Regarding things that can prevent the absorption of estrogen.

[Ltl89]

Hey All,

I have a few questions about preventing estradiol from being blocked and making sure it gets adequately absorbed.  My E levels have been a little on the lower side (not bad, but could be better) and I'm trying to make some changes.  Because I'm on a high dose, I want to do whatever else I can to make sure my levels remain good, so I wanted to go over potential problem areas.  I'm even thinking of switching to injectables and giving up on the pills which shows how serious I am about this given my fear of needles. 

One mistake I think I've been making is using melatonin every night.  I used take quite a lot of it (15 mg) every night for over a year to help me go to sleep.  However, I've been doing some reading and see that melatonin can reduce estrogen.  So, I've been shooting myself in the foot and have been trying to make up for it the past two weeks.  And I have to say, after stopping this for about 2 weeks, I already feel aches in my chest again which should be a good sign. 

Now onto the things I'm not sure about and could use feedback on.....

Does eating soy products hurt?  I'm a vegetarian and refuse to ever eat meat again, but this dietary restriction makes me rely on soy for protein. It's a huge part of my diet.  Sady, I've been reading that eating soy can block the absoprtion of estrogen.  Is this really true? Even for those of us on hrt? I usually eat soy but avoid drinking it as best as I can if that helps.  And if this does interfere with hrt, is there anything I can do short of giving up on soy?

What about these medications/substances?  Do any of these have a negative impact on estrogen levels?

Advil Pm?
Ibuprofen?
Cybmalta or other SNRI/SSRIS.
Caffeine?
Vit D, B and or other multi vitamin supplements?
Alcohol?
Valerian Root?
Kava?
Opiates like vicodin?
Xanax?

Just curious about this list as it contains the remainder of medications/substances that I have been on in any capacity, some short term (like once or twice) and others long term (like every night or day), since starting my hrt regimen.   If there is something you are aware of that isn't mentioned on this list that can cause what I'm afraid of, please make note of it.  Maybe there are things I'm overlooking which could be true for others as well I'm sure.   I'm being overly cautious here, but I want to be sure as something has got to give sooner or later with my situation.  Getting sick of the slow results and feel like somethings got to give.

Thanks for any help or assistance you may have to offer.  While I may have shot myself in the foot during the past few months, it's never too late to get back on a good track for an effective hrt regmimen.  So for anything that could be problematic or detrimental to my estrogen levels, please be sure to point it out to me. Thanks!

P.S.  I realize I could be overthinking things, but hey it's me, so shocker of the century, lol.

[calicarly]

Nicotine is estrogen's worst enemy for what I've read.

[Jennygirl]

I'm even thinking of ~ ~ giving up on the pills

Good idea LTL, this is all I feel that needs a response

Doing that trumps all other things

[Hikari]

What I was told is that many plant estrogens can bind to a human estogen receptor but that it might not be as strong of an effect or even have any effect at all. So this meant from my understanding that plant estrogens should be avoided as they would occupy receptors that would be better used for stronger estrogens.

I am no doctor or anything, but that explanation seemed legit so I pushed my diet more to things not soy. I do love soy stil and I haven't cut it out of my diet or anything. Then again I am on a very low dose of. E and I doubt I would be running out of receptors anyway.

It can be tough to get things tasty and with high protein avoiding soy for a vegetarian diet. I eat more meat than I used to because I really liked to use tofu in lots of things and I didn't mind some of the soy fake meat products either because they were low calorie alternatives that I enjoyed (I must be the only non vegitarian who eats that stuff).

What is even worse is mushrooms which account for quite a bit of my cooking apparently have anti aromatose properties. I assume that would not be an issue on CPA or spiro but I am pretty sure the only reason. I get away with such a low dose of E is that bicalutamide leaves my T to be aromatised (or however it is spelled) into estrogen so blocking that process for someone like me might really impact my E.

[Ms Grace]

Yeah, I don't know if it matters all that much. Surely some foods will act as blockers but other foods will counter that. I'm vegetarian, eat plenty of soy products and haven't had a problem with my estrodil levels. I have a sub dermal E implant though, don't know how you feel about getting one of those but most people swear by them! I do! (And they're better than injections from the point of view of consistent E release and not having to have frequent, regular injections... I've had this implant for 8 months now.)

[KayXo]

I think that if you switch to taking your E non-orally, you will be better off. I would also personally limit my soy intake as too much MAY interfere with estradiol binding at the receptor site. I'd rather not take a chance.

