I've been taking estrofem sublingually for the past month after my endo instructed me to do so. Before I was taking it orally and low dose. My endo wanted to increase me dose and also decided for me to take it sublingually.
anyway, I can't get in touch with my endo since he's out of the country right now.
So I'm asking you guys for "tips" on how to take it most efficiently for maximuim absorption?
1)Should I swallow while taking it, even though I'm only swallowing the saliva and not the medication?
2) any other tips and suggestion to get the most out of it?
ps. simple question...
I know people have said under the tung is better...but personally from what I've read theres no evidence to prove that this way is better. I tried it and with the estrace I was taking, the pill just turned into mush under your tung. And every time you swallowed you swallowed pieces of the pill. You couldn't taste it though but you could feel a slight grittiness. It took a long time to completely disappear, so long that it was just ridiculous to keep doing it cuz you couldn't talk or swallow until it was completely gone. It would make more sense to stick it up your bum..."no I'm not joking" The wall of the intestine will absorb up to 95% of a pill directly into the blood stream if you do it that way. And no I haven't tried it but it is true at least with other drugs. Just remember that you have to take HRT for the rest of your life, It shouldn't be a burden to do it. Personally I feel like theres no, or such a small advantage to taking estrogen sublingualy that it's just not worth it. :)
Quote from: Jessica G on February 11, 2008, 08:52:15 PM
I know people have said under the tung is better...but personally from what I've read theres no evidence to prove that this way is better. I tried it and with the estrace I was taking, the pill just turned into mush under your tung. And every time you swallowed you swallowed pieces of the pill. You couldn't taste it though but you could feel a slight grittiness. It took a long time to completely disappear, so long that it was just ridiculous to keep doing it cuz you couldn't talk or swallow until it was completely gone. It would make more sense to stick it up your bum..."no I'm not joking" The wall of the intestine will absorb up to 95% of a pill directly into the blood stream if you do it that way. And no I haven't tried it but it is true at least with other drugs. Just remember that you have to take HRT for the rest of your life, It shouldn't be a burden to do it. Personally I feel like theres no, or such a small advantage to taking estrogen sublingualy that it's just not worth it. :)
Jessica,
you really do have a point. It shouldn't be a pain to take HRT regurlary since it I will have to take it for life.
About swallowing it, I agree that you have a great point. But from what I've heard from Keira is that estrofem made it especially for sublingually. I do agree that their isn't enough proof and you may not get much benefit. But theoritically you will have higher bio avialablity.
I do swallow while I'm taking it sublingually BUT I don't feel the taste nor any grittiness that the medication is being swallowing.
Also wouldn't the med not be swallowed since it's under the tongue?
Anyway- tmrw the first thing I'll do is avoid swallowing while taking the med which I agree is a pain. It takes an approximate 45 minutes to fully dissolve.
If it doesn't workout- I will seriously consider the anal method(yuck) ::)
The reason why I want this is because I want a higher blood circulation of E.. I'm just picky.. but I do agree that oral can probably provide the same results for some people. Others may find sublingual to be the same.
Thanks sweetheart! :icon_flower:
I take estrogen under the tongue.
IT is noticably less hard on my liver.
I do notice a difference.
My liver hurts when I just swallow it.
It doesn't this way.
Sara
Quote from: Tanya1 on February 11, 2008, 09:05:41 PM
It takes an approximate 45 minutes to fully dissolve.
I take Estrofem under the tongue and for me the pill completely dissolves in 10-15 minutes.
I make sure the underside of my tongue has a little saliva under it as it is a great medium for
absorption.
Estrace properly disolves under the tounge in just a few minutes... keep your tounge flat against the bottom of your mouth after placeing the pill there... it dosnt take long if its the properly manufactured type, and you will have verry little if any cary over into your saliva that you can swallow... its like it just absorbs right into the skin... <if your using a cheaper generic I have no clue how long it takes to disolve and I dont know if the sublingual technique would actualy work with them>
I don't think that absorbing the estradiol pill anally would have any benefit as far as bypassing the liver. The veins from the large and small intestines head straight for the liver. Just look at a diagram of the human circulatory system. The benefit of sublingual, even if only a small percentage actually is absorbed that way, is a better approach as the estrogen would travel throughout the body before hitting the liver.
