ok techically it hasn't happened yet but I'm fearing it because I've read about it. someone was saying estrogen causes cholesterol to raise and if you already have high then well some doctors maybe even most doctors won't like that and won't be willing to risk that. so just trying to figure out if this is a thing. yeah i know its best to be healthy. I've had high cholesterol for over a year now I've been on medications, diet, exercise..hasnt made too much of a difference. any help with this is greatly appreciated thank you.

HRT did not raise my cholesterol.  I've never heard that before.  My HRT doctor does check it though once a year.


Conform and be dull. —James Frank Dobie, The Voice of the Coyote

I have never heard of anyone being denied HRT for high cholesterol. I have heard of some being denied HRT if they have a history of any type of vascular blood clots.

When I was first went on HRT, I had high cholesterol. The doctor was concerned about it, but didn't stop me from beginning treatment. Instead she had me follow up with my PCP and subsequently I ended up on statin to lower it. I don't think it will bar you from receiving treatment.

First, the idea that high cholesterol is unhealthy and a risk factor for cardiovascular disease is pretty much outdated if you look at the research these days. Associations were found but as any good doctor should know, associations don't prove causality. Also, findings were mixed and sometimes, NO association was found at all or the opposite. In recent years, the more important markers have been found to be HDL (oral estrogen increases it) and especially triglycerides...and blood pressure (bio-identical estrogen has been found to reduce it, as well as spironolactone). And glucose levels as well as HbA1c (non-oral estradiol improves insulin sensitivity). These matter much more. Do your research, and check out the site The International network of cholesterol skeptics. If anything, female HRT reduces your odds of getting any cardiovascular complications as estradiol promotes vasodilation of arteries and has a positive effect on your lipid profile RATIO (cholesterol:HDL, LDL:HDL).

Non-oral estradiol rarely, if ever, at doses prescribed for transwomen, raises cholesterol levels anyways or triglyceride levels because very little circulates through the liver. So, on non-oral, it shouldn't even be an issue. Estradiol also tends to lower LDL but as research has found in recent years, the LDL thing is more complex than we first thought and there are large particles of LDL and smaller ones. The latter have been found to be more atherogenic.

I'm on estrogen since 2004 and at times, my cholesterol levels have indeed gone up (more to do with eating habits than hormones) but so has my HDL so that my ratio remained perfect/ideal. Triglycerides have remained normal and the less carbs I ate, the lower they were. The reason my HDL is high is because I eat so much saturated fat.

Personally, I would never take statins as they are associated with several side-effects (muscle wasting/pain, memory troubles, mood problems, etc.) and I think that one can cut down their risks by simply eating healthier, exercising and taking the right sex hormones (bio-identical).  Statins, in my non-professional opinion, have been overhyped so much so that the pharmaceutical companies are reaping the benefits and some people are suffering as a result.

In any case, I encourage everyone to be proactive in their lives and do their own research. You make your own conclusions and then you can discuss with your doctors, seek a second and third opinion. Etc.

Best of luck and I highly doubt you'll be refused. If you are, find another doctor who is competent in the matter.

Quote from: KayXo on April 17, 2017, 10:00:23 AM
Personally, I would never take statins as they are associated with several side-effects (muscle wasting/pain, memory troubles, mood problems, etc.) and I think that one can cut down their risks by simply eating healthier, exercising and taking the right sex hormones (bio-identical).  Statins, in my non-professional opinion, have been overhyped so much so that the pharmaceutical companies are reaping the benefits and some people are suffering as a result.

I agree with you, Kay. About 10 years ago, my PCP said my cholesterol was high and wrote a prescription for one of the statins (I don't remember which one). He gave it to me with the caveat that I should do some research. I did and decided against starting with it. On my next appointment, I told him of my decision and he said, "I don't blame you." That's the last time we discussed it.

fwiw, I still have high cholesterol but that didn't cause any concern starting HT.

All the best,
--AshleyP

High cholesterol here, too. No problem getting HRT.

Hugs, Devlyn

I have had issues with triglyceride levels for years. did go on medication a few month prior to starting HRT. Told the doctor about it, and she did not see any problem with it. The good thing is: The HRT routine actually forces me to also take the meds for my triglycerides...

I just looked back at the guide to HRT that my endocrinologist gave me and high cholesterol was not one of the factors or risks. 

However, as part of the information I was given to prepare for future GCS I was told that many surgeons prefer to do the surgery on patients who are "healthy".  Most of them seem to use BMI as the prime indicator, saying that a BMI below 25 is necessary to be eligible for surgery with them.  Perhaps some doctors use different indicators to determine "healthy", but so far I haven't seen cholesterol as one of them.

Hope this helps.

Just came across a study where oral estrogen was found to actually REDUCE significantly:
- cholesterol levels
- LDL levels

And increase significantly:

- HDL
- HDL/LDL ratio

So, if anything, lipids improve. Triglycerides increased non significantly and VLDL decreased non significantly.

