Hormone Replacement Therapy E4 Women

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Starfish77
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Re: Hormone Replacement Therapy E4 Women

Post by Starfish77 »

I have shrunk three inches and my endocrinologist is putting me on EVISTA for my bones because I can't take estrogen
because my cancer in 1980 had estrogen receptors. Evista does something for your bones in the same way estrogen
does without the potential cancer causing effect of estrogen for someone who has estrogen receptors. I will also take
1000 units of vitamin D and 1000 units of calcium. This will be closely monitored because I am in remission from sarcoidosis. I'm going to tell the sarcoidosis researcher I'm going with the D and calcium because my concern with weak bones is greater than my concern with sarcoidosis at this time. I see the researcher for my six month blood
draw Jan. 24.
I feel good about the endocrinologist in that i believe she understands about sarcoidosis and the precautions that
must be taken. I feel so fortunate to have doctors that I feel comfortable with, Medicare and supplemental insurance
from the work I retired from. I think about all the doctors I have talked to and all the tests I have been given. I think about people who have all the medical concerns I do and don't have access or can't afford medical care. I have a lot to
be thankful for.
Silverlining
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Re: Hormone Replacement Therapy E4 Women

Post by Silverlining »

@Schnooks...it is overwhelming. However, I would say don't feel rushed, when you have time, you might do as Julie says and print some of the summaries out and talk with your doctor. It appears that there are pros and cons and I suspect it also individual even among E4 women. The women in my family do not experience significant menopause symptoms and so far, neither am I; in fact, some aspects of my health appear better with declining estrogen. It is so confusing, please don't stress. I plan to contact a few researchers on this subject and if I receive any illuminating feedback, I will certainly share.
TCat
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Re: Hormone Replacement Therapy E4 Women

Post by TCat »

Starfish, did you consider adding vitamin K2 to your list? I take 4 drops/day of this formulation: http://www.canprev.ca/products/d3_k2_drops

Here is a good summary: http://chriskresser.com/vitamin-k2-the-missing-nutrient
circular
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Re: Hormone Replacement Therapy E4 Women

Post by circular »

Okay gals, this just in from my NEJM Journal Watch email. Noteworthy is the usual lack of ApoE info and that these are estradiol levels of women *not* on HRT, so they are not equine estrogen.

"High (and Low?) Endogenous Estradiol Linked to Increased Dementia Risk in Postmenopausal Women

By Amy Orciari Herman

High levels of endogenous estradiol are associated with increased risk for incident dementia among postmenopausal women, especially among those who have diabetes, a Neurology study finds.

Using data from a French prospective cohort, researchers identified some 130 postmenopausal women who developed dementia and 540 who remained dementia-free over a 4-year period. Endogenous estradiol was measured at baseline. None were using hormone therapy.

After multivariable adjustment, researchers found a J-shaped association between estradiol and dementia: Compared with women with moderate estradiol levels, those with the highest levels had a 2.4-fold risk for dementia, and those with the lowest levels had a 2.2-fold risk. In an analysis stratified according to diabetes status, diabetic women with high estradiol had a 14-fold increase in dementia risk.

The researchers attribute the increased risk at low estradiol levels to possible reverse causation. Regarding the link between high estradiol and dementia in diabetic women, they write: "It is plausible that higher endogenous [estradiol] together with diabetes promote a set of unfavorable vascular processes to increase risk of dementia in postmenopausal women.""

http://www.neurology.org/content/early/ ... 7.abstract
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Julie G
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Re: Hormone Replacement Therapy E4 Women

Post by Julie G »

And then there's this
http://epirev.oxfordjournals.org/content/36/1/83.short

"Our findings support current recommendations that hormone therapy should NOT be used to prevent dementia."