Audrey
I take the generic equivalent of Estrace/Estrofem (labelled "Estradiol"), and I just put mine under my tongue and hold it there. Within two minutes, it's gone, and all that's left is the taste in my mouth. One drink of water, and that's history. It doesn't taste bad, either.
I've wanted to do the "grapefruit juice" thing, too (to slow down the absorption), but I take Lipitor, too, and grapefruit juice is a definite no-no with that drug.
Carol
^ Don't drink water. Let the taste dissolve...
thanks a lot!
I'm using the real estrofem- so it's not some "cheap" generic- Although generics can work just as effective depending on the drug though...
I don't feel the taste at all while I'm dissolving so I guess I doing it right... ;D
Quote from: Sarah on February 13, 2008, 10:04:41 PM
I take estrogen under the tongue.
IT is noticably less hard on my liver.
I do notice a difference.
My liver hurts when I just swallow it.
It doesn't this way.
Sara
... Thats Scary.
Quote from: Sarah on February 13, 2008, 10:04:41 PM
I take estrogen under the tongue.
IT is noticably less hard on my liver.
I do notice a difference.
My liver hurts when I just swallow it.
It doesn't this way.
Sara
Wow. Thanks for sharing that - I will definitely be looking into patces or gels as an alternative to pills, I think.
I take estrace, it dissolves very quickly for me, like, in a minute, sometimes a tiny bit more. Two at most. *shurgs*
Quote from: gothique11 on February 15, 2008, 01:42:26 AM
I take estrace, it dissolves very quickly for me, like, in a minute, sometimes a tiny bit more. Two at most. *shurgs*
I think it depends on your ph level too.
anyway....is their a special type of estrofem? or is ALL estrofem meds designed for sublingual use?
Actually Lady amarant the patches are superior to the pills as you get a steadier dose of E that bybasses the liver. I started on the patches and it was awesome, but my skin is really sensitive and I developed a sensitivity to the adhesive that caused me to itch like you wouldn't believe. The patches wouldn't even be on for 24 hours and my skin would start to react. :( Thereafter I was switched to sublingual estrofem.
Audrey
!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
When you swallow a pill of estrogen, only about 1/30th of it is actually absorbed into the blood stream.
Your doctor knows this and is accounting for it...
Have you ever seen a patch? The amount of actual Estrogen is labeled at like .1mg...
so heres the deal all the estrogen in the patch is dissolved into the blood stream
If you take the pill by dissolving it under your tounge, you are going to be taking in TOO MUCH estrogen, you should not put it under your tounge, because the pill was designed to dissolve in the stomach, and be absorbed by the intestine wall, but only .1mg of it.
Taking it under your tounge will effectively be like tripling your dose that you were prescribed... Which is dangerous...
If you would like to challenge me on this, I would be happy to PM you the phone number of the most prominent Endo in the state of Colorado, she will also be speaking at the Gold Rush, and she was considering speaking of this subject at the Gold Rush...
Posted on: February 15, 2008, 01:53:40 PM
I would like to add, that there is Estrogen Designed for sublingual consumption,
But if you are prescribed like Estrodiol, and it doesnt say sublingual on it, IT ISNT....
Quote from: Audrey on February 15, 2008, 01:16:26 PM
Actually Lady amarant the patches are superior to the pills as you get a steadier dose of E that bybasses the liver. I started on the patches and it was awesome, but my skin is really sensitive and I developed a sensitivity to the adhesive that caused me to itch like you wouldn't believe. The patches wouldn't even be on for 24 hours and my skin would start to react. :( Thereafter I was switched to sublingual estrofem.
Audrey
Thanks Audrey. Here's hoping I don't run into the same problems if I do patch!
Though I've actually been looking at the Gels like Sandrena and Estrogel and such. Anybody used them to good effect?
Quote from: lady amarant on February 15, 2008, 12:11:30 AM
Quote from: Sarah on February 13, 2008, 10:04:41 PM
I take estrogen under the tongue.
IT is noticably less hard on my liver.
I do notice a difference.
My liver hurts when I just swallow it.
It doesn't this way.
Sara
Wow. Thanks for sharing that - I will definitely be looking into patces or gels as an alternative to pills, I think.
Dont take it to heart, something is wrong if your liver is hurting.
