HRT Safety

@kisu, thank you for your reply and sharing this info. Did you experience any side effects when starting HRT and also did you notice any positive improvements in mood or sleep? If you experienced side effects, how long before they diminished? Is the DHEA cream prescription as well? Has HRT improved your bone health? Once again, I appreciate the feedback. I am contemplating making an appointment with an endocrinologist to discuss HRT again.

@mayblin Wow your CTX result looks fantastic! What was your number before you started the HRT and what are your before and after HRT dexa results? Your improvements are really encouraging! I assume you are remaining on the same dosage of HRT? My CTX was 670 in April of 2024, three months before I started HRT. I will have my next CTX results in 2 weeks, which I will post, and will be pleased if my numbers have come down. Thanks for sharing your results. Fingers crossed as you say.

@pking1952 Thanks for sharing your experience and results. That is amazing news that your dexa increased by 12% after 12 months of supplements! Would you mind sharing your dexa results before and after the supplements? Like you my osteoporosis started after heavy medication-- high those long-term prednisone--and like you I postponed OP medication to see if I could get this condition under control through other means. I also take K2 and many other supplements and will have my first follow-up dexa soon since starting the supplements and BHRT. It sounds like you are quite active so that can only help as well. I wish you continuing success in managing this challenging condition we are all dealing with.

Debbie - I'm not very good at understanding or reading these scans. But I've copied my scores since my first scan in 2021. This is T-Score Change
vs. Baseline results: I think that it what you were looking for.

AP Spine L1-L3 1/24/2025 72.6 1.284 g/cm² 0.8 12.4 %
AP Spine L1-L3 6/21/2023 71.0 1.141 g/cm² -0.3 -0.1 %
AP Spine L1-L3 6/22/2021 69.0 1.142 g/cm² -0.3 baseline

DualFemur Neck Mean 1/24/2025 72.6 0.863 g/cm² -1.3 2.0 %
DualFemur Neck Mean 6/21/2023 71.0 0.831 g/cm² -1.5 -1.8 %
DualFemur Neck Mean 6/22/2021 69.0 0.846 g/cm² -1.4 baseline

DualFemur Total Mean 1/24/2025 72.6 1.019 g/cm² 0.1 5.8 %
DualFemur Total Mean 6/21/2023 71.0 0.972 g/cm² -0.3 0.9 %
DualFemur Total Mean 6/22/2021 69.0 0.963 g/cm² -0.4 baseline

@pking1952 , Thanks
For posting your before and after results. I'm afraid I'm not familiar with the layout of the results on your report. They are different from the numbers displayed on my dexa. It appears as though all your numbers are in the osteopenia range. Is this correct? Perhaps someone else on this forum could interpret them better.

Mayblin, thank you for all your contributions and hard work.
Unfortunately, I have no helpful information. My last dexa was on 6/2024. I had been on a .025 patch for only 2 months. There wasn't a change from the dexa two years previously, 6/2022. I expect the same numbers in 6/2026, after the patch increases to .05 and the added testosterone. The two endocrinologists I went to don't do CTX or P1NP.

This is what Gemini said,
Let's analyze these bone density results over time to understand the changes and their clinical significance.

Understanding the Data:

AP Spine L1-L3: This measures bone density in the lumbar spine (vertebrae L1 to L3).
DualFemur Neck Mean: This measures bone density in the neck of the femur (hip).
DualFemur Total Mean: This measures overall bone density in the hip region.
g/cm²: This is the bone mineral density (BMD) in grams per square centimeter.
T-score: This compares the patient's BMD to that of a healthy young adult.
% change: This indicates the percentage change in BMD compared to the previous measurement.
Baseline: This is the initial measurement used for comparison.
Analysis:

Lumbar Spine (L1-L3):

6/22/2021 (Baseline): BMD 1.142 g/cm², T-score -0.3. This indicates normal bone density or mild osteopenia.
6/21/2023: BMD 1.141 g/cm², T-score -0.3, -0.1% change. very little change over 2 years.
1/24/2025: BMD 1.284 g/cm², T-score 0.8, 12.4% increase. This is a very large increase in bone density. This could be due to treatment, or an anomoly in the scan.
Femoral Neck Mean:

6/22/2021 (Baseline): BMD 0.846 g/cm², T-score -1.4. This indicates osteopenia.
6/21/2023: BMD 0.831 g/cm², T-score -1.5, -1.8% change. Slight decrease in bone density, still in the osteopenia range.
1/24/2025: BMD 0.863 g/cm², T-score -1.3, 2.0% increase. Slight improvement, but still within the osteopenia range.
Femoral Total Mean:

6/22/2021 (Baseline): BMD 0.963 g/cm², T-score -0.4. This indicates normal bone density or mild osteopenia.
6/21/2023: BMD 0.972 g/cm², T-score -0.3, 0.9% increase. Very little change.
1/24/2025: BMD 1.019 g/cm², T-score 0.1, 5.8% increase. Improvement in bone density.
Summary and Interpretation:

Lumbar Spine: There has been a very significant increase in the lumbar spine BMD. This is a very large change, and should be discussed with the ordering physician.
Femoral Neck: The femoral neck shows osteopenia throughout the entire testing period, with minor fluctuations.
Femoral Total: The femoral total shows improvement, now in the normal range.
Overall:
The large increase in the spine is an important result.
The hips have shown a slight improvement.
This person should speak to their doctor.
It is very important to determine the cause of the large increase in the spine density.
Important Note: This analysis is for informational purposes only and should not be considered medical advice. A healthcare professional is needed to interpret these results in the context of the patient's medical history and other relevant factors.

I started slowly with a .025 transdermal estradiol patch for 3 months, then .375 for 3 months, and then .05 which I'll stay on. With each new dose, I had breast tenderness. It wasn't bothersome and went away in a short amount of time. I tried 100 mg of oral Progesterone for sleep improvement but alas it didn't happen. I would say my mood was more mellow. I stopped taking it since I don't have a uterus. You can get DHEA with a prescription or over the counter. My systemic DHEA cream is a compounded prescription. There is an excellent local Rx vaginal DHEA but it's expensive, "Intrarosa". Amazon sells a vaginal DHEA "Bezwecken" that doesn't need a prescription. My next Dexa won't be until 2026 so I won't know for sure about my bone health but I'm confident that my numbers will stay in osteopenia (or better?). Try to be knowledgeable about HRT before you see your endocrinologist so you can advocate for yourself.

Thank you for v your input. I appreciate it very much.

CTX right before HRT was 793, bearing in mind that I was treated with Forteo and had a high turnover rate because of the treatment. With CTX at a low of 163 currently, I definitely will stick with the current dose. After 6mo HRT, Lspine bmd had a further 8.7% increase, right hip +4%, left hip stable, femur necks 5-6% increase. Prior treatment with Forteo probably was a big factor in the continued bmd improvements. I had an early DXA done for a confirmation that the low dose is adequate.

I'm sure you will see a good downturn in CTX, which is what estrogen is supposed to do. It will be interesting to see how yours results turn out.