HRT and the liver

[El]

Ok so im really hoping its not the case but its a well know side affect of HRT to cause liver problems, i have a liver disease called auto immune hepititus which means my immune system attacks my liver as if it were a foreign body, ive had the condition for about 6 or 7 years now and my liver function tests are all within the normal range now but im still on azerthrioprine (sp?) as a substitutes for the prednisolone i was on and im on a few other meds (mostly vitamin supplements etc). What i am wondering is does anyone here have any medical knowledge or experience that could tell me how likely being tunred down for HRT on the grounds it could cause me more damage is?

Sorry for the rambling post XD

[rejennyrated]

Sorry I can't answer the question but I think you do have a valid cause for concern.

To be on the safe side you probably should ask to talk to an endocrinologist before starting anything and ask them the question.

[Renate]

Most anything that you could conceivably metabolize could be hard on the liver.
Cyproterone acetate is mentioned for hepatotoxicity.
Estrogen and testosterone also cause loading on your liver.
Injected drugs usually cause less problems than oral drugs.

Most doctors will want to keep an eye on your liver panel blood tests to see if your liver is accepting a new regimen.
This is true even in the case of minor adjustments.

Your therapist is the one who generally recommends you for HRT, a medical doctor figures out how.
It sounds that with your existing problems you would be better off with an endocrinologist rather than a GP.

[El]

Well im not even in therapy yet so its a little while before i see an endo, i am trying to get healthier to improve my chances, i quit smoking and drugs as my new years resolution (which is going well) so that may help my blood test results. Maybe an orchi would be another option i dont know lol, ive been told that the facilitator of the local support group might be able to help me approach my doctor in a manner that could streamline the process somewhat and a few days after im seeing my liver doctor so i could talk to him aswell. I am worried though, things are going so well right now i think being denied HRT would be one of the worst thing thats ever happened to me.

[myles]

Just make sure they do a liver level or enzyme test before the HRT and retest it often. I am on T and my liver has not handled it well . Because of this I have lowered my Testosterone intake. Definitely not something to take lightly but easily monitored with blood test.
Good luck with whatever you choose!
Myles

[sylvie]

Hi El,

From a personal standpoint.  When I had my first run of bloodwork done my doctor was concerned for my liver.  Some of the results came back a little high.  She made me go see an endocrinologist for more blood work as well as an ultrasound.  Come to find out that I have a fatty liver.  Not so much of a problem as you are concerned with, but it is still a concern nonetheless.  She did let me start hormones, but I have my liver checked out every 3 months now to make sure that it is still doing okay.   It's been a little over 9 months now and so far no problems.  Hopefully it'll stay that way.

It'll depend on your doctor as to how to proceed.  Mine is very overcautious, and for that I'm grateful, even if it'll mean that she tells me something that I don't want to hear, or the dosages that she prescribes.  Her first concern is my health, and the second is to help me transition safely.

I wish you luck with your journey.  Every step is another step forward.  I don't recommend streamlining myself as I wouldn't want to harm myself just to push through for changes.  Everything will come with time, and we all have our own path along this journey to become who we are.  Some of us just have to take a pathway that's a little bit more winding.   

[Chrissty]

Well im not even in therapy yet so its a little while before i see an endo, i am trying to get healthier to improve my chances, i quit smoking and drugs as my new years resolution (which is going well) so that may help my blood test results. Maybe an orchi would be another option i dont know lol, ive been told that the facilitator of the local support group might be able to help me approach my doctor in a manner that could streamline the process somewhat and a few days after im seeing my liver doctor so i could talk to him aswell. I am worried though, things are going so well right now i think being denied HRT would be one of the worst thing thats ever happened to me.

Hi El,

Renates advice is excellent as usual, but she probably doesn't realise that you are in the UK, and things are a little different here.

Quitting smoking and drugs is a good idea, and anything you can do to improve your health will help your case. Everyone involved in your medical assessment should be aware of your history via the NHS system, so there is no hiding.

An orchi requires the same level of paperwork and assessment as final GCS surgery in the UK, so getting one on the NHS is rather unlikely.

Don't be surprised if "things" take a little while to sort out, a lot depends on your GP to start with. An advisor can help you with advice about what to do, but some GP's can react badly to being told what to do by a 3rd party in particular. It's much better if it sounds like you have done your homework (get copies of the NHS guidance documents, etc.) and have carefully considered your own feelings without interference. 3 to 6 months from initial consultation is normal.

Hopefully from what Jay says, your local PCT will take a favourable view on your case in Norfolk, but funding and politics can change things from one year to the next.

BUT....and it's a big one...don't take an initial rejection as the "worst thing ever" and leave it at that, it's not uncommon and there are ways to appeal, but things may take a little longer....just don't self medicate with your condition, it's way too dangerous and the damage could be done before you realise it.

The best idea you have is to talk to your liver doctor about what you are proposing. He will be fully aware of the effects of HRT and may even be able to give you a letter which will prevent your condition being used as an excuse downline.

Good Luck



Chrissty

[melanie2009]

I cannot stress enough how important it is to get a complete medical before you start hormones, and cut right back on (or quit) smoking and intake of alchohol. Get your doctor on board no matter what you do. They have a sworn duty to assist you with all your health matters, and are there for you.

Melanie

[El]

lol well i havent smoked or done drugs in 4 days, and i havent drank in 3 years. and ofc ill see a doctor first lol