Pills do not do this, in the right amount....
SARAH I RECCOMEND GOING AND SEEING YOUR DOCTOR THAT
PRESCRIBED THEM IMMEDIATLY, or dropping the dose...
Quote from: Tanya1 on February 15, 2008, 05:26:22 AM
Quote from: gothique11 on February 15, 2008, 01:42:26 AM
I take estrace, it dissolves very quickly for me, like, in a minute, sometimes a tiny bit more. Two at most. *shurgs*
I think it depends on your ph level too.
anyway....is their a special type of estrofem? or is ALL estrofem meds designed for sublingual use?
I was curious about this too. It says "Oral" and I'm wondering which freakin' oral they are talking about. Maybe there are different variations.
Quote from: deviousxen on February 16, 2008, 08:55:23 PM
Quote from: Tanya1 on February 15, 2008, 05:26:22 AM
Quote from: gothique11 on February 15, 2008, 01:42:26 AM
I take estrace, it dissolves very quickly for me, like, in a minute, sometimes a tiny bit more. Two at most. *shurgs*
I think it depends on your ph level too.
anyway....is their a special type of estrofem? or is ALL estrofem meds designed for sublingual use?
I was curious about this too. It says "Oral" and I'm wondering which freakin' oral they are talking about. Maybe there are different variations.
lol- I think it's the same but I making sure so I don't hinder my results...
Quote from: lady amarant on February 15, 2008, 12:11:30 AM
Quote from: Sarah on February 13, 2008, 10:04:41 PM
I take estrogen under the tongue.
IT is noticably less hard on my liver.
I do notice a difference.
My liver hurts when I just swallow it.
It doesn't this way.
Sara
Wow. Thanks for sharing that - I will definitely be looking into patces or gels as an alternative to pills, I think.
Under the tounge isn't bad.
It works fine for me.
It's much more cost effective anyway.
Just a thought..
Sara
Mara:
No, I have a sensative liver.
I always have.
Has to do with some old issues.
So avoiding liver roughness is a priority to me.
I like being kind to my liver.
It's been good to me :angel:
So don't worry about it.
I mentioned it because I can detect it.
So it does have an impact.
Somthing people might want to consider when choosing meds.
Sara
Been so good to you?
Hahahaha. I'm imagining a party monster in our midst.
Quote from: Tanya1 on February 10, 2008, 04:11:10 PM
I've been taking estrofem sublingually for the past month after my endo instructed me to do so. Before I was taking it orally and low dose. My endo wanted to increase me dose and also decided for me to take it sublingually.
anyway, I can't get in touch with my endo since he's out of the country right now.
So I'm asking you guys for "tips" on how to take it most efficiently for maximuim absorption?
1)Should I swallow while taking it, even though I'm only swallowing the saliva and not the medication?
2) any other tips and suggestion to get the most out of it?
ps. simple question...
Try placing the pill between your lower gum and the lower lip, off to the side. It lasts much longer than under the tongue like that. Some say since estradiol decays very quickly, too quickly for the body to absorb optimally from a pill, that prolongs the exposure time.
Quote from: soldierjane on February 20, 2008, 11:40:13 AM
Quote from: Tanya1 on February 10, 2008, 04:11:10 PM
I've been taking estrofem sublingually for the past month after my endo instructed me to do so. Before I was taking it orally and low dose. My endo wanted to increase me dose and also decided for me to take it sublingually.
anyway, I can't get in touch with my endo since he's out of the country right now.
So I'm asking you guys for "tips" on how to take it most efficiently for maximuim absorption?
1)Should I swallow while taking it, even though I'm only swallowing the saliva and not the medication?
2) any other tips and suggestion to get the most out of it?
ps. simple question...
Try placing the pill between your lower gum and the lower lip, off to the side. It lasts much longer than under the tongue like that. Some say since estradiol decays very quickly, too quickly for the body to absorb optimally from a pill, that prolongs the exposure time.
I'll try that today..thanks...
Quote from: lady amarant on February 15, 2008, 01:58:25 PM
Quote from: Audrey on February 15, 2008, 01:16:26 PM
Actually Lady amarant the patches are superior to the pills as you get a steadier dose of E that bybasses the liver. I started on the patches and it was awesome, but my skin is really sensitive and I developed a sensitivity to the adhesive that caused me to itch like you wouldn't believe. The patches wouldn't even be on for 24 hours and my skin would start to react. :( Thereafter I was switched to sublingual estrofem.