Least we fail to muddy the waters ;) Silver will soon be weighing in with some opinions from various experts...
circular
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Re: Hormone Replacement Therapy E4 Women

Post by circular »

Hi,

I'm not sure that last link helps much, since they just compared no use with any use, presumably use with all combinations of duration and starting age vis menopause age, and didn't study ApoE4. At the end they say "We discuss trends in hormone therapy research that could explain our novel findings and highlight areas where additional data are needed." I hope they cited the earlier 2013 article about ApoE4 benefitting while ApoE3 didn't, simply speaking, and recommend all future studies include ApoE status. To me it seems the *one* study (afaik) that looked at ApoE4 was strongly suggestive of estrogen's potential to help us, a difference which *might* help explain the varying results in other studies that this study harkens to. Since the original study I posted here indicates too much *or* too little is a problem, maybe bioidentical low doses are the sweet spot? All I know is for now, at 51, bioidentical estradiol/estrone has made a big positive difference in the stress and wellbeing levels in my daily life, which itself must be neuroprotective :mrgreen: :P :mrgreen: :P :mrgreen: :P :mrgreen: :P :lol:
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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Re: Hormone Replacement Therapy E4 Women

Post by RedNailz »

I am not well-informed on HRT but trying to make sense of it as an option in a couple of years. I have a question for all of you: What happens when HRT is stopped? How long can you stay on it?

I imagine there are medical warnings about staying on it too long, but quite frankly, I am ok with dying of something other than AD. I do worry about ending HRT too soon. This is based strictly on what I heard from a woman whose mother stopped HRT, then had a severe cognitive decline before being diagnosed with AD.
4/4
circular
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Re: Hormone Replacement Therapy E4 Women

Post by circular »

Unfortunately the problem is there's no clear advise on how long you can take it and what happens when it's stopped. We're all kind of wishing for something cut and dry, but studies are usually murky. Your anecdote is very interesting, although of course it doesn't indicate stopping HRT was the cause of the mental decline. It could be though! My mother, from whom I'm sure I inherited the ApoE4 (her mother and aunt had Alzheimer's) is 80 and no signs of AD, in spite of typical western diet and lifestyle. She's been on HRT since about age 46 after a hysterectomy. Knowing these people really makes it easy to say, put me on HRT and I do it too. The most intriguing article I've seen, and mentioned it above, is:

http://consumer.healthday.com/cognitive ... 73445.html

http://www.ncbi.nlm.nih.gov/pubmed/2341 ... t=Abstract

Here's one, not ApoE related, saying pre-manopause contraceptive use had a duration-linked beneficial effect on cognition. I had this in my links, and was on contraceptives for about 10-15 years, but forgot ever reading this :?

http://www.ncbi.nlm.nih.gov/pubmed/22994984
ApoE 3/4 > Thanks in advance for any responses made to my posts.
RedNailz
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Re: Hormone Replacement Therapy E4 Women

Post by RedNailz »

I had to chuckle at this line from the Healthday article (which I did find interesting): "He also noted that the researchers looked at averages: Not all E4 carriers on hormones seemed protected against telomere shortening. By the same token, carriers who were off of hormone therapy did not always show accelerated shortening." I laugh a little at this because it is so typical of study results. "Maybe this might help E4 carriers except when it doesn't help and we don't know why."

So I shrug my shoulders and say, "Well, why not try it?" I'm perimenopausal so I hope there will be more data to work with in a couple of years.
4/4
circular
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Re: Hormone Replacement Therapy E4 Women

Post by circular »

RedNailz exactly! I am on bhrt because I'd become a mess without my vital life force! They all agree it's safe for short-term, so I'm hoping by the time short-term comes along things will be clearer, but probably not since we need good, well-designed LT studies including ApoE4-specific results :cry: I figure if I can't feel like a normal human without the HRT, I will take it. If I get AD I will take a bottle of pills. I'd rather have quality of life until then :lol: What I *don't* like is I can't take progesterone because it makes me too lax (hypermobile EDS), so I have to worry about that, but juliegee says it might work after a while on estrogen.
ApoE 3/4 > Thanks in advance for any responses made to my posts.
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