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Author Topic: HRT - "Official" Blood Levels?  (Read 456 times)

ABoatNerd

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HRT - "Official" Blood Levels?
« on: September 23, 2020, 02:55:59 PM »

Greetings everyone!

My first post as a newbie.

Your opinion/analysis please and thank you in advance.

Question - For a post menopause female of 13 years - Is there any "approved" minimum levels for estrogen and progesterone - levels where you Really get the health benefits for bones and heart?

I have been on HRT for 9 years - estrogen, progesterone and testosterone. 
Never felt is amounted to any benefit to be honest. My amounts have been fairly consistent over these years.

I get this prescription from a retired family doctor practicing menopausal health care as he still has his operating license.
He says I am very sensitive to hormones.

I have been under tremendous stress for the past 4 years, despite being retired, I have been leading the care of my elderly mother and father in their home - a  lot of stress with no help from my sisters. I am doing better now as my dear momma has passed (sigh) and my father has just moved into a retirement facility.

My Current Health

I am 62, last period 13 years ago, I have:

Slight high blood pressure
Slight high cholesterol
Osteoporosis
Sleep Apnea (obstructive) use a CPAP
Hashimoto thyroid confirmed by ultrasound and antibodies

I believe I have thyroid resistance - I have every official symptom despite having so called "normal" blood work (TSH 1.39 (range 0.35-5.00),  Free T4 16 (range12-22), free T3 4.6 (range 3.4-5.9).  I am not being treated for thyroid disease as the family doctor and encrinologist say I am fine (what else is new, sigh).

I have been told my cortisol is lowish - Cortisol morning (358 (range 130-540), Cortisol Evening at 4 pm 251 (range 65-330). I am exhausted in the morning and then gradually get more alert and active as the day goes on.

I feel totally awful with exhaustion, unable to do stairs, sleepy all day, hoarse voice, difficulty swallowing pills, shallow breathing, constant shaking, feeling of loud heart beats (have done the haulter test, fine), loss of muscle tone, Hashi face puffiness, gum disease etc, thinning hair, dry scaly skin, brain fog etc.

My sleep is awful, wake up at 2am wide awake, mind going......


My current HRT hormone application is:

Biest - 4mg/gm 80:20 (E3:E2) in versabase - 1 pump (0.2ml) 1 x per day (vaginally)

Progesterone - 5% in versabase  - 1 pump (0.2ml) 2 x per day (inside arms and thighs)

Testosterone - 0.2% (2mg/g) in versabase - 1 pump (0.2ml) 1 x per day (vaginally)



My current test results are:

Progesterone - 5.7 nmol/L (range post menopausal <0.7 nanomole/Liter) - This assumes you make no progesterone on your own I understand!

Estradiol - 78 pmol/L  (range post menopausal <202 Picomole/Litre) - Seems on the low end of the range

Testosterone, Free - <20 pmol/L (range post menopausal <29) - Not sure this is helpful as it is <20, it does not say if I am 10, 11, 8 or 9


My Thoughts On My Hormones

I believe due to my stress, my adrenals are fatigued. I believe that my thyroid hormones are not getting into my cells for a number of reasons.

I immediately feel better an hour after taking the estrogen - so too low a dose I think

Testosterone makes my body shake and heart race - I have stopped it for 2 days, feel more stable

Progesterone calms me - took my 1st of 2 doses an hr ago, my body is more calmer


What I have been Told

My naturopathic doctor (not the one dispensing the HRT) says the following regarding the minimum levels necessary to really provide heart and bone health:

Progesterone should be a minimum of 7.5 and that it can ONLY happen using pharma oral progesterone, not HRT progesterone

Estrogen levels should be a minimum of 150 - that would require a massive increase in estrogen for me

I asked what research supported this claim, she sent me a number of reputable studies, but I did not see the numbers 7.5 and 150 as minimums.

Also, what do people think of the progesterone - using the pharma oral?
_________________________________

I sure need to figure out how to feel better - there is something(s) very wrong.

I would appreciate your assessment of my situation and analysis on the 7.5 pharma progesterone and the 150 estrogen base levels.

Kindest Regards from ABoatNerd (P.s. I love ships!)




