HRT and the immune system?

[Padma]

I finally had "the conversation" with my brother last night (we'd only skirted round it before) and it went fine. One thing that came up was he asked me what I knew about HRT affecting the immune system, as he'd heard that it can compromise it.

I've been googling about this, but can only find in-depth medical study reports that might as well be in Klingon for all the sense I can make of them. Does anyone know of any laybeing-readable resources on this subject? I'm interested because I have a slightly dodgy immune system (from something caught off dogpoo when I was 3 years old) and want to make sure I continue to take care of it through this process.

[Janet_Girl]

I finally had "the conversation" with my brother last night (we'd only skirted round it before) and it went fine. One thing that came up was he asked me what I knew about HRT affecting the immune system, as he'd heard that it can compromise it.

I've been googling about this, but can only find in-depth medical study reports that might as well be in Klingon for all the sense I can make of them. Does anyone know of any laybeing-readable resources on this subject? I'm interested because I have a slightly dodgy immune system (from something caught off dogpoo when I was 3 years old) and want to make sure I continue to take care of it through this process.

chugh 'oH ta'ta' compromise ones immune system chaH would]ghobe' nob 'oH Daq be'pu'.   'ach Daq chIl lIj brother's yab talk Daq SoH doctor.

sorry could not resist. 

v hidden translation v
If it did compromise ones immune system, they would not give it to women.  But to ease your brother's mind talk to you doctor.

[Cindy]

There is no evidence that HRT compromises the immune response. Indeed the available evidence suggests that people with a female hormonal structure live longer than people with a male hormonal structure. A visit to any aged care facility proves this.
I realise that the previous comment maybe  facetious but tell your brother to get real. Do woman get more disease than men? 

Ignorance may be bliss, but not thinking is stupidity
'Cindy

[Padma]

Thanks, that's reassuring.

[pebbles]

Umm it's complicated... not necessarily.
Progesterone is an anti-inflammatory and estrogen protects your blood vessels so that's why women live longer oddly a less extreme inflammation reaction causes less vascular damage in the form of arteriosclerosis.

However it increases the risk of auto-immunity possibly due to this anti-inflammatory response but when a woman is sick her immune system mounts a larger immune reaction as if to compensate for the above effects, females also have less blood but higher levels of circulating white blood cells while males have more red blood cells.

It's complicated. to say the least :/
How many of these factors are influenced by estrogen and progesterone are unclear.

[Padma]

One of the things on my todo list once I move is to get referred to an immunologist - one of my previous doctors recommended it (but I've been moving around too much to organise it) because I seem very prone to viral infections, and this may actually be something treatable. That'd be nice! For one thing, every time I get a virus I go cross-eyed, which has stopped me being a professional proofreader, dammit (not that anyone seems to bother with those any more, sigh...)

[japple]

I've seen studies that link sex hormones to immune response but I have a full blown autoimmune disease and my doctor didn't hesitate with HRT.  HRT has increased my visible psoriasis but helped nail pitting and arthritis.

Stress definitely affects the immune system and GID is very stressful.  So I'll take my chances.  Maybe HRT will actually help.

[Cindy]

The higher risk of autoimmune disease in females is genetic rather than linked to female hormones. Indeed many woman with autoimmune disease go symptom free during pregnancy.

But it is a very complicated area.

All in all I would not worry about autoimmunity and HRT. Suicide is a bigger killer of people with our problems.

Cindy

[Padma]

Thanks - the issue I have is not an autoimmune one, I'm sure - something just got knocked out of shape by the early illness, and if I can get it identified, it might get improved on - but that's way off to one side of the HRT issue. And certainly, having my libido drop will have a very positive impact on my immune system .

[Simone Louise]

To slightly highjack the thread, while you with knowledge are gathered here, what about the other health risks of HRT, especially in older people. The warnings of the Mayo Clinic are typical of what I read online and hear from my wife and her doctor and my gender therapist:

"According to the study, over one year, 10,000 women taking estrogen plus progestin might experience:

Seven more cases of heart disease than women taking a placebo
Eight more cases of breast cancer than women taking a placebo
Eight more cases of stroke than women taking a placebo
Eighteen more cases of blood clots than women taking a placebo
An increase in abnormal mammograms, particularly false positives"

While the comment about suicide would apply to many, I don't feel that's a risk for me. And I realize the risks are small. I just haven't seen a discussion of them for older mtfs.

