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Old 06-10-2008, 11:05 AM   #1
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Puzzling Question About HRT for Osteoporosis

Taape Alert-maybe something for you here.
Also long message alert.
After recently completing 18 mo. of forteo, my dr. has scripted vivelle dot.05 and I will see a gyn for the progesterone part , likely to be prometrium. With a regimen of several mo. on vivelle , then 10 days prometrium (and vivelle same time??-not sure will get more info)Anyway, I wanted to share what I have looked at on the topic of hrt and osteo. Also, someone at another board asked me a question and this will serve as sort of a response regarding her question which concerns use of the menostar patch.And, maybe this will be helpful for others who don't want bisphos. or full dosing hrt.
I have recently learned about the menostar patch that contains .014
estradiol for the prevention of osteoporosis among post meno women. Because the estrogen component is so low apparently it doesn't need to be opposed by progesterone (for those with a uterus), and that is seen as a huge plus because progesterone is thought to have been a culprit in causing cancer among hrt users.I looked at the prescribing infor for menostar and it indicates that it maintained estradiol levels on ave of 13.7. And, if you look at their data it shows that users showed better bmd than placebo.
Also I compared this data to the vivelle dot .05, and saw that the vivelle dot .05 maintained estradiol levels at an ave. of 57. Also there is a chart there at prescribing info showing bone density effects of their various doses on the patch.
What it seems to come down to with the low dose is whether it will stop bone loss. For those lucky enough to confront this problem before they have lost alot,I could see that either the menostar ultra low .014 or vivelle .025 which I understand is now available might really be a possible answer. And the menostar doesn't need to be opposed by progesterone which may make it better for those in pretty good bone shape and just trying to stop loss during meno.
On the other hand for those of us with significant loss already, or completing forteo and looking for something with enough strength -I can only question whether the menostar could be adequate.
Anyone really wanting no bisphos in their life, should probably check this stuff out and ask their doctor.
Taape-if you are out there I am wondering about either the evista or the menostar for you until you come up with a better alternative. I know you are concerned about breast cancer but maybe the menostar would be safe. Check with your doctor.
Access-if you come by here, when you should have your next dexa, I really think depends on your numbers. If you are seriously into osteoporosis territory , maybe your doc. would order at 12 mo. If not so serious then perhaps the 2 yrs. is adequate.Do you want to share your numbers. Are you post meno?
My big question now is really about estradiol level. What level do we post meno women need to maintain to protect our bones?? Could it really be as low as 13.7 as offered by the menostar ultralow dose or does it need to be higher.
I have read at a source that I would call non-authoritative that post meno should try to maintain ave estradiol level of 50 and perhaps closer to 60 for bones. And, that would necessitate at least the .05 vivelle.
Also depending on your estradiol level when you start, your dose could be lower because you don't have such a gap to make up. Anyway, I focused on menostar because it is low dose and Access is on it and compared it to the vivelle dot that I am on. Of course, there are many other options. It does seem the patch has some advantages because the estradiol doesn't have to be processed through the liver-so doesn't task your system as heavily .
Well, I will end this grab bag of info. and hope that it resonates with someone .I would love to have a discussion of this stuff if anyone else is interested

Last edited by osteoblast; 06-10-2008 at 11:10 AM.

 
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Old 06-10-2008, 12:28 PM   #2
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Re: Puzzling Question About HRT for Osteoporosis

Thanks Osteoblast for your suggestion. I also wonder about getting enough hormones from like eating soy products which is also can create a problem for someone who is more suspectable to breast cancer. At least that's a natural way without taking hormones but I don't know it may involve eating more soy products daily than one may feel like consuming. I'm awaiting my T score results, apparently it's gotten alot worse but I don't have the report yet. Also awaiting that app't with the new endocrinologist. Plus get this-my primary wants me to go back to see the encrinologist who treated me with Forteo and insists I take bisphosphonates. I just don't know what to do.

