HRT and alcohol

[E-Brennan]

Not that I'm out getting hammered, but I do enjoy a beer or two or three once in a while.  Will this have an impact on how effective HRT is?  My concern is that alcohol has some kind of mellowing effect on spiro or estrogen which might slow my progress; if this is the case, then it's goodbye beer, but it'll be a teary goodbye.   

[Julia-Madrid]

Hiya - I'm not sure about whether the alcohol will affect efficacy of estrogen and anti-androgen. 

However, both of those things do place some degree of strain on one's liver, especially when E is taken orally.  Since your liver would be metabolising more chemicals than it used to, alcohol adds a bit more metabolic load.   

A beer once in a while is probably not going to do any harm, but what I would recommend is that you check your liver function every 4-6 months - there are three key enzymes and a few other markers that indicate liver distress: just make sure yours are low and stable.

I know that "zero-alcohol" beer is a sad, sad thing, but I've got used to it.  Try it a few times

[Julia-Madrid]

Hiya - I'm not sure about whether the alcohol will affect efficacy of estrogen and anti-androgen. 

However, both of those things do place some degree of strain on one's liver, especially when E is taken orally.  Since your liver would be metabolising more chemicals than it used to, alcohol adds a bit more metabolic load to a liver already working a little harder than before.   

A beer once in a while is probably not going to do any harm, but what I would recommend is that you check your liver function every 4-6 months - there are three key enzymes and a few other markers that indicate liver distress: just make sure yours are low and stable.

I know that "zero-alcohol" beer is a sad, sad thing, but I've got used to it.  Try it a few times

[EllieM]

Liver stress, good point from Julia-Madrid. Although I am not a doctor, I would say that moderation is the key. I am also on statins, yet another hepatic insult. I have bloodwork done at least four times annually, so far so good. My drinking habits went from several every day pre-hrt to a few drinks per week after I started. It was not a conscious effort, just sort of happened. As far as efficacy of E and AA, I guess that depends a bit on timing and method of hrt delivery. I can't say that I notice any deleterious effects so far, but statistically, I am a N of 1, hardly a representative sample. Can anyone cite a study?

[KayXo]

As far as alcohol interacting with estrogen, it appears that, on one hand, CYP3A4 enzymes can increase with consumption of alcohol and those enzymes metabolize estrogen heavily when taken orally. More CYP3A4, less estrogen in the blood. Not good!

But, on the other hand, as alcohol appears to be broken down by both CYP3A4 and CYP1A2, enzymes that both metabolize estrogen orally, it may act as a competitive inhibitor of estrogen metabolism and thus increase its concentration.

My thoughts. If you take estrogen orally, alcohol may affect levels and thus, it would be wise to limit or even not drink alcohol at all. If taken non-orally, then no worries. But, as always, if you do drink, drink with moderation and be careful.

Re: liver and estrogen...the risks seem quite low though and I think alcohol would probably affect it much more adversely. The bad rap about estrogen and liver comes from prescribing high doses of non bio-identical estrogen such as Premarin and Ethinyl Estradiol to transgendered women in the past. Times have changed, we take bio estrogen now and risks are much reduced.

[KayXo]

I am also on statins, yet another hepatic insult. I have bloodwork done at least four times annually, so far so good.

https://www.statineffects.com/info/adverse_effects.htm
http://www.thincs.org/index.php

I'm not sure how right or wrong the overall information is and you most probably know some of it already...but still a very interesting read, in my opinion. You make your own conclusions and could discuss this with your doctor. Always good to hear both sides of the argument to get a more accurate picture.

[EllieM]

Thanks for that! Indeed an interesting read, not all of that stuff is in the product monograph. I have already had my dosage halved, and have been planning to halve it again this fall if my LDL numbers hold. Had conversations with a few doctors (cocktail party talk) about this issue, including with a few who are also taking it. There was a a recent study which indicated that the risk of type II diabetes increases with statin use, but another study refutes that claim. In one of my discussions with a physician, the consensus was that since the median BMI of statin users is high, the risk of diabetes stems from that rather than the presence of statins.

I have experienced some of these side effects, for sure, but unfortunately, breast enlargement was not one of them. Had to undertake a major hormone adjustment to achieve that