can't stretch too much because of the hypermobility problem). I heat my glutes then too and sometimes spend a few minutes with the pad under my back. It doesn't take long. The other non-supplement thing that helps is going back to sleep with earbuds and, usually, brain entrainment. I use this Brain Wave app on my phone and find that for me, rather than the sleep options, the Deep Relaxation one really helps me drop back off to sleep. There's one for anxiety that sometimes helps too.


I can have low blood pressure, but I'd say that nowadays, it's usually normal. But I still get lowish numbers sometimes.

That's interesting about your hamstrings and hip flexors. Mine can get tight, and I should stretch them every day. I'll experiment with stretching them before bed, though using a heating pad sounds a bit luxurious. :)

Funny you asked about what hormone targets I use. Countless times when I'm away from my computer I think 'I have to send alysson a PM and thank her for sending me those hormone targets'! Right now I'm not sure what my targets are, but I recall in the list you shared testosterone was pretty much as tolerated. I don't tolerate a lot of that so I pay attention to symptoms for it. I'm undecided about estrogen and progesterone and haven't taken the time to make up my mind. While focusing on so much else I guess I've just been glad I'm getting hormones. Doctor Gundry thought my estradiol was way high at 100.5. I think it was TheresaB who posted that Dr. Gundry said he disagrees with Dr. Bredesen on that because Dr. B is focused only on the brain wrt it while Dr. Gundry is looking outside the brain too. 100.5 is high for Dr. Bredesen too I think (?), but he wants it higher than Dr. Gundry. It would be interesting to hear more from Dr. Gundry's perspective. I need to go back to your PM and see what those targets were and remind myself where you got them :D


In my PM to you, I was quoting what Lilly wrote in that long thread about HRT in E4 women. She wrote about Dr. Trutt's recommendations for E4 women (post-menopausal, I assume). He is an expert in BHRT, and Lilly travels to see him in NYC. Here goes:

===
Estradiol: Correct (75 is where he wants us)
The other numbers are much harder to answer; data not as strong.
Progesterone: probably serum level above 5. (anywhere from 5-20 is ok; 20 is often too high for many women)
DHEA: 200 (average level for a 30 y.o. woman)
Pregnenolone: No one knows (though some claim to know). I just make sure it's not below normal range.
Testosterone: If using cream or oral, free testosterone in normal range. Where in normal range depends on the woman (is she getting oily skin, is libido too high or too low, is she feeling irritable, etc). If using pellets, we go by total testosterone.
===
ApoE 4/4 - When I was in 7th grade, my fellow students in history class called me "The Brain" because I had such a memory for detail. I excelled at memorization and aced tests. This childhood memory helps me cope!

circular
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Re: Can I take BHRT with my coronary artery disease?

Postby circular » Mon Feb 20, 2017 10:05 pm

Thanks for reposting those hormone targets from Dr. Trutt via Lilly! I need to see but I don't think I've added them to the biomarker spreadsheet. Must remember to do that.

I wasn't bothered by not knowing if I have CIRS or mold. I think it will become clear over time. I'm happy to be addressing the MRSA in my sinuses and hope it helps. I think it may be but don't want to say yet in case it's something else. I am my most miserable when on days my sinuses are at their worst. That's when the brain fog and fatigue are strongest. If I can peel off that layer then I'll see what may still be beneath it. I'm reading a little that vitamin D is antiviral, so I need to get that retested and see where I stand now after about a year of supplementation.

I usually do a combination of heating pad and light stretches. Last night I had insomnia even after doing that before bed. When I got on the floor to stretch my hamstrings they were even tighter than usual. I then remembered I'd done an exercise I don't normally do that would tighten them. It seemed to have a direct effect on my sleep pattern, but then it might have been something else too.
ApoE 3/4 > Thanks in advance for any responses made to my posts.

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Re: Can I take BHRT with my coronary artery disease?

Postby circular » Mon Feb 20, 2017 10:25 pm

alysson wrote:circular, thanks for posting this comment with Masterjohn's response. I hadn't looked at the comments. Your post encouraged me to search his site, and I found two relevant podcasts (which include transcripts):

Ketogenesis Isn’t All About Carbs and Insulin

Insulin Resistance Isn’t All About Carbs and Insulin

These are good. Thanks for posting them!
alysson wrote:I'm seriously considering abandoning the ketogentic diet, at least for now. Yesterday, I came across two sources that say if you have thyroid disease, the ketogenic diet is not for you. I have Hashimoto's with a burned-out thyroid gland and an unusual pattern with low free T3, low free T4, and low TSH. I had this pattern before I delved into ketosis last year, but I went low carb years ago.