S

[Joelene9]

  I read an article back in the late '70s that they tried using small amounts of estrogen in older males ~68 and above to see that it would decrease the appearance of heart attacks.  Back then, women were known erroneously to have much less heart attacks.  The test group developed more clots that would cause strokes that they cancelled the study.  It took a lot of women to die from misdiagnosed heart attacks for the medical community to realize that women do have heart attacks as much as men.  Women's heart attack symptoms are usually different then men's.
  Joelene

[Petra von Kant]

Sticking with the slightly off-topic post above, find this recent publication on mortality in transgender (both FtM & MtF) people treated with HRT http://www.ncbi.nlm.nih.gov/pubmed?term=Asscheman%20H%2C%20Giltay%20Megens%20EAJ

Cheers, Petra

To slightly highjack the thread, while you with knowledge are gathered here, what about the other health risks of HRT, especially in older people. The warnings of the Mayo Clinic are typical of what I read online and hear from my wife and her doctor and my gender therapist:

"According to the study, over one year, 10,000 women taking estrogen plus progestin might experience:

Seven more cases of heart disease than women taking a placebo
Eight more cases of breast cancer than women taking a placebo
Eight more cases of stroke than women taking a placebo
Eighteen more cases of blood clots than women taking a placebo
An increase in abnormal mammograms, particularly false positives"

While the comment about suicide would apply to many, I don't feel that's a risk for me. And I realize the risks are small. I just haven't seen a discussion of them for older mtfs.

S

[Padma]

  I read an article back in the late '70s that they tried using small amounts of estrogen in older males ~68 and above to see that it would decrease the appearance of heart attacks.  Back then, women were known erroneously to have much less heart attacks.  The test group developed more clots that would cause strokes that they cancelled the study.  It took a lot of women to die from misdiagnosed heart attacks for the medical community to realize that women do have heart attacks as much as men.  Women's heart attack symptoms are usually different then men's.
  Joelene

This may have involved earlier "versions" of oestrogen that have now been discontinued due to increased risk such as you mentioned.

[Padma]

"According to the study, over one year, 10,000 women taking estrogen plus progestin might experience:

Seven more cases of heart disease than women taking a placebo
Eight more cases of breast cancer than women taking a placebo
Eight more cases of stroke than women taking a placebo
Eighteen more cases of blood clots than women taking a placebo
An increase in abnormal mammograms, particularly false positives"

It's worth noting that some of these increased potential risks are more specific to the progesterone, which only some trans women take.

[Joelene9]

This may have involved earlier "versions" of oestrogen that have now been discontinued due to increased risk such as you mentioned.

It was the same estrodiol that I am taking now.  That test group was 70+ years old with family history of heart problems.  They had a time getting a younger set, about 50+ years old, to do that test due to the doctor's ethics and no volunteers. 
  Joelene

[Asfsd4214]

The problem with this subject is that there's a LOT of female sex steroids and a lot of HRT drugs.

People tend to talk about HRT like it's all one thing but it's not.

Ethylestradiol used in birth control pill and some HRT supplements has probably the most risks of cardiovascular health.

Regular estradiol based HRT you have to keep in mind many of the studies have been done with women taking it and increasing exposure well beyond a normal timeframe, and thus might not apply to us.

There's issues with Progesterone but most of those studies involve Medroxyprogesterone, chemically different. As opposed to the compound naturally found in the human body.

As someone mentioned pregnancy has a habit of reducing autoimmune symptoms, most of the research on that implicates Estriol, which most TS's don't take anyway, in having that effect.

Let me put it this way, I used to get sick a lot, since I started HRT I've gotten sick less. Might be totally unrelated, but that's the thing. If there are effects they're minor.

Personally I wouldn't worry about the studies, because you need to understand the full picture to take anything from it, and if you do all you can usually take from it is a whole bunch of 'maybe's.