I don't know if real low doses of estrogen would help me any. I guess the hormone level can be checked, right? thanks for thinking about me.

Last edited by taape; 06-10-2008 at 12:31 PM.

 
Old 06-10-2008, 02:00 PM   #3
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Re: Puzzling Question About HRT for Osteoporosis

Taape-I am here for you! I am so glad that you saw the message. If you can't do the forteo again--then I was thinking if you can just go into a holding pattern until something better comes up. As, I know you can't do the bisphos.
Are you post menopausal?? Have you had your estradiol and FSH levels checked? Do you know what they are??
OK-let's say you are post meno then maybe these options are possible .
When you go back to the dr. that scripted the forteo, maybe you could take a print out of info on menostar and also vivelle dot which is also available in the low .025 dose now for osteoporosis.I think the .025 vivelle would require progesterone too, but the menostar apparently does not. I am not saying these are perfect solutions-but I do think they should be on the table for discussion along with the evista. I do not recall, did you say evista would be a problem for you?
The thing is to get low bone turnover and if you aren't going to do it with a bisphos. then these are possibilities to be looked at with your doc in light of your particular history and risk for various cancers based on your immediate family and close family relatives as well.
From what I gather some docs are now thinking that following the forteo with evista or hrt has validity. While it is sometime since you took forteo, if you are still losing bone then the thing is to try to at least stop loss.
I don't know if eating soy is any kind of a solution. Maybe a wee bit of help-
Maybe none of this will be appropriate for you but at least you could have the discussion with your doctors.
Let us know how it all goes, I am still hoping that you regain some of your loss. And, the doctors seem optimistic about new developments in the field. So we need to keep hope alive.

 
Old 06-10-2008, 02:11 PM   #4
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Re: Puzzling Question About HRT for Osteoporosis

I debated on replying to this post since my situation is a bit different but decided to anyway since I have heard some info on this topic. I am nearly 36 and had a hysterectomy with removal of both ovaries three years ago. I was placed on hrt right away but went through several kinds (Estratest, sublingual compounded bioidentical troches, drops, creams in the forms of estrogen and progesterone and testosterone in cream and troche form) and had numerous problems with them. At one point in 2006 I had my estradiol levels checked as well as other hormone levels and my estradiol came back at something like 17 pg/ml, waaay post menopausal even with hrt. I was not absorbing the hrt I was on. My testosterone and progesterone levels were extremely low also. Two months later (one year after my surgery) I had my first dexa scan which showed a t score in spine of -3.2 and right hip -1.8. I was also down to 102 lbs at 5'6" at the time (digestive problems, strict diet, eating disorder, and smoking all contributed). This prompted me to change some things in my life. I quit smoking (still quit), gained weight (now at 120 lbs but was up to 130 lbs for some time), upped my vitamin D intake along with calcium, and started the Vivelle Dot patch. After some initial adjustments I settled at .075mg patch. I also was already exercising but saw a physical therapist and trainer and began a more intensive weight bearing regiman at the gym and at home. One year later in 2007 my dexa scores were as follows: Spine -3.0, right hip -1.4, left hip -1.2, wrists normal. So there was an improvement (.2 in spine and .4 in right hip over the year). I might also add that around the same time as my second dexa scan I had my estradiol levels checked again and they were at 130 pg/ml. Whether it was quitting smoking, gaining weight and better diet, upping the vitamin D and calcium, or the hormone patch at a higher dose that contributed I cant say for sure. Maybe all of them. But I am certain adding the higher dose patch and finally absorbing some estrogen had a lot to do with it. There are studies that confirm that enough estrogen is needed for the proper absorption and utilization of calcium (even in men testosterone converts to estrogen and provides that needed estrogen). How much estrogen to achieve this I dont know, but since women in natural menopause still continue to secrete small amounts of estrogen from the ovaries and yet still commonly lose bone density it makes you wonder.
In her book "Screaming To Be Heard: Hormonal Connections Women Suspect and Doctors Still Ignore", Dr. Elizabeth Vliet, M.D. claims that women need at least estradiol levels of 70-80 pg/ml to maintain healthy bone density and protect what you have. She claims that her clinical experience has shown this to be true, and mentions recent studies but does not cite exactly which studies which is frustrating. I have also seen studies regarding some of the hormone patches such as Menostar, Vivelle Dot etc. and claiming that there was an improvement in bmd compared to placebo in post menopausal women even at doses as low as .014. Of course the studies do not take into account how well the patches are absorbed by each individual woman, what kind of diet was followed and if diet included estrogenic substances. And what bmd was at baseline. All the studies I have seen also tend to be short term as opposed to ten years or longer.