According to the one source, anyone with hypothalamic-pituitary-adrenal (HPA) axis dysfunction shouldn't go on a ketogenic diet, and I definitely have that. (It really should be HPAT axis, with the "T" meaning "thyroid.") I probably should be on a moderate carb diet, which would better support my thyroid and my gut microbiome. However, what I'm not clear on is whether supplementing with ketones is a good idea for someone with thyroid disease (and ApoE4). I suspect it is.

It might be a timing thing to as you heal different layers. I also wonder about the long daily intermittent fasting. I think the number of hours is somewhat relative. Except occasionally when I'm really not hungry, I don't think going past 12 or 13 hours is good for me. It's too destabilizing, regardless of macro ratios. Sometimes I think the old adage about having some protein, carb and fat at every meal to keep blood sugar stable has its place. For me these days I front load most of my carbs in the morning and have a small amount in the afternoon, while fats are the reverse. Then I'm working to have protein at every meal, not just two, but one can be plant protein.
ApoE 3/4 > Thanks in advance for any responses made to my posts.

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Re: Can I take BHRT with my coronary artery disease?

Postby ncrocker » Tue Nov 26, 2019 8:07 pm

Does anyone have any thoughts on pellet hormone therapy?

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TheBrain
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Re: Can I take BHRT with my coronary artery disease?

Postby TheBrain » Wed Nov 27, 2019 4:52 am

ncrocker wrote:Does anyone have any thoughts on pellet hormone therapy?


I considered trying pellet hormone therapy, but my functional medicine practitioner convinced me not to. She has seen many patients who are miserable on this therapy, and there’s nothing they can do but wait the three or so months until the hormones are used up. If I recall correctly, the problem is getting the dosing right, and if it’s not right, symptoms ensue.

Also, my health insurance wouldn’t cover this therapy, but it does cover the estradiol patch and oral progesterone. I tried compounded testosterone (not covered by my insurance), but my body seemed to reject it. At whatever dose I tried, my blood level remained relatively low and none of my symptoms improved.

That said, I know someone who uses pellet hormone therapy and is very pleased with it. It has been great for her since her very first treatment.
ApoE 4/4 - When I was in 7th grade, my fellow students in history class called me "The Brain" because I had such a memory for detail. I excelled at memorization and aced tests. This childhood memory helps me cope!

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Re: Can I take BHRT with my coronary artery disease?

Postby ncrocker » Wed Nov 27, 2019 3:02 pm

Thank you!

Maybe I could start with the estradiol patch and oral progesterone and testosterone and then move on to pellets once I have confidence that my doctor has the dose right. We should gain information by using the patch and orals. The pellets are supposed to be best because they provide the most even dosing and you don't have to do anything about them for some weeks.

I am considering hormone replacement for Alzheimer's prevention as well as to ease some of my Parkinson's symptoms. I'm curious if anyone has tried it for Parkinson's. I will be my doctor's first Parkinson's patient to try hormone replacement. I started the keto diet for Alzheimer's prevention and ended up discovering that it helped my Parkinson's, so I am hopeful. I am getting used to being n=1.

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Re: Can I take BHRT with my coronary artery disease?

Postby Ssa » Tue Dec 03, 2019 6:55 am

Hi ladies!
I thought I would jump in on your discussion. I’ve been exploring the past posts on the forum and found this thread.
I have been on bio identical pellets for over four years and love them. I am on estradiol, two testosterone pellets ( one of these has an added anti estrogen that prevents the testosterone from converting into more estradiol). I take oral progesterone at night 100mg. It helps with sleep only if it’s oral. Progesterone cream does not help with sleep. At first I got them inserted every 3 months and it seemed a bit much so now I get them closer to four months.

After my second round of pellets I thought I was going to have to stop getting them because I started spotting and cramping like a period. I panicked and called my doctor. She really had no advice and seemed disappointed that maybe I would fall into the category of women who couldn’t do pellets. I asked if I should up my progesterone and she said no. I had upped it and everything got worse. I researched and it was hard to find any solution. I finally found info on women doing pellets in Europe and learned that should stop the progesterone and just have a period. I did that. This was so strange since I hadn’t had a period in 10 years. It took about a week or two and then it was over. That was 3 1/2 years ago and it hasn’t happened again.

I think many women on pellets that don’t like them are doing this maybe and they never stop the progesterone to go ahead and have a period. I have my annual Pap smears and have no build up and have never spotted again.

I just got my pellets again last September and she raised my estradiol a good bit. She said my estrogen was low. We will see if I spot again but so far I haven’t. It has really helped my sleep to raise my estrogen which was much improved but beginning to wake again in middle of night which is why she raised me.


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