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CLKD

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Re: HRT - "Official" Blood Levels?
« Reply #1 on: September 23, 2020, 03:02:19 PM »

Hi!

Which symptom would you like to ease first? 

My Gynae won't do blood tests because hormone levels rise and fall 24/7. He treats on symptoms.

R U in the UK? 

If you put 'Hashimoto' into the search box here threads should pop up.  Make notes ;-)

Put the names of your medication individually into the search box - I am sure that someone will have responses.

What is the different from HRT and Pharma .......... Hormone Replacement Therapy is made by Pharmaceutical Companies.

When was your last full blood count, thyroid function and VitD level tests?  One shouldn't blame everything onto menopause ;-)

 :welcomemm:  browse round.  Join in.
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Avalon

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Re: HRT - "Official" Blood Levels?
« Reply #2 on: September 24, 2020, 02:47:53 AM »

Can you obtain a script for regulated bioidentical hormones?
I assume you are in USA? The medical (non) profession here in AU are very anti hrt.
There was a scare campaign on TV last night.
No menopause medical authority endorses BHRT.
The progesterone does not protect the endometrium.
I was started on low dose hrt. Then went back to ****when the holistic dr precribed Biest and progesterone cream. Started coming back to life when I got back on hrt.
I had your symptoms and then some!
Yes, search this site for thyroid help. Is that why you are using BHRT?
There are also thyroid posts on the How to take Utrogestan thread.
Transdermal E and miconised prog. are safest. The latter is calming.
I'm still plagued with crashing fatigue at times but generally am a lot more functional, physically and mentally.
Best Wishes!
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Mary G

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Re: HRT - "Official" Blood Levels?
« Reply #3 on: September 24, 2020, 11:55:21 AM »

ABoatNerd, your oestrogen levels are extremely low and far too low to give much relief from menopause symptoms or protect you from osteoporosis, high blood pressure and high cholesterol. 

Generally speaking, you need to aim for about 300 pmol when post menopause and this is the level most menopause specialists aim for.  Very often women need much higher oestrogen levels in peri menopause ie 800s. 

I take it you are using compounded hormones.  I use compounded progesterone but I use standard Oestrogel and testosterone which I think works better.   I was always happy with standard oestrogen but I hated Utrogestan so I use bespoke compounded 50mg progesterone and it's fantastic.   I'm going to bump up my thread on compounded hormones.

Your progesterone levels look about right and roughly the same as mine.  My oestrogen levels are always around 300 pmol using one pump of Oestrogel.   

My womb lining measurement is consistently around 3.3mm so the compounded progesterone definitely works for endometrial protection.

My advice would be to add some Oestrogel to your regime.  You could keep going with the vaginal oestrogen and the otherwise hormones.

I can't help with thyroid issues but there are plenty of others on here who are very knowledgeable.

I hope that helps.
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CLKD

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Re: HRT - "Official" Blood Levels?
« Reply #4 on: September 24, 2020, 07:51:50 PM »

 :thankyou:  girls.  Come in ABoatNerd - let us know how you are ;-)
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ABoatNerd

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Re: HRT - "Official" Blood Levels?
« Reply #5 on: September 25, 2020, 06:29:55 PM »

Greetings everyone:

Apologies for the delayed response. Wanted to get the "word" from my menopause Dr yesterday to share.

First, thanks for all the great responses. I am in Ontario Canada. A huge limitation is that we don't have many doctors available and there is no private system or labs - so it is a very challenging and not helpful medical system we have here.

I have a menopause Dr only because he did not retire from family practice, he changed his focus AND the Ontario College of Physicians and Surgeons are close to shutting him down as they hate alternative medicine in Ontario. So soon I will lose him.

My family doctor, which I am lucky to have to be frank), is just out of med school and rather not knowledgeable but sure likes to prescribe anti depressants for my anxiety (I refuse to take them)....sigh.

Soooooo here goes....

1) Regarding the 300 pmol level for estrogen - the Dr was astounded at my suggestion. Never heard of it and was offended with the notion of such a level.