I still dont feel great even with my estradiol levels where they are and still have symptoms of low estrogen but again I am younger and in surgical menopause and my estrogen needs are probably way different than someone older. I did try the .1 mg patch but bloated up and felt horrible. I just recently added compounded bioidentical testosterone back into my hrt regiman due to very low levels tested and symptoms of low testosterone. This time I am trying sublingual drops for testosterone which I have not tried before. I didnt do well with troches or creams. I am hoping this too will make a big difference for my bones. Testosterone is one hormone that is often overlooked for women in menopause. Not all women will need it but some benefit greatly from it, and women without ovaries especially benefit. As far as progesterone, I have a terrible time with even natural progesterone of any delivery method (cream, pills, troches, etc.). I simply can not tolerate it. For me though it is not life or death as it might be for a woman with a uterus using unopposed estrogen. I have heard good things about natural progesterone also helping with bmd though. Somewhere I read that human bone has receptors for progesterone as well as for estrogen. I will have to dig up that info.
Anyway, not sure if I helped any but just wanted to share what I have heard. I plan to stay with the Vivelle Dot for a long time. I do not have a family history of estrogen dependant cancers and without hrt I am a complete physical and mental basket case. I am hoping to avoid the bisphosphonates as long as possible. It will be interesting to see what my next dexa scan shows. I will certainly post about it here one way or another.
Elaine

Last edited by moderator2; 06-10-2008 at 03:24 PM. Reason: the huge quote!

 
Old 06-10-2008, 03:36 PM   #5
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Re: Puzzling Question About HRT for Osteoporosis

Osteoblast and Elaine444,
Thanks you for your suggestions and comments. I will take them to my doctor. I'm in my second year of menopause and don't have any symptoms that I know of except sometimes problems sleeping but then I also have chronic back pain from an injury. I did have my hormone levels checked several times when I became perimenopause. I don't know much about this but if I don't have physical noticeable symptoms of menopause I still may have some estrogen in my system but not enough to grow bone or something?? Maybe low dose hormones would help, I'll ask my doctor.

I don't smoke and never have and exercise as much as I can with my back limitations and am eating lots of dairy products. My calcium level was good when last tested in Dec 07 so it seems I'm absorbing the calcium. I found out that the Forteo kept the calcium level stable throughout each day and that's probably why it worked so well.

I'm currently dealing with some severe dental problems so there's no way I'm going on IV bisphosphonates. My appointments are coming up soon and I'll let you know what is recommended to me.

Osteoblast - I'm reading posts most days but recently have been ill so wasn't posting much.

 
Old 06-10-2008, 05:43 PM   #6
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Re: Puzzling Question About HRT for Osteoporosis