Just for your information and from what I gathered over the years, oral estrogen is metabolized (converted to less potent or inactive form) by CYP1A2 and CYP3A4 enzymes so that anything else that you take that either increases the production of these enzymes (inducer) like nicotine (or alcohol) or decreases them (inhibitor) like grapefruit or is even metabolized by those enzymes as well (substrates) like Xanax or caffeine might interact with estrogen. In the case of inducers, estrogen will be negatively impacted, concentrations of estradiol will be lesser. In the case of inhibitors (and possibly substrates), estradiol concentrations will increase and its half-life prolonged. But, the other stuff you are taking might also be impacted by estrogen so the effect is multi-directional. When taking so many things at the same time, it's always good to check with your pharmacist/doctor about interactions and check for yourself what they are by browsing reliable sites on the internet. 

[KayXo]

I get away with such a low dose of E is that bicalutamide leaves my T to be aromatised (or however it is spelled) into estrogen

Estrogen is only slightly increased on bicalutamide and its aromatization lessened by the addition of E since less T is produced. I think the reason why you get by on so little E is because bicalutamide so strongly inhibits androgen. Akin to those who are partly or completely insensitive to androgen. 

[Ltl89]

Nicotine is estrogen's worst enemy for what I've read.

I've never smoked a cigarette in my life, so I'm good on this front.

Good idea LTL, this is all I feel that needs a response

Doing that trumps all other things

I'm considering it, but I'm not sure.  My therapist wants me to do it as she claims it's more effective and all, but I don't know.  I think I'm going to reach out to a second endocrinologist and get another opinion on my levels.  I'm a bit concerned that my current one isn't  as knowledgeable on transcare as I'd hope.

What I was told is that many plant estrogens can bind to a human estogen receptor but that it might not be as strong of an effect or even have any effect at all. So this meant from my understanding that plant estrogens should be avoided as they would occupy receptors that would be better used for stronger estrogens.

I am no doctor or anything, but that explanation seemed legit so I pushed my diet more to things not soy. I do love soy stil and I haven't cut it out of my diet or anything. Then again I am on a very low dose of. E and I doubt I would be running out of receptors anyway.

It can be tough to get things tasty and with high protein avoiding soy for a vegetarian diet. I eat more meat than I used to because I really liked to use tofu in lots of things and I didn't mind some of the soy fake meat products either because they were low calorie alternatives that I enjoyed (I must be the only non vegitarian who eats that stuff).

What is even worse is mushrooms which account for quite a bit of my cooking apparently have anti aromatose properties. I assume that would not be an issue on CPA or spiro but I am pretty sure the only reason. I get away with such a low dose of E is that bicalutamide leaves my T to be aromatised (or however it is spelled) into estrogen so blocking that process for someone like me might really impact my E.

Yeah this is my big worry.  I eat a lot of soy, but I also am on a high E dose.  Maybe things are more likely to cancel each other out because of this.  Maybe this is why I haven't been getting the resuts I have wanted all along.  I've recently reached my year on E, so it's getting kind of like "when is something going to happen".

Yeah, I don't know if it matters all that much. Surely some foods will act as blockers but other foods will counter that. I'm vegetarian, eat plenty of soy products and haven't had a problem with my estrodil levels. I have a sub dermal E implant though, don't know how you feel about getting one of those but most people swear by them! I do! (And they're better than injections from the point of view of consistent E release and not having to have frequent, regular injections... I've had this implant for 8 months now.)

I'd do implants if I could, but it's not in my budget.  Right now, I can only afford to switch to injectinos and that's a huge deal for me.  First I'm going to consult with a second endo before making any definitive plans.

I think that if you switch to taking your E non-orally, you will be better off. I would also personally limit my soy intake as too much MAY interfere with estradiol binding at the receptor site. I'd rather not take a chance.

Just for your information and from what I gathered over the years, oral estrogen is metabolized (converted to less potent or inactive form) by CYP1A2 and CYP3A4 enzymes so that anything else that you take that either increases the production of these enzymes (inducer) like nicotine (or alcohol) or decreases them (inhibitor) like grapefruit or is even metabolized by those enzymes as well (substrates) like Xanax or caffeine might interact with estrogen. In the case of inducers, estrogen will be negatively impacted, concentrations of estradiol will be lesser. In the case of inhibitors (and possibly substrates), estradiol concentrations will increase and its half-life prolonged. But, the other stuff you are taking might also be impacted by estrogen so the effect is multi-directional. When taking so many things at the same time, it's always good to check with your pharmacist/doctor about interactions and check for yourself what they are by browsing reliable sites on the internet. 

