HRT for bone loss any advice

[Val-55]

I’m posting to ask a question for my sister ,, she has been taking thyroxine since she was 23 ,, she is now 53 ,, and has been told that she has osteoporosis! She is going through the menopause and has been suggested that she takes HRT to help arrest the bone loss and other menopause symptoms . She is worried obviously about the risk of cancer etc ,, but had read that it is not effective in halting bone loss iif you take thyroxine ,,, and you may need to take more ( she is on 75 /100 . I would appreciate any advice from anyone that may have been in the same position ,, with positive results ? Obviously she needs to do something , but not keen on the osteoporosis drugs either !

Thankyou in advance

[Nanaedake]

There is new information on HRT. You could check out the website that Davina McCall is championing - to read information. It seems to say the risks are lower than once thought. Maybe it will help bone density as I'm not sure anyone really knows so maybe read and find out?

themenopausecharity.org/

[radd]

Val-55

Healthy bones need an optimal amount of thyroid hormone. If your sister has been kept slightly under medicated for many years she will have risked experiencing an unknown slowing of the process needed for healthy bone growth, where old bone is dissolved or resorbed and new bone can be produced to replace what was resorbed. This then results in fragile & brittle bones (osteoporosis, osteopenia).

'Bioidentical' oestrogen and progesterone (now known as 'body identical') has a much lower risk of cancer, etc than the previous HRT's available, and oestrogen has bone preserving effects. If she is proposing to take oral oestrogen she will need to increase her dose of Levo to offset the extra binding proteins. If she is taking transdermal oestrogen or by patch the risk of excess binding proteins massively reduces as oestrogen is bypassing the liver. So although her Levo dose & sex hormones will still need monitoring, it will be to a lesser degree. If Levo is prescribed by her GP he should know all this.

Ask your sister to post any recent blood test recents complete with ranges (numbers in brackets) for members to comment.

[Val-55 in reply to radd]

Thankyou for your very helpful reply .She is just having a full Thyroid blood test to check levels . Is Bioidentical HRT what is offered now or is this more specialised and do you have to pay privately ?

[haggisplant in reply to Val-55]

After watching Davina, it’s Bodyidentical that’s now prescribed. You need oestrogen and progesterone if having periods.

Bio identical isn’t regulated.

[radd in reply to Val-55]

Val-55,

It's available on the National Health. Myself & many other members have been prescribed it.

I use Estrogel (oestrogen gell) & Utrogestan (micronized progesterone pills) but there are others too. Just ensure her doctor knows she would like 'body-identical' as these should be but are not always the first to be offered.

[haggisplant]

I’m sorry to hear about your sister. May I ask about how she found out? I’ve been on thyroxine since I was 21 and at 45 do worry about my bone density as I know there’s been times when I’ve been too low and too high.

[Val-55 in reply to haggisplant]

Thanks for reply ,,Facebook group etc .My sister and I both had a dexa scan,, as both now menopausal ,, my sister has always found it hard to balance her thyroid often over ,,, but the menopause I think is what has done the damage ,, I’ve taken thyroxine for 15 years and have osteopenia but at 61 I think too old to start HRT. Keep taking vIt D ,exercise and pos HRT when time comes I think as I was never offered it and had all the symptoms 🙁

[haggisplant in reply to Val-55]

From the fact book group, It sounds like you could still be offered at 61, do seek info from the menopause support network, menopause matters or dr Louise newson’s website. The issue might be getting a Gp who knows what they’re doing.

[radd in reply to Val-55]

Val-55,

You can start HRT at 61 years but the cancer risks increase.

You could initiate a discussion with your doctor who will look at your whole medical history and make an evaluation as to whether the advantages could outweigh the disadvantages.

I started HRT at about 52 years old and because I have been on it for 5 years now it was reviewed and cancer risks assessed, but because my bone density has increased & I am fairly healthy otherwise, it was deemed I should stay on HRT for another 5 years.

Edit - Or maybe the next review is 2 years - I can't remember.

[radd in reply to haggisplant]

haggisplant,

Try asking your GP for a DEXA scan whilst explaining your worries. I had my first at 48 years old whilst having a load of investigations for numerous symtoms for hypothyroidism (although I didn't know it then). The earlier we know of these issues the earlier we can treat them .

[Val-55 in reply to radd]

Thankyou got your kind reply ,, yes myself and sister had a dexa a year of more ago ,, I’m 61 and it showed osteopenia in my spine and hips ,, I’ve taken thyroxine when menopause hit at 47 ( no hrt offered then ,,,, more concerning is my sister at 53 with osteoporosis in her spine ,, I’m hoping she will take the HR T as it seems it has been beneficial to you ? Regards Val

[haggisplant]

There’s an excellent face book group called the menopause support network. I’d join there and ask the same q. May women on thyroxine and dealing with bone density issues.

[humanbean]

If your sister wants to discuss HRT with her doctor it would be worth her while understanding what is on offer via the NHS, and what the NHS thinks about HRT.

nhs.uk/conditions/hormone-r...

If she can find a list of possible HRT drugs which can be prescribed for her then I suggest reading the info from this site - the BNF - British National Formulary - which gives lots of information about any prescribed drugs in the UK :

bnf.nice.org.uk/drug/

And another thing worth knowing about is this site - the Electronic Medicines Compendium :

medicines.org.uk/emc/

It gives Patient Information Leaflets and other info for many prescribed drugs and some over-the-counter drugs and supplements. I always think it helps to know what to expect from any drug I might get prescribed before I actually collect it.