2) Yes my estrogen is very low he acknowledged - I asked why my estrogen at 78 (range <202) is so low. Got no answer. I suggested gently that my adrenals are likely tired hence they are not producing even the normal amount of estrogen for a post menopausal person - cause a level of 78 IS with some HRT - so would it not be 10 without the HRT????

The Dr agreed to increase the estrogen a bit.

3) Progesterone is still low - the Dr agreed to increase it a bit. He did not acknowledge the suggested level of 7.5.

4) Testosterone - the Dr is lowering this a bit

5) The Dr prescribed 30 mg of dessicated thyroid (Victory he does not Synthroid, saying it is not helpful for older ladies who have trouble of converting... so give him credit for that one)

_____________________________________________

So, guess I made a bit of progress yesterday.

My big concern is a) the body shaking b) the feeling of a loud heart beat c) the shallow breathing and d) emotional ups and down from depression to rage to clenching fists etc

I have read these are all related to low estrogen and thyroid levels and in some way low adrenal function.

Would appreciate your analysis dear folks!

ABoatNerd
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Mary G

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Re: HRT - "Official" Blood Levels?
« Reply #6 on: September 27, 2020, 11:55:38 AM »

I can't think why your doctor was astounded about an oestrogen level of 300 pmol unless he was confused and thought you meant pg/mL.   Is there any way you can ditch this person and find someone who is more knowledgeable about the menopause ie someone like Dr Louise Newson in the UK?

Your progesterone level looks OK to me.

All consultations are carried out by zoom/telephone now so you could have a consultation with a UK specialist.   My clinic has patients from all over the world and will happily post prescriptions anywhere.

Any doctor who doesn't understand the importance of oestrogen for osteoporosis is not worth having.
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CLKD

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Re: HRT - "Official" Blood Levels?
« Reply #7 on: September 27, 2020, 12:03:39 PM »

Morning!  Could the Dr interested in Menopause not set up privately?  He could liaise with Dr Newsom to gain knowledge, there is a good website.

Shallow breathing can be a trigger for anxiety.  Do you sing?   My teacher told me that people don't breath correctly and that singing encourages us to slow down in order to project ........  what is considered 'older'  >:(.  it should be discussed on symptoms rather than age;-).

HRT helps protect bones and heart health.  MayB put the product names into the search box here to see what pops up?  Make notes ;-)
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Merela

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Re: HRT - "Official" Blood Levels?
« Reply #8 on: September 29, 2020, 04:53:02 PM »

I can't think why your doctor was astounded about an oestrogen level of 300 pmol unless he was confused and thought you meant pg/mL.   Is there any way you can ditch this person and find someone who is more knowledgeable about the menopause ie someone like Dr Louise Newson in the UK?

Your progesterone level looks OK to me.

All consultations are carried out by zoom/telephone now so you could have a consultation with a UK specialist.   My clinic has patients from all over the world and will happily post prescriptions anywhere.

Any doctor who doesn't understand the importance of oestrogen for osteoporosis is not worth having.

Hi Mary G,

Can you give me the contact number for the clinic you mentioned?  I would very much like to set up a consultation with the doctor.  So cool they are doing tele-health for people internationally.  My doc here (in the US) is useless.

Thanks so much!
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Mary G

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Re: HRT - "Official" Blood Levels?
« Reply #9 on: October 04, 2020, 06:47:22 PM »

Merela, I've sent you a PM.

Sorry, just realised, you will need to post 10 times before I can send you a message.   I'm afraid I can't give you the name of my clinic on here.   You could go to the Newson Clinic website and make an appointment but I would ring them first to find out if they take overseas patients.

« Last Edit: October 04, 2020, 06:51:47 PM by Mary G »
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Merela

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Re: HRT - "Official" Blood Levels?
« Reply #10 on: November 06, 2020, 09:15:18 PM »

Merela, I've sent you a PM.

Sorry, just realised, you will need to post 10 times before I can send you a message.   I'm afraid I can't give you the name of my clinic on here.   You could go to the Newson Clinic website and make an appointment but I would ring them first to find out if they take overseas patients.

Hey Mary G,

I just met the 10 post quota.  Would love for you to PM me the info.  I thought I just sent you a PM but my message box doesn't show any sent messages.  Not sure what happened. 

Merela
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