I never would have guessed coffee and estrogen interact, but I drink a lot of it and am still waiting for substantial changes.  Maybe I'm getting too hard on myself like usual, but my last two tests were 120 and 70, so that's pretty low considering where a transwoman should be.   As for the soy, I really don't know what to do at this point.

[KayXo]

My therapist wants me to do it as she claims it's more effective and all

In my experience, it has been. And I don't think it's just because the levels are much higher but because when you take estrogen non-orally, you get more estradiol relative to estrone and perhaps (pure speculation) get much less undesirable effects from the conversion of estradiol to other metabolites and overproduction of liver proteins/enzymes, etc.

Yeah this is my big worry.  I eat a lot of soy, but I also am on a high E dose.  Maybe things are more likely to cancel each other out because of this.  Maybe this is why I haven't been getting the resuts I have wanted all along.  I've recently reached my year on E, so it's getting kind of like "when is something going to happen".

If you are worried about phytoestrogens (from soy) interfering with estradiol binding to receptors, you should also be worried about too much estrone from oral intake interfering with estradiol binding to receptors. Estrone is weaker than estradiol and exceeds it by quite a lot when taken orally. This is not so when taken non-orally.

I never would have guessed coffee and estrogen interact, but I drink a lot of it and am still waiting for substantial changes.  Maybe I'm getting too hard on myself like usual, but my last two tests were 120 and 70, so that's pretty low considering where a transwoman should be. As for the soy, I really don't know what to do at this point.

I found coffee and chocolate made me quite hyper while on oral estrogen but have not resumed taking either since switching to injectables (but I also continue to take progesterone orally which is metabolized by those enzymes).

Those levels that you mention are quite low. At around 200, I still had nothing! Some need more than 500. Right now, my levels are around 4,000, 3 days after my last injection BUT everyone reacts differently so instead of focusing too much on levels, find the dose and route (with doctor) that serves you best, both emotionally and physically. I would cut down on soy, just in case but that's just me. Do what feels most right to you, as always.

[Ltl89]

In my experience, it has been. And I don't think it's just because the levels are much higher but because when you take estrogen non-orally, you get more estradiol relative to estrone and perhaps (pure speculation) get much less undesirable effects from the conversion of estradiol to other metabolites and overproduction of liver proteins/enzymes, etc.

If you are worried about phytoestrogens (from soy) interfering with estradiol binding to receptors, you should also be worried about too much estrone from oral intake interfering with estradiol binding to receptors. Estrone is weaker than estradiol and exceeds it by quite a lot when taken orally. This is not so when taken non-orally.

I found coffee and chocolate made me quite hyper while on oral estrogen but have not resumed taking either since switching to injectables (but I also continue to take progesterone orally which is metabolized by those enzymes).

Those levels that you mention are quite low. At around 200, I still had nothing! Some need more than 500. Right now, my levels are around 4,000, 3 days after my last injection BUT everyone reacts differently so instead of focusing too much on levels, find the dose and route (with doctor) that serves you best, both emotionally and physically. I would cut down on soy, just in case but that's just me. Do what feels most right to you, as always.

Yeah, I'm going back to my endo soon to double check things.  I'm hoping that by discontinuing the melatonin and making sure that I take my pills the morning before my blood work will raise my E levels a bit.  If not, I may have to make some serious changes.  I'm not sure how to cut the soy as it's central to my vegetarian diet, but I'll think about it.  Right now, I'm considering going to the injectinos and hoping that will do enough, if that's even needed.  We'll see.  Got to make another appointment and get a second opinion from a different Endo's office.  I'm 25, so it's really not fair for me to be waiting and waiting for results that don't seem to be coming. 

As for coffee, I would die without it.  I need that to stay alert at work and in life in general.  It's like my life source or someting.

[KayXo]

As for coffee, I would die without it.  I need that to stay alert at work and in life in general.  It's like my life source or someting.

LOL yeah...I used to be the same...and i looooooove the taste...of bitter/dark chocolate too. But, feel calmer without 'em. Both were like drugs to me. I still miss them though. Just yesterday, I was craving chocolate ice cream with chocolate chip bits. Oh well...