HRT Safety

Hello @kisu , thank you for the conversation,
I love the LEVQIO! it dramatically clears my sinuses at the time of injection and is the only injection I consistently have ZERO side effects or inflammatory reaction to, over the last year or two since I've been on it.
I inherited familial coronary artery disease FH CAD.
My baseline cholesterol lipid tests are quite good. I have a post menopausal stubborn 240 which drops 40 points when I include more fish. When I stop it goes back to 240. Now on the LEVQIO it has dropped more (I tested with the fish alone, so feel its due to the LEVQIO):
Overall: 186 • HDL-Cholesterol 72 • LDL-Chol (Calc) 87
Calculated using NIH Sampson Equation Near Optimal Value 114;
Did not do APOB
From my research before starting this journey I did READ LPa can rise in the first year due to its loosening of soft plaque which is carried out in the bloodstream and measured....
I don't use HRT patches - I use transdermal compounded hormones; here's an article which may interest you, but I conclude the jury is still out on this one - and my situation only matches parts of the studies here (ie, I was ON BHRT for 11 years upon menopause, gave it a break for 10 years now on it again, and they didn't test familial CAD as far as I can tell and also BHRT transdermal)
The biggest point is to have your heart arteries tested. mine were: 3 clear and 1 block 1/3 That is my baseline - the biggest baseline that matters. My heart calcium level was perfect on the 3 arteries and 28 on the 1/3 blocked. Those are the things that matter.
I found out last week I can't take the Prometrium transdermally so that might have thrown something off I don't know, will find out in few months when I test again.
Correct - you don't have to take a statin BUT you get increased benefit and actually possibility of plaque being removed over the long term (from my reading)
When you ask what will keep the new plaque (stable?) maybe you mean from depositing and hardening -BOTH work on DIFFERENT mechanisms. The LEVQIO inhibits the PCSK9 protein (a problem I believe I have, and that is why it will work for me), statins work on a different mechanism. The best interference is a low-fat, heart-healthy diet and exercise - I am a steadfast believer in this since I was a teenager and believe that is responsible for me not going the way of my dad and cousins. My father took statins for a couple of decades lowering his cholesterol to 169 from 350. But it obviously didn't stop his heart arteries from clogs (had three major clogged artery surgeries and many stints/angioplasties over 30 years. And eventual TIA and a major hemorrhagic stroke.
So keep the cholesterol low but be concerned about the condition of the arteries and our particular bodies' propensity to lay down plaque is my thought....

If I remember correctly, it's 3 months on the Tymlos and then after 1 year. I had the Reclast 9 months before that. Don't expect much at 2 months or even 6 months if it's your bones you are doing it for @kper. You need a baseline, which should be done before starting. Or if not soon, asap after starting both. In which case, you might not see any change in the HRT. Wait until your 1-year DEXA TBS test. That will be a good thing to see. Things that come out of one's bloodstream can not be true markers, as what is in the bloodstream is inconsistent at any test. DEXA scans should have the TBS score included so find a source to do that. The bone changes if you are on the TYMLOS will have positive changes 2-3 years AFTER you have stopped the infusion. https://www.medicalnewstoday.com/articles/reclast-infusion-for-osteoporosis#duration

Hello @celia16 I’m new to this site and am very interested in HRT. I’m curious if you did start and what your experience has been so far? I’m just turning 62 and am very nervous about all the medication options.
Thanks!

I haven’t located anyone to help me yet and I’m very busy with a family matter right now, but it’s definitely still a priority for me. Sadly, the new gynecologist I saw wasn’t helpful. Neither was my endocrinologist. I’ve found a new endocrinologist though. There are some suggestions around here about some other doctors, but I haven’t had time to check them out. I’m now still just using Estradiol cream. I am pleased with that, but would like more in the form of HRT.

Good luck with your search.

@kshea2 I started BHRT at age 67 9 months ago. I found a naturopath certified by the N.A. Menopause Society very knowledgeable about OP and qualified to prescribe HRT. The Naturopath told me that the HRT would stop further bone loss progression of and possibly provide some small gains as long as I remain on the HRT. I had lost bone density at a staggering rate (one year on high dose Prednisone) over a four year period with a DEXA spine score of -2.8 in November 2019 to-3.5 in November 2023. I began following Keith McCormick's "Great Bones" diet and supplement recommendations in December, 2023. A REMS Echolight bone scan showed me at spine T score -3 in April prior to starting the BHRT in July, but Echolight scans often show better scores from what others report so the -3 likely doesn't mean a .5 improvement from 6 months previous. I had a follow-up Echolight scan last month, 8 months after starting BHRT and 10 months after my previous Echolight. My spine T score was -2.6. I feel fairly confident that my bone loss progression has stopped which is a win for me, but I am waiting for a booked DEXA with TBS to cover all my bases. I will post these results when I receive them. I have so far not fractured and the Echolight shows my fracture risk just above low into the moderate range. I am anxious to compare what the TBS says about my bone quality. I hope to avoid medication as I have suffered severe side effects from other medications. However, I am a realist. If my bone loss continues to plummet again, I am open to considering an anabolic.