Elaine-Thank you so much for adding your experience! While your situation is different, so much is similar to the issues for post meno osteoporosis . This really helps me alot to get a handle on a number of issues that I am trying to understand. Your post was so informative!
First, congrats on all the great things you are doing for yourself! Quitting smoking is super! And all the bone stuff you are doing is great. The ex. program and watching vit d -sounds like you are doing just the right stuff. Keep on , keepin on and I think you are going to continue to make excellent improvements.
Your journey with hrt is interesting though it must have been awful for you going through everything that didn't work. Glad to hear the vivelle dot .075 worked for you-134 estradiol def. shows it is working.I saw from the prescribing info for vivelle dot, that the ave. level with .075 is 72(+-24) for women with ave 11 estradiol level to start with .Are you doing 2 dots a wk? And, when they tested your level on the .075 did they require it to be a certain time after you put on a new patch? With your situation the way it is , physically can you produce any of your own estrogen? What would you think your level would be without any estradiol?It seems you have a big response to the .075 based on the infor they provide. I am hoping that the vivelle .05 works as well for me-though I certainly won't be expecting estradiol levels to be much more than the ave which is 57 also with a +- factor .
From what I have read, you are so right about the variances in absorption of the estradiol . I just hope the .05 will do it for me. How soon after starting it, do you think I can get levels checked to see how it is doing?
About the level that we should be at for our bones. Your level in the 130's should be very bone protective. Have you seen the chart that they have on the prescribing info about bmd increase with the various doses? I would think at your dose not only are your protecting but adding to what you have-well, I guess that is obvious from your dexa.
I think my doc wants the lowest possible dose that will do an adequate job with mininal risks. I will look at the Dr. Vleit book-I just have a feeling my doc probably won't go over the .05 though, if my estradiol came back surprisingly low , then maybe I could ask for the .75 but there is also the issue of tolerating the dose and of course the risks... Plus I will ask her about the Dr. Vliet info. But, I won't see the spec. again until Oct. So, will hope to follow up with you on this topic later.
I am not a hrt fan by any means and feel backed into a corner. My dexa recent numbers were -3.5 spine and -2.2 and-2.4(right left total hips).I made big gains while on 18 mo forteo in my hips but spine mostly stayed steady with a decrease in L-4.Anyway, I made clear to my bone spec. that I was scared to death of the bisphos. and while on fosamax for 7 wks. had an altered/unpleasant sense of taste that really put me off food(she said she has heard of this reaction.)So, she scripted vivelle .05 for me. I should add I am 55 and about 6 yrs. post meno.My fears on fosamax incl. onj and strange microfracturing as time goes by.
Again, congrats on all the great work you have done for your bones and thanks so much for sharing your journey and information.
Whether the .014 menostar could do it is really something that still puzzles me for a post meno woman not producing much estrogen. I hope though that it will help because the bisphos are such a lousy option.

Last edited by osteoblast; 06-10-2008 at 05:55 PM.

 
Old 06-10-2008, 05:57 PM   #7
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Re: Puzzling Question About HRT for Osteoporosis

Taape-I hope you feel better soon. Take care. Maybe you should ask your gyn or gp to get your hormone levels checked so you have this info when you go back to the endo . It may help in figuring out options as well as what is going on. Keep us posted.

 
Old 06-11-2008, 06:25 AM   #8
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Re: Puzzling Question About HRT for Osteoporosis

Hi osteoblast! I found my way over here. Very good thread for debate.

I'm on the Menostar 14mcg patch since February after a disastrous try at Boniva once monthly. I'm 49, going thru menopause, still cycling occasionally, had my uterus and one ovary removed in '94, have a very rare thyroid hormone receptor defect that makes me hyperthyroid, have renal tubular acidosis, am on the border of stage 3 CKD, immune deficient, recently diagnosed diabetes, took high dose prednisone for 2 years back in the early '80's, have a mother with severe osteoporosis that has resulted in so many fractures that I've lost count, (she's 76) who developed two different estrogen dependent breast cancers, one in each breast after doing HRT. I'm very small in size and last fall, it was suggested that a DEXA might be in order. Results: Spine 0.7 (yes, that's a plus), left femur neck -2.0, right femur neck -2.2, total left femur -2.2, total right femur -2.2. Because of my age, non-post meno status, having had many fractures throughout my life, family history and other medical problems, I was diagnosed as having osteoporosis and not osteopenia. I was a vitamin d deficient sun worshipper (I've got it up to 71 with supplements!!!) and my last estradiol level done in february was <10. It's been going up and down and I figure within the next year or so, I'll officially be post meno. Does that cover everything? Probably not but who can keep up with all this stuff anyhow?

