So....my Dr was extremely stern about not smoking on hrt, but she said nothing about alcohol.  I actually didn't even think about it to ask her at the appointment.  Is alcohol actually very bad while on hrt?  Over the past week I have had a bottle of wine.  Would drinking one bottle between now and over the weekend be too much?  I don't drink to the point of being drunk very often, but darn it, wine is one of the perks of adulthood that I quite enjoy.  Also, she said my kidney and liver function was normal on my bloodwork.

Oh no, I am going to ruin your day. A small a amount of alcohol would be safe but alcohol is known to damage the liver. Estrogen, especially pills are hard on the liver. Should you have issues with your liver, you will be asked to quit both HRT and alcohol. Your doctor should be able to tell you how much you can consume.

Well poo.  I guess it's herbal tea this weekend hahaha

Alcohol in moderation is fine.

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It probably wouldn't kill me to not drink until my follow up in november.....it also might help some of this stubborn belly fat if I wasn't drinking liquid carbs from a fancy glass at night ha!

I also think (I am not a doctor) alcohol in moderation is fine if your liver is healthy to begin with but it may affect how your pills are metabolized resulting in lower or higher levels of the said substance.

Bio-identical estrogen taken orally (and non-orally) has not been shown to be harmful to the liver. This was an issue with high doses of oral non bio-identical estrogen. Things have changed in the last 10 years or so.

World J Gastroenterol. 2007 Aug 28;13(32):4295-305.

"These lines of evidence suggest that the greater progression of hepatic fibrosis and HCC in men and postmenopausal women may be due, at least in part, to lower production of estradiol and a reduced response to the action of estradiol."

Exp Clin Endocrinol Diabetes. 2005 Dec;113(10):586-92.

"Sixty male-to-female transsexuals were treated with monthly injections of gonadotropin-releasing hormone agonist (GnRHa) and oral oestradiol-17beta valerate for 2 years to achieve feminisation until SRS."

"Liver enzymes, lipids, and prolactin levels were unchanged."

Maturitas. 1980 Jul;2(2):95-100.

"The material consisted of 32 patients, 12 of whom were selected for control. All were cases approaching the menopause and had been subject to oophorectomia bilateralis and hysterectomia for myomas. All 20 investigation patients received estradiol valerianate orally(...) of 6 mth. During the course the serum estradiol level increased 5--6-fold from the postmenopausal levels."

"In the liver enzymes no changes occurred."

Estrace is bioidentical, correct?  It's premarin that isnt, right?

I am bad with little things like that. I smoke socially so probably 1 to 5 cigarettes slash cigars a month. I also smoke weed about once a month. I drink moderately between once and twice a month. There are other substance i have introduce in my body since too. But meh i feel fine and all my blood work coming back normal.

  I also do injection less stress for liver and less likely form blood clots. Smoking concern because increase risk for blood clots and damping effect on hrt. drinking concern for liver damage especially if your taking a cocktail of hrt pills. Weed is actually unknown and i seen study suggesting it can increase and or decrease the effect of hrt.

I recommend playing it safe and do what your doctor says. I am just saying off of my personal experience and what i read on the subject matter. Also i am legally prescribe weed so it not illicit use and legal for me to actively enjoy.