Audrey
Thanks Audrey. Here's hoping I don't run into the same problems if I do patch!
Though I've actually been looking at the Gels like Sandrena and Estrogel and such. Anybody used them to good effect?
I remember reading that the problem with the gels are that the dosage requires the gel to be spread out over large areas of the body, like both legs. Work with your doctor. You may be better off with injections.
Quote from: Sarah on February 13, 2008, 10:04:41 PM
I take estrogen under the tongue.
IT is noticably less hard on my liver.
I do notice a difference.
My liver hurts when I just swallow it.
It doesn't this way.
Sara
Sorry .... but livers just do not hurt (no nerves in there - you can be in terminal chirrosis without pain warning !) so the pain is either imagined or from elswhere.
Regular blood tests will tell you about your liver's health.
Quick absorption of an estradiol tablet "under tounge" means that you are digesting most of it in your saliva which is the same as swallowing (guess at best skin absorption will be 33% and that's when you wake up in the morning and still have tablet residues in your mouth).
Estradiol tabs are prescribed in "swallow doseage" and I think this "under the tounge" thing is a TS myth .....
Laura
Thats what I have been hinting at since the start, a TS myth. lOl
Why would you go against the directions printed on the bottle???
So the scientists who created it, didnt sit there and say, hmmm maybe this particular drug is going to be engineered to be dissolved under the tounge. they said lets engineer it for stomach absorbation in the intestine.
So just follow directions and cut the BS.
Good grief, sublingual works, shhh.
Sublingual is the same mode of absorbtion as supposatories,
you'll tell me that doesn't work either!
Estrogen that is absorbed through the stomach gets
matabolised differently than the one that's absorbed directly
into the bloodstream. This processing creates more by products,
including those linked to DVT. But, unless taking non bio identical
estrogens and dosages, this risk is rather low. The liver itself
is usually not the issue unless it is already severely impaired.
The reason they don't promote one mode over another often
has more to do with FDA approval than anything else.
Another mode of absorbtion will need a whole new protocol
and tests. Since estrogen is basically a cheap generic, there's not much money
in getting it certified for something else than what already works.
Anyone who's taken estrogen sublingually properly will immediatly feel
an immediate strong effect that you feel as it is a stimulant and
a vaso dilatator.
If you swallow the pill, you don't get that since it will be absorbed slower.
The reason pills are pushed over sublingual is first because that's how
they were tested and FDA approval for another means is expensive;
secondly, the reason they were tested that way was because
there is much better compliance for pill taking than taking
a pill and waiting 10 minutes that it will dissolve. Compliance
is a big deal, since you don't get all the benefit of the medication
if you don't take it.
The reason sublingual works is because micronised estrogen in a binder was a convenient
way of packaging estrogen and micronised particles can be absorbed by highly vascular tissues
like under the tongue and the anus.
Micronised progesterone is the same, except its not very robust so they've got to suspend it in oil to give some a chance to be absorbed before being broken down by the stomach acids (that's why
the content of the capsules are rather high).
(since its in oil, sublingual doesn't quite work since you'll have trouble not swallowing it). But, the capsules do work as suppositories, which is not always advertised on the capsules. Again, FDA would require testing for this new method, why bother for something so cheap with such a low margin of profit.
^ I second Kiera. They have done tests on sublingual estrogen. They did a few tests on the difference of abosption of micronised estrogen and it works because micronised estrogen absorbs very easily. You can google it if you want.
The reason for not printing it on the bottle is because of FDA approval and also they may get hit with a lawsuit since sublingual administration gives another dose.
Question - Would crushing the tablet and putting that resulting powder under ones tongue or between the gums and lower lip make for better / faster absorbtion.
Also does anyone know if there are sublingual liquid versions of Estradiol?
Quote from: Azusa John on September 12, 2013, 01:58:01 PM
Also does anyone know if there are sublingual liquid versions of Estradiol?
No and no to either (oral liquid estradiol or sublingual liquid anything other than glucose gel) unless it's compounded and even then no more benefits than taking an oral tablet sublingualy or with food.