The endo wanted to put me on HRT. I told him no way. Not with my mother's history and a calculated lifetime risk of breast cancer at 76.3%. He offered estrogen receptor blockers saying that would protect me but would also provide me with the joy of experiencing all the wonderful meno symptoms. I thought with my stomach of steel that Boniva was the perfect choice. Wrong. Worse mistake I could have ever made. I'm still wondering how long this pain is going to last. It's been almost 6 mos. and I only took 2 doses. No one ever mentioned this cute little side effect.

Anyhow, I knew I had to do something. I started looking at HRT trying to convince myself that it would be safe. I couldn't. Then I ran across the Menostar patch. I found it intriguing. I was already doing the vitamin d, calcium, sodium bicarb and phosphorus for the renal tubular acidosis. BTW, I've run into lots of studies that show the addition of phosphorus to the d and calcium improves BMD more than d and calcium alone. But here was a patch that claimed to prevent the bone loss of menopause while actually reducing the risk of breast cancer and having the same cardio protective effects of regular HRT. I researched it to the max and found other studies that backed the claims and trials. I wrote out a script, the gp signed it and I've been putting on a new patch once a week ever since. Only time will tell. I feel pretty confident in my decision and think I made the right choice for me.

I'll be having my female hormone levels checked again in august. His idea. He was happy that I was finally going on HRT and I didn't tell him I really wasn't. My gp's pretty good about letting me have what I feel I need and since I'm dying of curiosity, I think I may request a DEXA at the one year mark. I absolutely do not want to go down the same path as my mother. You breathe on the woman and she breaks.

taape, I feel for you. I've been dealing with the dentist all year too. I suddenly developed major dental problems the beginning of the year. I'm getting my third root canal done on the 30th. The only saving grace is the laughing gas. Man, I love that stuff.

 
Old 06-11-2008, 09:14 AM   #9
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Re: Puzzling Question About HRT for Osteoporosis

Access- Glad that you found your way over to the osteo board Good luck to you with the menostar. It seems like you too are faced with no great decision-so you just have to try and pick the best for you.
My mind still has trouble grasping that the .014 can do the job, for a post meno woman or peri meno woman with very low estradiol-under 10.Maybe your estrogen is not so totally depleted. But, I am sure that you will get that checked again. If under 50 , I still just wonder how you will get the protection you need. But I do not have the 50 number on any medical authority. Another poster put something about a book by Dr. E. Vliet that I am getting from the library in the next day, apparently she has opinions about the level required to protect bones. Also I am getting Dr. Love's book on hrt. So with those two , I will see what I find and post what they have to say about the needed estradiol level for bone protection.
I looked at the menostar info. and I am going to look at it again today. I am going to look at their bmd info and see also what it says about reduction of breast cancer risk.
It certainly sounds like the bisphos. are not for you. It seems that there are some huge concerns that with the bone made by the bisphos. may not hold up well over time and that microfractures may be very dangerous and problematic as the person ages. And, some of the bisphos have such an incredibly huge half life that they are just not going to leave your system and apparently there is no way to get that stuff out.
I saw that there is now a clinical trial going on in late phase with a comparison of evista and menostar looking at bmd. That will be interesting.
Are you certain that the menostar offered some breast cancer protection , I thought that was just the evista?
Well, at least there are some options other than just the bisphos. But, everything does seem to have a downside, you just have to pick what is best for you.
In your case, with your family history and your prior fractures , I would say push for the one yr. dexa and stay on top of this situation.
It would be great if you would do a thread with the info that you found about phosphorous. I will do a little poking around but I know others would be very interested in that as well. See ya

Last edited by osteoblast; 06-11-2008 at 09:47 AM.