I forgot to mention I am using the Estradiol patch with micronized Progesterone. I am experiencing no side effects except improved sleep and mild calming effect. The naturopath recommended a Coronary Artery Scan. With a score of zero she said my risk on HRT was minimal and arteries would be quite receptive to Estrogen still. She checked my cholesterol, A1c, triglycerides etc., ordered another CTX, vitamin D and recommended a Lipo A test.

Good info. Thank you. I hope things continue to improve for you.

I am in the exact same position, avoiding medicines at all cost. My endocrinologist is not happy about that as she does not believe in any alternative medicine. I told her if my bones start to really decrease then I will consider meds. I have been holding at worst -2.2 after hormone replacement treatment, My forearm is -4 which it has been for the past 20 years. I don’t even know if most doctors measure the forearm, My doctor is going off of that one score. I pray every day that I remain steadfast in my numbers and they continue to at least stay the same if not improve. As I have mentioned before on this site, my doctor wanted me to go on Prolia 15 years ago!!!! I can’t imagine where I would be today if I did that. My numbers are better now than they were then as far as the DEXA, but I did supplements and exercise, etc., and the HRT.

This is fantastic information, thank you! Your results look very encouraging. I was not aware of the NA Society, so will leverage that source to help find a provider.

I'm just turning 62 and had a dexa in December, 2024 which showed Spine -2.9 (Osteoporosis) /Total Hip -1.8/Femoral Neck -1.8 T-Scores (osteopenia) . Unfortunately one week later I fainted, fell and experienced a compression fracture in T12. January, 2025 I had a Echolight scan which showed Spine -2.2 (Osteopenia)/Femur -2.5/Right-2.9 (Osteoporosis). Fragility scores are in the green zone. I know you can't really compare these types of scans 1:1, but it's a bit confusing.

I've taken Vitamin D for years and have now added K2 and Magneium. I'm working hard to get more calcium through diet. I'm very nervous about the drug therapies and believe HRT could also help with sleep and couple other post menopause issues I experience.

Hoping I can find a provider in the Minneapolis area that is open to this approach. I'm looking forward to hearing your updates! Thanks again!

@kshea2 I'm so sorry to hear about your fall and fracture. I hope you are not suffering a lot of pain. This is a stark reminder of how fragile and vulnerable we are often without knowing. Your REMS Echolight scores are interesting. The difference in your spine T score compared to DEXA is similar to my initial Echolite spine score compared to DEXA. Mine was .5 lower than the dexa and yours .6. My femur neck T score however was the same as the dexa score at -2.6. My second Echolite 10-months later showed my femur neck at -2.3. When I was initially diagnosed with osteoporosis in 2019 with spine T score -2.8, I took calcium and vitamin D for the next 4 years but still rapidly lost bone to a level of -3.5. However I was taking high dose prednisone during 2019/20 for a year for an autoimmune condition. I began many other supplements and diet changes, including increased calcium from food sources, increased protein, K2 Collagen...suggested by Keith McCormick in December of 2023. I find the nutritional and supplement counseling another benefit of the N.A. Menopause Society naturopath. I provided her records of all my DEXAS, Echolight, CBC lab tests, including urine calcium, CTX, vitamin D etc. My blood tests were mostly fine, including vitamin D, calcium and urine calcium. My CTX was at 670 which the naturopath and osteoporosis doctors surprisingly said was okay (Lab test shows 100 to 1000 is acceptable) However Keith McCormick says this number is too high and should ideally be below 400. So it will be interesting to see the result of my follow-up CTX next week. I have heard that HRT can reduce the rate of bone turnover (confirmed also on chat GPT). I consulted with an internal medicine doctor specializing in osteoporosis in May of 2024. She recommended Evenity. I said I would like to hold off to see if I could stop the progression of bone loss first and consulted with the naturopath in July of 2024.