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Hello! I sure have mentioned transdermal hrt to my functional medicine aprn, pcp and gynecologist. All say no because I carry the gene factor v leiden heterozygous which puts me more at risk for blood clots. There are no studies in the United States including women with this genetic disorder. It has been approved in United Kingdom for women at risk for blood clots and had/have cancer. Bioidentical transdermal hrt is the safest way to go. My main cause of osteoporosis is loss of estrogen. Took Teriparatide then had to stop after 6 months due to high levels of calcium in 24 hour urine. Had my first Reclast infusion last month. Just have to take one day at a time. I'm due to have a Dexa scan in 2025 with tbs so hopefully some improvements since this years testing though I never had tbs with my dexa before, so hoping I have good quality bones.
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I have Factor V also and found out only in 2000, when I had a knee replacement and my entire leg clotted afterwards. Fortunately the Genome Project had just completed its work, so Factor V was a known thing and one of the specialist called in for my knee issue ordered a test. I've had other clotting but so far only post-surgically. I'm now 86 and have had a second knee replacement and recent broken femur surgery without incident though I always have a hematologist on the case.
I've also taken transdermal bioidentical estrogen and progesterone for several decades now. It was recently upped a bit for the osteoporosis diagnosis. One of my doctors who approved its use for me is the founder of the lab system for Functional Medicine at the Cleveland Clinic. Another is endocrinology royalty, in the direct family line of the discoverer of hormones - her late father and her brother are also endocrinologists. They're Belgian, so a little out of the mainstream. If you can find someone to prescribe it for you, I don't think you should worry about it, and you will feel better and presumably your bones will have a bit of an advantage as well.
What you SHOULD worry about with Factor V is eye surgery, especially if you're on one of the newer drugs like Xarelto. I lost an eye that way in 2018, when I was assured by the hematology establishment that I should be off it for only two days for a drainage tube insertion. I'm leery of Xarelto, so I stayed off it for four days. Still I had a huge bleed from a collapsed eye wall several weeks later, plus more surgeries to remove blood. A year later, the retina guy explained that the blood vessels are teeny and weak, and you need to be off these newish drugs for at least 10 days. I had researched everywhere and seen nothing like this, and when I asked him why he said that, he said when you're a retina specialist you see a lot of older people and quite a few of them are on these drugs. "It's my experience." My three doctors were going to write a case report about this but one thing and another kept them too busy and they didn't. When it turned out the optic nerve was too damaged, the hematologist said, that's because Factor V makes an especially hard clot that's really difficult to dissolve. I'm now on 10mg of Xarelto, which is a fairly recent lowering of the dose recommended for genetic clotting patients.