 
Old 06-11-2008, 11:47 AM   #10
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Re: Puzzling Question About HRT for Osteoporosis

What you're going to find when you look is that in studies using unopposed estrogen, the risk of breast cancer was slightly lower. The one thing that I did see in study after study if you look at those charts they have that show the different categories of side effects, the low dose estrogen alone always had a slightly lower number in the breast cancer column no matter what it was compared against. Menostar has been studied in women with a uterus with unopposed estrogen and they saw a tiny, like 1 person, increase in uterine hyperplasia. Because of this, the manufacturer suggests that a woman take progesterone for 14 days every 6 to 12 months. It's not required though. It's a matter of choice.

In a 2-year, double-blind trial, 417 postmenopausal women 60 to 80 years old with an intact uterus were randomized to either unopposed transdermal E2 14 mcg/day or placebo. All patients received daily calcium and vitamin D. After 2 years, BMD in the lumbar spine increased by 2.6% in the E2 treatment group and by 0.6% with placebo. Total hip BMD increased by 0.4% in the E2 group and decreased by 0.8% with placebo (B Ettinger et al Obstet Gynecol 2004;104:443).

My main concern is I'd rather the numbers were reversed. I don't need it in the spine, I need it in the hips. But I guess I'll take what I can get.

I'll see what I can dig up on the phosphorus. I got it around here somewhere. I am totally disorganized now. I'm in one of those stages where as I find myself coming, I'm passing myself leaving. I'm back at school on top of everything else. Sometimes I think I'm insane.

 
Old 06-11-2008, 01:56 PM   #11
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Re: Puzzling Question About HRT for Osteoporosis

Access- You insane???? You seem very sane, intelligent and blessed with a very quirky sense of humor . You always make me laugh! Somehow it just helps,in the context of discussing all of this very technical stuff.
You are fortunate that it is your spine that is better than your hips, because I think you can do alot with exercise for your hips. Unfortunately it is very hard to add bmd to the spine with exercise . You want to do exercises though to strengthen back muscles to help with maintaining good posture and that will help by not putting added stress on the spinal column from hunching over.

Last edited by osteoblast; 06-11-2008 at 02:17 PM.

 
Old 06-11-2008, 06:07 PM   #12
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Re: Puzzling Question About HRT for Osteoporosis

I know exactly how you feel with your fears of the bisphosphonates! I have heard so many horrible things about them and have talked to several women, including my Grandma (who has severe osteoporosis and is in her nineties), who have had terrible side effects from them and could not tolerate them. I am extremely sensitive to many many medications, foods, hormones, vitamins, you name it, and I do not have a strong stomach at all, and frankly my quality of life since my hysterectomy has not been good despite much healthier habits. I really dont want to deal with any more side effects than I have to. It is amazing to me that there are still such limited options as far as treating osteoporosis when it is such a widespread and debilitating problem.

To answer some of your questions, yes I do take the Vivelle Dot twice a week. When my estradiol was tested while on the patch, I was not required to wait until a specific time. My estradiol was tested while on the second day of the patch (the day after changing it). I should mention that at that time I was wearing tegaderm over my patch to keep that awful ring of dirt from collecting around the edges of the patch. However, I had terrible problems with sore breasts all the time and intense body aches just before and the day of changing the patch. It took a long time and lots of experimenting for me to figure out that the tegarderm was actually pushing more hormone from the patch into my body at once and then the patch would lose strength long before time to change it. I stopped putting the tegaderm over my patch and within a month the sore breasts and aching stopped and has not returned. I mean I spent months trying progesterone and vitamin E and lowering my patch dose and everything else to help those sore breasts, and here it was the tegaderm causing it! So now I suspect that my higher level of estradiol on the second day of wearing my patch might have been due in part to the tegarderm. I did just have my levels tested again last week (without tegaderm) along with a bunch of other stuff due to starting testosterone but have not received the results yet. It is possible my estradiol levels could be much lower now but I still feel that they will be robust since this patch has helped reduce a good bit of my symptoms (insomnia, mood swings, night sweats, hot flashes, fatigue, joint pain and muscle aches, crying spells, dry skin, dry vagina, brain fog, headaches, etc.). I am still having bladder incontinence issues and am hoping the added testosterone will help with that. I still do get some of the other symptoms too but not as intense.

