Biodentical HRT

I never considered HRT after menopause, because I never had hot flashes or other postmenopausal symptoms. Thanks to having undiagnosed hypothyroidism, I was cold all the time and my blood pressure and pulse were 'nice and low' (according to my traditional PCP).I also didn't want to risk getting cancers associated with HRT. However, after I fractured my hipbone and had a DEXA scan, my naturopath suggested that I consider biodentical HRT, which was less likely to cause cancers.  Also Lara Pizzorno in "Your Bones" described how estrogen and progesterone help bone growth.  So 17 years after menopause I decided to try biodentical HRT for no more than 2 years.


My insurance company agreed to cover the Estradiol patch (0.05 mg/24 hr ptwk).  However they wouldn't cover the biodentical progesterone product, Prometrium (micronized 100 mg caps), one cap daily. My ND recommended that I take both the estrogen and progesterone products together to minimize side effectt. After my ND appealed twice, my insurance company agreed to cover Prometrium. So I started taking a daily prometrium capsule and wearing the Estradiol patch.


I had read that I would experience side effects. However what I experienced during the first five days seemed more like my typical food allergy reaction, than menstrual cramping pain.  After five days of intestinal cramping I rechecked the ingredients, which I foolishly assumed my naturopath had checked before prescribing to me, and found SOY (one of my diagnosed food allergies) among the inert ingredients.  When I confronted my ND, she said 'some of my patients react to the soy'. GRRRRR!!!! I ALWAYS react to soy with gut cramps, bloating, gas, diarrhea or constipation.


So I went off both the estrogen and progesterone for a week to let side effect symptoms subside.  Meanwhile my friendly compounding pharmacist created a compounded version of prometrium without soy.  So after a week break to recover from soy symptoms, I resumed taking my 'safe' prometrium and estrogen patch.  During the next 4 weeks I experienced many of the listed side effects for estradiol patch and prometrium, including breast swelling and tenderness, weight gain, abdominal bloating and tenderness, significant white vaginal discharge with no odor, and pretty severe reflux.


I could tolerate the other side effects, but I would not tolerate severe reflux.  I do NOT have excess stomach acid.  I actually have to take betane hydrochloride capsules to digest proteins and fats.  I don't want to take acid blocker pills or even biocarbonates, because I need stomach acid to digest all the calcium I take for bone health. So I stopped the HRT for another month to recover from all those side effects.


During the first 2 weeks after I stopped taking the estrogen and progesterone, the other side effects subsided, but I increasingly felt faint when I stood up. So I wondered whether I had low blood pressure and started checking my blood pressure and pulse regularly at local drugstores.  Initially my blood pressure was 86/56.  So I continued to check that every other day and noticed my pulse and blood pressure slowly rose back to normal (for me) over the next 2 weeks. When I talked to my ND after discontinuing bio HRT, she suggested I cut my dose in half. When I reminded her that the progesterone was a capsule, not a tablet, she suggested I stop taking the progesterone.  However I had recently read that estrogen raises blood pressure and progesterone lowers blood pressure. I knew I needed both for balanced blood pressure.
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I waited a few more weeks to overcome all the side effects before I asked my compounding pharmacist to show me how to accurately split the contents of each prometrium capsule.  That was a time consuming procedure, but I learned shortcuts as I went along.  Then one month ago I resumed half dose of estradiol patch (1/2 patch or 0.025 mg/24 hr ptwk) and 1/2 dose of compounded prometrium (25 mg capsule daily).  During the past 4 weeks, I experienced some breast tenderness and swelling and slight vaginal discharge, which seem to be diminishing now.  Actually I welcomed the breast swelling, which gave cleavage without wearing a push-up bra.  I began my second month today and hope the side effects really do disappear after the first month, but neither side effect is bothersome. Nevertheless, I will reassess the benefits of bio HRT after I see my next DEXA scan results.

OSTEOPOROSIS TREATMENT

After fracturing my left femoral neck (hip bone) last June 2014, I had a DEXA scan in mid August which showed pretty significant osteoporosis. Just getting an order for the DEXA was challenging. The doc substituting for my PCP (who was on maternity leave) insisted that a hip fracture already says I have osteoporosis. He wanted me to take Fosomax (side effects: jaw necrosis, spontaneous fractures and gastrointestinal damage) ASAP.  I convinced him to order the DEXA and postpone Fosomax until I saw the results. 


The naturopathic doc, whom I'd seen regularly for 5 years, freaked when she saw my DEXA results. However, she prescribed a great nutritional supplement plan, biodentical hormones and lowering my T3 supplement. She also recommended I read "Your Bones" by Laura Pizzorno and Jonathon Wright MD, who heads the clinic where I first met my ND. 


I had taken calcium regularly when I was younger, before I had hypothyroid symptoms (esp. constipation).  Then after my celiac and dairy allergy diagnosis, I tried to get calcium fron nondairy sources.  Obviously many years of undiagnosed and misdiagnosed celiac disease prevented me from absorbing calcium and other bone strengthening nutrients. So, despite my doing regular weight bearing exercise and lifting weights for years, I have significant osteoporosis now.  I knew I was losing height (I'm 2 inches shorter than when I was in my 20s), but didn't realize the extent of bone loss before my DEXA.


So after my DEXA and visit to my ND I started taking the following supplements: 

AlgaeCal 5 caps daily for 1250 mg total calcium (Per cap 250mg Ca, 22 Mg, 333 D3);

Magnesium 3-3/4 caps daily (Per cap 300mg Mg, 200mg K) plus AlgaeCal Mg;

Strontium 2 caps daily (680 mg for 2 cap) 3-4 hours after calcium;

Vitamin D3 (1000 IU per tab) 1-1/2 tabs daily (plus Algae Cal which also contains D3);

Vitamin K2 (100 mcg per cap) 1 cap daily;

Vitamin B Complex (includes 80mg Niacinamide, 400mcg Folate, 600mg B12) 1 cap daily;

Vitamin B (balanced B 100) 1 cap daily;

Niacinamide (500mg per cap) 1-2 caps daily for thumb joint and elbow arthritis;

Vitamin C (500 mg per cap) 2 caps daily;

Vitamin E (400 IU) 1 cap daily;

Zinc (30 mg tab) 1 tab daily 

Custom Probiotics Adult CP-1 Formula (50 billion live cells per cap); 1 cap daily;
IAG (arabinogalactans) 1 tsp dissolved in 6 oz water daily (2 g arabinogalactans) for immunity;
Betaine Hydrochloride (650 mg per cap) 2-4 caps per meal w/ fats and protein for hypochloridia

I also do weight bearing exercise (walking, jumping and lifting weights, as well as pt exercises to strengthen my hips and back) daily.

I'm still taking all those supplements and doing well.  However, I had to battle my insurance company to get biodentical hormones.  I also had to find a doc who would give me an effective level of my thyroid supplement.  Neither too little or too much thyroid hormone is good for bone health.  However, I'll describe those battles in another post.

I suspect this post will make me  vulnerable to loads of comments, criticizm and suggestions by posting my osteoporosis treatent supplements. However, I'll try to respond to every comment, unless it's really an advertisement for drugs for osteoporosis, which I will immediately delete and/or block. Nevertheless I'll reply to questions about treatment and my experience with supplements.