As regards to transdermal estrogen, trend was the same for cholesterol and LDL (albeit to a lesser degree) but other factors remained more or the less the same.

Quote from: KayXo on April 17, 2017, 10:00:23 AM


Personally, I would never take statins as they are associated with several side-effects (muscle wasting/pain, memory troubles, mood problems, etc.) and I think that one can cut down their risks by simply eating healthier, exercising and taking the right sex hormones (bio-identical).  Statins, in my non-professional opinion, have been overhyped so much so that the pharmaceutical companies are reaping the benefits and some people are suffering as a result.

In any case, I encourage everyone to be proactive in their lives and do their own research. You make your own conclusions and then you can discuss with your doctors, seek a second and third opinion. Etc.

Best of luck and I highly doubt you'll be refused. If you are, find another doctor who is competent in the matter.

   New GOOD news for taking statins. According to abc, ...  Several studies have found that reducing the level of low-density lipoprotein or LDL can reduce the short-term risk of heart disease by as much as 40 percent.

http://abcnews.go.com/GMA/DrJohnson/story?id=126975

Hugs,
    Jeanette

Quote from: sarah1972 on April 17, 2017, 09:16:12 PM
I have had issues with triglyceride levels for years. did go on medication a few month prior to starting HRT. Told the doctor about it, and she did not see any problem with it. The good thing is: The HRT routine actually forces me to also take the meds for my triglycerides...

Seems like the triglyceride meds are affecting my estrogen levels... They had to be bumped up again since I am still below the target range of my doctor. That is certainly something to consider that there are cross reactions. Usually Estradiol increases triglyceride levels, so I'll have to have them monitored closely.

I always had very high cholesterol before HRT from bad habits of working night shift even though I cycled about 400+ ks a week and my docs approved my transition and it wasnt till about a year ago I changed that I changed what I was eating after 10 years being on HRT and now its almost at the recomended level and the E dose never played a roll in my cholesterol being high......

Quote from: JeanetteLW on April 18, 2017, 08:03:52 PM
   New GOOD news for taking statins. According to abc, ...  Several studies have found that reducing the level of low-density lipoprotein or LDL can reduce the short-term risk of heart disease by as much as 40 percent.

http://abcnews.go.com/GMA/DrJohnson/story?id=126975

Associations don't imply causation and I'm not impressed by that number 40%. Why? Because in absolute numbers, it may be much less impressive. Also, what do they mean by short-term? What happens long-term? They also don't distinguish between DENSE and BUOYANT LDL, the former type having been found to be atherogenic while the latter, not. Before jumping to conclusions after reading such an article, I think it's always important to read the actual studies (and other studies that may contradict these findings) and draw your own conclusions. Remain critical.

This feels to me, personally, like advertisement for statins, recommending people to take them right away instead of trying other approaches, telling women to ditch estrogen (when studies have shown that it clearly reduces the risk of heart disease IF not combined with certain progestogens) and downplaying the side-effects. Also, they suggest cutting down on saturated fat when recent studies have unequivocally shown no association exists between the intake of saturated fat and cardiovascular disease, much less a cause and effect relationship.

Do your own homework, and find out more, is all I'm saying before taking these recommendations at face value. Other people's intentions are not always pure because money (and pride) gets in the way, sadly.

My 2 cents.

Quote from: sarah1972 on April 18, 2017, 08:30:47 PMUsually Estradiol increases triglyceride levels, so I'll have to have them monitored closely.

That depends on the type of estrogen, the dose and the route of administration. For instance, one study found that percutaneous estradiol (gel) at a normal dose in postmenopausal women actually DECREASED triglyceride levels (and also VLDL, another risk factor). Another meta-analysis, taking into account 248 studies found that, in general, transdermal estrogen lowered triglycerides. And, if triglycerides don't go down, they stay more or less the same, despite, at times, high doses of non-oral estrogen (i.e. transdermal patches in men with prostate cancer). Bio-identical estradiol has also much less of an effect on triglycerides than older forms of estrogens such as conjugated equine estrogens. These distinctions are important and should not be ignored. Studies will sometimes, wrongly, group all types of estrogen into one category, oral estrogen. One study found oral ethinyl estradiol increased triglycerides while oral estradiol valerate reduced them.

It's more complicated than just estrogen increases triglycerides.

That seems odd. Cholesterol is the building blocks of the endocrine system.

Exactly and an essential component of cell membranes.

It has to be really really high to be denied hrt for cholesterol.  At my first visit where I get my hormones mine was borderline high and they still prescribed.  If you are worried about it though my suggestion is to start taking a fiber supplement it will bring your cholesterol down.  I take a fiber supplement once a day a coq10 pill, and fish oil and my cholesterol has fallen like a rock