I am quite a small active person with not much body fat so I dont think my body would produce much of it's own estrogen without the hrt. The 19 pg/ml that I tested at when I had my estradiol checked in 2006 was when I was already on an hrt, just not absorbing it well. I can't imagine my levels on nothing at all. What my body does produce would be in the form of estrone which is more commonly made by body fat and the estrogen generally more common in post menopausal women. Unfortunately estrone does not have quite the same protective effect on bone as estradiol. In fact I do have a small amount of fat around the waistline that is characteristic of menopause and it is truly frustrating that not even intensive daily exercise and a very lean diet makes a difference in getting rid of it. Even when I weighed 102 lbs I had the waist. I have read that the body will draw estrogen from fat reserves when there is a shortage from the ovaries hence the menopausal waistline. It is more severe when you lose your ovaries suddenly.

As far as testing, some doctors dont believe in testing hormone levels at all since there is such a variance as to what is considered normal. I went to a number of doctors before finding one who was willing to test and to even let me try different forms of hrt. But even she likes to go more by symptoms. However, I also have hypothyroidism and those symptoms can be so very similar to low estrogen that at times it gets very confusing as to what is causing what for me. So from time to time we do test. If your doctor is open to testing, more than likely they will want you to give it two or more months on a single dose of your patch before checking to see if it is doing what it is suppose to. Starting low is probably a smart idea since you really dont know how your body will respond. I started at .0375mg for several weeks and then moved up to .05 mg for two months and finally up to .075 mg. At one point I tried to go back down to .05mg when having the breast pain but had horrid symptoms so went back to .075 in a short time. Another time I tried increasing to .1mg due to continued bladder problems but also had unwanted symptoms of bloating, irritability, nausea etc. so back to .075mg in a short time. I have been at this dose for over half a year steady now and it seems to work the best...for me. I just feel that my body also needs other hormones for problems that the estrogen alone doesnt help, like libido for one. Hormones are complicated that is for sure. I dont blame you for being hesitant. I guess I am more willing to take the risks with hormones than a lot of people because I absolutely can not live without my hrt. I can't function at all. If ever that choice was taken away I would end up in a mental hospital somewhere.

I hope everything works out for you! I would very much like to hear of any future results in your journey through this. It is amazing how much we can learn from each other on these boards! Take care!
Elaine

Last edited by moderator2; 06-11-2008 at 06:34 PM. Reason: please do not leave huge quotes in your post

 
Old 06-11-2008, 09:04 PM   #13
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Re: Puzzling Question About HRT for Osteoporosis

Elaine-there is alot of great info in your post that I want to respond to.Thanks for taking the time to be so detailed with sharing your experience. Tonight I just wanted to send off a few quick remarks/questions and then tomorrow a bit more.
First, I am hypo too. Meno, hypo and osteo have been alot to deal with! And, it looks like you know exactly what I am talking about and then some too. Do you have hashimoto's thyroiditis?
Sorting out symptoms of hypo and estrogen deficiency is -I think near impossible.
Yet, I remain hopeful that the hrt will help, whereas the hypo treatment doesn't seem to have helped much . My thyroid levels are and have been very unstable.
Anyway, just wanted to let you know we had that(hypo) in common as well.
Also, I am one week and a day into the .05 vivelle dot treatment and all is ok. Of course, everyone is difft. When you were getting accustomed to the vivelle .075 how long did it take for you to experience difficult symptoms?
I will be very interested to hear your new estradiol level on the .075. When I look at the vivelle dot prescribing info it looks like it probably takes at least the .075 to give us some real bone help-that is, for people like us with seriously low density.
Maybe our body types are somewhat similar too. I am 5-3 , I believe you are taller but mostly my weight has been around 104-110 for most of my life. My bone spec. has given me orders to gain some weight. So, I don't really have much fat either perhaps though a bit more than you.
I read in the vivelle prescribing info that if the patch is put on the buttocks that it boosts the dose by I believe some 10&#37;. .I thought this was interesting because it must have something to do with easier absorption in fatty tissue??
Also I got Dr. Vliet's book from the library Screaming to be Heard-and saw that she said estradiol level of 100 for bone protection.

