HRT Safety

Posted by debbie1956 @debbie1956, Jun 8, 2024

I wanted to share this Medscape article I received today about new study on HRT. I am considering HRT for my osteoporosis at age 67 and am so encouraged by this article: https://www.medscape.com/s/viewarticle/hormone-therapy-after-65-good-option-most-women-2024a10007b2?ecd=mkm_ret_240608_mscpmrk_obgyn_menopause_etid6577682&uac=36

Interested in more discussions like this? Go to the Osteoporosis & Bone Health Support Group.

@bluebonnet242

I’m happy for your success! Thank you for sharing your amazing results. Would you mind sharing which supplements McCormick suggested you take?

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I forgot to include omega 3s fish oil on my long list. They are an effective anti inflammatory and help manage my triglyceride levels.

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@mayblin

This is awesome @debbie1956! The reduction in CTX is phenomenal. This paper published long time ago showed that a greater than ~55% reduction of CTX after 6mo estradiol patch is correlated with a positive bmd response at 2 years:
https://pubmed.ncbi.nlm.nih.gov/10831925/
Your ALP changes over time is interesting and confirming the information that we knew. Mine almost doubled from pre-tretament of Forteo to 13mo with Forteo. Yours went the other way. As you suggested, the reduction in your ALP could be indicative of a downturn in bone formation which is best confirmed by bone-specific ALP. Curious, were your other liver enzymes such as ALT, AST and total bilirubin all within normal range during the period you had 'abnormal' high ALP?

Your results also confirm that transdermal estradiol patches, even at a low dose, could suppress CTX to this level. Well, at least for both of us 🙂 . When I first saw my CTX result, I was thinking that I might have a low baseline (which I did not have) to start with. Now I don't really need to second guess estrogen's power. Thanks Debbie.

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@mayblin, Thanks so much for this Pubmed study. The results of this give me encouragement that the .4 increase in my second Echolight T score after 10 months may be valid and not a fluke. I've been reviewing my ALT, AST, ALP total bilirubin and Gamma GT results, you asked about, back to January of 2020. The rise of my ALP appears to be independent of my raised ALT and AST. The ALT, AST and Gamma GT were out of range in January, 2020. The ALP began creeping up in September, 2020 and went out of range in December, 2020 until two weeks ago. My bilirubin was always at a good low level, never out of range. My high level Gamma GT correlated with the ALP and AST high levels. All these liver test results were down within range as of February 28, 2025. I'm not sure what the pattern of these results means. I would need further testing, such as a BALP, for definitive answers I imagine. I know I was rapidly losing bone between November, 2019 and November, 2023 with DEXA spine T score plummeting from -2.8 to -3.5. I was also on high dose Prednisone from February 2020 until September, 2020. Have your liver enzymes stayed within normal range? Thanks again Mayblin for all your input.

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@debbie1956

I forgot to include omega 3s fish oil on my long list. They are an effective anti inflammatory and help manage my triglyceride levels.

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Thanks so much!

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@debbie1956

@mayblin, Thanks so much for this Pubmed study. The results of this give me encouragement that the .4 increase in my second Echolight T score after 10 months may be valid and not a fluke. I've been reviewing my ALT, AST, ALP total bilirubin and Gamma GT results, you asked about, back to January of 2020. The rise of my ALP appears to be independent of my raised ALT and AST. The ALT, AST and Gamma GT were out of range in January, 2020. The ALP began creeping up in September, 2020 and went out of range in December, 2020 until two weeks ago. My bilirubin was always at a good low level, never out of range. My high level Gamma GT correlated with the ALP and AST high levels. All these liver test results were down within range as of February 28, 2025. I'm not sure what the pattern of these results means. I would need further testing, such as a BALP, for definitive answers I imagine. I know I was rapidly losing bone between November, 2019 and November, 2023 with DEXA spine T score plummeting from -2.8 to -3.5. I was also on high dose Prednisone from February 2020 until September, 2020. Have your liver enzymes stayed within normal range? Thanks again Mayblin for all your input.

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@debbie1956 Endo was explaining to me that total ALP comes from bone + liver/GI, roughly 50/50 but % varies among individuals. When total ALP goes up without other abnormalities in liver/GI functions, then the increase is most likely coming from bone (increased bone-specific ALP). Since my other liver enzymes didn't change when total ALP surged, the surges were expected as I was on Forteo at the time. So total ALP could be a surrogate marker for bone formation during anabolic therapy, provided liver/GI functions are normal. In your situation, CTX result said it all (that estrogen is doing its work). It's equally important that your current liver enzymes are all within normal ranges. Past elevation reflected a state of liver function during that time - many factors could cause an elevation including certain prescription drugs. I hope my last comment didn't inadvertently give rise to any unnecessary worries.

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I thought this article on the correct term "Menopause Hormone Therapy" from Dr. Streicher's newsletter, I subscribe to, would be of interest: https://drstreicher.substack.com/p/hrt-is-the-incorrect-terminology?utm_campaign=email-half-post&r=50wuh7&utm_source=substack&utm_medium=email

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@debbie1956

I thought this article on the correct term "Menopause Hormone Therapy" from Dr. Streicher's newsletter, I subscribe to, would be of interest: https://drstreicher.substack.com/p/hrt-is-the-incorrect-terminology?utm_campaign=email-half-post&r=50wuh7&utm_source=substack&utm_medium=email

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Definitely keeping my husband. Thanks for the laugh!

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@tiny28

Hi yes I am about to start hrt and testosterone treatment. My osteoporosis is quite severe but I don’t fancy the drugs as I am sensitive to meds. No fractures yet touch wood!!

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I have been doing the hormones for 20 years. I switched to the pellet therapy last year and my bones have remained stable and some of the areas have gotten better. I am with an integrative medical doctor. I am so happy I went this route.

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@nme1985

I have been doing the hormones for 20 years. I switched to the pellet therapy last year and my bones have remained stable and some of the areas have gotten better. I am with an integrative medical doctor. I am so happy I went this route.

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I only wish I started it twenty years ago but at the time it wasn’t recommended by doctors here so much. I began treatment just over a week ago but have had uterus pain and lightheaded. I was told to just take the uterogestan for a week and then begin again the estriadol gel very small dose gradually. However the pain in my uterus on sitting is extreme so I hope it settles. My weakness in lower back is becoming worse.

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@tiny28

I only wish I started it twenty years ago but at the time it wasn’t recommended by doctors here so much. I began treatment just over a week ago but have had uterus pain and lightheaded. I was told to just take the uterogestan for a week and then begin again the estriadol gel very small dose gradually. However the pain in my uterus on sitting is extreme so I hope it settles. My weakness in lower back is becoming worse.

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I feel so bad that you are experiencing this. Do they think the lower back pain is from the testosterone? I have always taken testosterone, progesterone and estradiol. Everyone is different. I started out with the creams which were bioidentical and now have switched to the pellets. Are they doing bloodwork to check your levels? That is very important. Good luck to you.

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@nme1985

I feel so bad that you are experiencing this. Do they think the lower back pain is from the testosterone? I have always taken testosterone, progesterone and estradiol. Everyone is different. I started out with the creams which were bioidentical and now have switched to the pellets. Are they doing bloodwork to check your levels? That is very important. Good luck to you.

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Thank you. They will check my levels in three months . I hope I can tolerate it otherwise I am in trouble with my bones

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