It really worries me I am cheating myself on self by shallowing estrogen by water not under the tongue. Any words of wisdom? Do we have two oral estrogens or what?

Love,
Michelle

Ask your doctor but at 2 1/2 weeks on hormone swallowed, I am feeling the effects.

I honestly saw no difference in breast growth, psychological effects or anything else, swallowing vs. taking it sublingually. Swallowing was also less hassle. Don't worry about it.

I spoke to my Dr last week and read some online papers and came to these rough conclusions.

Under the tongue absorbs faster and creates a higher peak for a shorter period so you should then spread out over multiple times a day.

Swallow with water slow releases over more than 36 hours and combines with previous dose to set a more even level with less up and down.

Doc should then blood test and depending on level adjust dose up or down to put you in the therapeutic range.

So do whatever feels right and is most convenient but probably don't "under the tongue" straight before a blood test as it will measure your short term peak not your average.

Happy to be corrected if someone knows more.

This is just my experience with no science to back it up but I tried taking mine sublingually for awhile then just went back to swallowing it after I felt like there wasn't a marked difference other than it took longer to take and was kind of a pain.

Once I did that I swear I noticed a definite uptick in development so, for me at least, just swallowing it works best.

Ultimately though, probably should just follow your doctors' advice on the matter. 

There are uncoated pills which can be dissolved under the tongue.
Its for example bioidentical micronized estrogen like estrace or estradiol valerate.

If the liver encounters estrogen in the digestive tract it seems to presume a leak and raises clotting factors.
Taking estrogen sublingually bypasses the liver with intake. It enters into the bloodstream via the mouth.
So its less straining on the liver and also supposed to be less causing clotting factors.
Its also more effective since the liver builds down part of it.
Some of it is swallowed nonetheless so some people take daily a very small dose of aspirin to thin the blood.

With sublingual intake levels rise fast, and drop after a few hours...
here is a graph showing that this indeed has an influence on levels:
https://www.susans.org/forums/index.php/topic,186946.msg1665088.html#msg1665088

So spreading the daily dose in a few small doses might be a good idea.
Otherwise there might be a menopausal like effect a few times a day which might affect mood.
The same is true for swallowing pills if times of intake are far away from each other, like once a day.
There are small dose pills for example, or there are pills which can be seperated in half.

Talk all of this through with your doc.


*hugs*

Thank you for the great responses👍🏻😘😘😘😘

Quote from: lilijames on March 16, 2016, 11:24:53 PM
Doc should then blood test and depending on level adjust dose up or down to put you in the therapeutic range.

No such thing as therapeutic range. Arbitrarily set by doctors. Range in women varies from as little as 20 pg/ml to 650 pg/ml during menstrual cycle and up to 75,000 pg/ml during pregnancy. Any level you end up with will be within that range.

Quote from: Laura_7 on March 17, 2016, 05:49:31 AM
If the liver encounters estrogen in the digestive tract it seems to presume a leak and raises clotting factors.

Portal vein, from digestive tract to liver, contains estrogen receptors. When estrogen triggers these, certain clotting factors are increased while other proteins/factors are reduced with the net effect of increased coagulation. The more times estrogen passes through the portal vein, the stronger the effect. But, estradiol also affects other things like fibrinolysis, fibrinogen and plasminogen-activator inhibitor which can reduce likelihood of clotting.

QuoteTaking estrogen sublingually bypasses the liver with intake. It enters into the bloodstream via the mouth.

Via veins under tongue because particles are micronized (very small) so can easily pass into veins. Under tongue is also very permeable and vascularized.

QuoteSo its less straining on the liver

Strain appears to be minimal. Alcohol is more strain.

QuoteIts also more effective since the liver builds down part of it.

Liver breaks downs estradiol into other substances which are less potent or inactive due to enzymes like CYP3A4.

Quotesome people take daily a very small dose of aspirin to thin the blood.

The risk of clots with bio-identical estradiol, even if taken orally, appears to be small given several findings from studies. Whether it is worthwhile to add aspirin is subject to debate as it could prove more harmful than beneficial (i.e. intestinal irritation, ulcers).

My Dr wrote the scrip to dissolve under the tongue, so that's what I do. 

I actually kind of enjoy dissolving them every day too... Feeling them melt into my system.


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