Last edited by osteoblast; 06-12-2008 at 06:49 AM.

 
Old 06-12-2008, 04:03 AM   #14
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Re: Puzzling Question About HRT for Osteoporosis

Hey osteo, thanks for the quirky. Most people call it sick. But actually I've been trying to be on my best behavior. I've found sick gets me in trouble and I kinda like it around here.

I kinda contribute my spine density to two things. The two different types of bone and the effect of thyroid hormone on each different type and my compulsion to lay rocks. I am a rock addict and if I see a place that needs a rock wall, I build one. Been doing it for 25 yrs. I can lift and carry some monsters. For my little size, 5'2 105lbs, I can put some of the boys to shame.

I also got a horse. Two months before I was diagnosed. I spent the winter trying to decide what would happen if I fell 17 hands. Of course I had gotten one of the tallest horses in the county. He was sweet as can be and he matched my hair but I was scared to ride. Now I've decided it would do wonders for my hips and I'm not going to worry any more about falling. I've always been a walker. We hike these mountains all the time. Nothing around here is downhill until you've been uphill. My hips have been exercised to death over the years. The only thing I can contribute that too is the affect of the thyroid hormones.

Now to the ring. Why in the world did they make those darn patches clear if after a day, they're going to look like crap? You put it on and it looks so pretty and invisible and then a couple hours later you look and it's black all around the edges. Who in the world wants to run around with ring around the patch? It's vulgar. You can pick it off but then you end up with a red ring instead. WD-40 works for getting the black off but it loosens the patch a bit. Anyone found a true solution? Help!!!!!!!!!

 
Old 06-12-2008, 07:21 AM   #15
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Re: Puzzling Question About HRT for Osteoporosis

Access-Must be alot of rocks around there just right for building rock walls. I have never built a rock wall in my life-but could see the fun of it. Sort of like putting a puzzle together but more fun since you will see it in the landscape afterwards.Definitely lifting those rocks could have worked to build up your spine.But you really need to be careful now to use good lifting technique!
I would think though that trudging up and down those hills would have worked your hips big time- so wonder about the greater loss in your hips. But as you have said maybe it is the effect of thyroid hormone on the two difft. types of bone . Do you think you were going hyper due to too much thyroid hormone ? Was your level being checked or did you think you arrrived at the right dose and just let it be?
Now you have a four legged companion to go up and down those hills. I used to ride horses and loved it too-many years ago in my youth. A girl and her horse-one of the great love stories. I did take a number of tumbles-it seemed an inevitable part of the whole process to me-maybe I just didn't know what I was doing.
Now to the question of the day-it concerns the mirena bone info and the vivelle dot physcian prescibing info about bone results. This is what I am wondering--If you look at the vivelle dot info , it seems almost to take greater than a .0375 dose just to try to hold even from base line starting bone density. I still can't see how the .014 is going to keep you even- that is where you start at and not have you losing. What I am getting at is the way they did the chart at mirena- maybe it means that while you have a let's say 2&#37; increase compared to placebo--that perhaps placebo users lost 4%-so you have only lost 2% while you have that gain versus the placebo users yet you have lost. I hope I have somewhat expressed this clearly? What do you think?Could you look at the bone data charts for both the vivelle and the mirena and let me know what you think? Am I reading it wrong?
About the ring around the patch-truly I haven't seen it -maybe it's my eyesight.But i do two patches a week-and I think you just have one for the whole week. But I did read somewhere that people were using baby oil to remove any lingering sticky stuff from the patch. Wd-40, my goodness your mind works in very strange ways!

 
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