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Thread: HRT frustrated

  1. #26
    Reality Check
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    It is a real shame when our health care is determined by an insurance company, not our doctors.
    Krisi

  2. #27
    Just finding my way.... StaceyJane's Avatar
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    Congratulations on starting HRT. I'm glad you didn't let the weather be an excuse to delay.
    Stacey

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  3. #28
    Junior Member Lizzy Straite's Avatar
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    Another congrats on getting started. Just wait till it kicks in........wow! I felt like a whole new person
    Lizzy

  4. #29
    Call me Pam pamela7's Avatar
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    Quote Originally Posted by Pat View Post
    In terms of protecting your liver, gel or patches should be about the same. It's the oral meds that put a strain on the liver, as I understand it.
    Hi Pat, I feel we must be very careful here to be clear on these factors, as medical professionals' opinions are key. My doctor has said that the female hormones do not create such strain, it is the anti-androgens that cause the biggest problems. This is why he is administering to me, and to others, quarterly decapeptyl (triptoerlin) that instead signals the pituitary to stop asking the testes to produce testosterone. It is considered a harmless approach so far. So, do you have any sources that state that estradiol causes liver strain?
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  5. #30
    Transgender Person Pat's Avatar
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    I'm not saying that estradiol causes liver strain. I'm saying that the delivery mechanism does. Transdermal delivery methods and injections involve the liver much less than oral medications (usually meaning premarin) do. My endo specifically chooses transdermal methods for older patients because she says it reduces strain on the liver. The literature on administration of estradiol says basically the same thing. I did a quick google about it and found this: http://www.virginiahopkinstestkits.c...llorpatch.html which is kind of interesting.
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  6. #31
    Senior Member Laura912's Avatar
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    From the medical corner...here is how the conventional wisdom of oral estrogen being more strain on the liver got started. If one looks at the metabolism of estrogen taken otally, there will be two passes through the liver to convert the molecules to their final form. Estrogen absorbed directly into the bloodstream only requires one pass. So when the non- orals first came out, marketing sold them as less stressful on the liver which is sort of true but a healthy liver can handle any of the forms. If ones liver function is so compromised that oral estrogen is a worry, then there are a lot more serious things to worry about. My wife has been on oral estrogen for over 25 years without sequlae.

    And with all due respect to Pat, the physicians in the reference are quotting anecdotal experience and are prescribing “natural hormones” which sounds great but are not supported by good randomized clinical trials.
    Last edited by Laura912; 02-14-2018 at 10:23 AM.

  7. #32
    Member HelenR2's Avatar
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    I put mine under my tongue and leave them there to 'melt'.
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  8. #33
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    Laura, what final form? As I understand it, most prescribed endogenous estrogens are - or contain - estradiol in a form that is already biologically active on estrogen receptors without a pass through the liver.

    The liver metabolizes estradiol into: estrone (and back again to estradiol), estradiol and estrone sulfate, and various oxides (oxy..., hydroxy..., methoxy..., etc.) that are mostly eliminated. Estrone is a far weaker estrogen than estradiol. The sulfates do not act on estrogen receptors. There are other metabolites released into circulation that have little or nothing to do with desired HRT effects.

    One impact of passage through the hepatic portal is that far more of the estradiol taken up by the digestive tract will be eliminated compared to estradiol in general circulation, as a full 75% of the blood flow through the liver is via the hepatic portal vein. Thus much estradiol is eliminated before ever so much as seeing an estrogen receptor of interest.
    Lea

  9. #34
    Senior Member Laura912's Avatar
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    Lea, you are correct. I just stayed away from all the “chicken wire” names for simplicity. What methyl does with ethyl is entirely their business.

  10. #35
    Transgender Person Pat's Avatar
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    Quote Originally Posted by Laura912 View Post
    And with all due respect to Pat, the physicians in the reference are quotting anecdotal experience and are prescribing “natural hormones” which sounds great but are not supported by good randomized clinical trials.
    Pat does not feel disrespected. I can hide behind the fact I said "quick google" not that it was my personal knowledge. However, here's a better google: https://www.ncbi.nlm.nih.gov/pubmed/22011208 -- which, though admittedly is just a survey of literature comes from a more credible source.
    I am not a woman; I don't want to be a woman; I don't want to be mistaken for a woman.
    I am not a man; I don't want to be a man; I don't want to be mistaken for a man.
    I am a transgender person. And I'm still figuring out what that means.

  11. #36
    Senior Member Laura912's Avatar
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    Much better Pat. And there are some additional articles in the right sidebar of your reference. It is too bad there is not a national registry for treatment protocols where data could be pooled along with lab work. This was done with many chemotherapy regimens enabling quick results.
    Last edited by Laura912; 02-25-2018 at 09:15 AM.

  12. #37
    Gold Member Read only Rachael Leigh's Avatar
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    Not that anyone was really all that interested, but just thought I would update everyone here.
    I’ve made my final decision that I will not go on hormones. I realized that there for me was no point in doing this if I was
    not going to be commited to a life of being fulltime. Not saying that would be the only reason for HRT but to me it made the
    most logical sense. I want to thank all you ladies who have gone through this process for advice and wish you well on your
    journey. My heart is with anyone here who has gender identity issues.
    I know I’m still trans but HRT is just not something I need for my survival
    Blessings to you all Rachael

  13. #38
    Female Illusionist! docrobbysherry's Avatar
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    How did u decide that, Rachael?
    U can't keep doing the same things over and over and expect to enjoy life to the max. When u try new things, even if they r out of your comfort zone, u may experience new excitement and growth that u never expected.

    Challenge yourself and pursue your passions! When your life clock runs out, you'll have few or NO REGRETS!

  14. #39
    Gold Member Kaitlyn Michele's Avatar
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    gotta read all the threads Doc!!!!! get with the program!!!
    I am real

  15. #40
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    Hi Rachael. I'm so glad you were able to come to a decision and support you completely. I hope that it brings positive results to you and those around you. Take care. Rian x
    HE doesn't know what SHE wants because HE doesn't know who SHE is

  16. #41
    Aspiring Member grace7777's Avatar
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    Hi Rachael,

    HRT does carry health risks, and I would have not started hormones if I did not plan to go full time. So I definitely understand your decision. I have been on hormones for 16 months, and full time for 9 months.

    I wish you the best in the future.

    Take Care,
    Grace

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