@cliffdweller

Also check out Dr. Lauren Stricher and Dr. Risa Kagan: Your Bone on and off Estrogen;
https://substack.com/@drstreicher/note/p-162890954

Hi @cliffdweller, have you noticed any correlations between your blood estradiol (E2) levels and the timing of the blood draw in relation to a patch change? I've read that maintaining a consistent blood draw timing relative to patch change is ideal, specifically, drawing right before a patch change to capture the trough level.

Do you monitor your bone turnover markers such as CTX and/or P1NP?

A blood level of E2 reflects the degree of absorption - it can vary significantly from person to person. Even at same E2 levels, different individual can have varied degree of biological responses. Because of this, i think it makes sense to track the impact of HRT on bone health with 3 distinct tiers: 1) serum E2 level - measures delivery and individual absorption; 2) bone turnover markers (BTMs), serve as a proxy for the biological response at one point of time; 3) DXA scan for ultimate confirmation.

For example, I use a 0.025mg/day patch, a low dose, and my trough E2 level was 42pg/ml, indicating decent absorption. I've only had my level checked once as my docs are not keen on monitoring hormone levels (i will push for another lab just for my own curiosity). However, my periodic CTX results have been consistently staying below 120pg/ml, showing a strong biological response. My 1st year with HRT (post-Forteo) DXA remained stable with a 5% BMD increase in L-spine, and my DXA after 2nd year HRT is pending.

@cliffdweller Thank you for this information/links. I hope that in the next 2 months, my gynecologist or my PCP will move me up to .05 patch. I'm doing alright with the tiny amount I'm currently.