Estradiol patches and vegetables to avoid

[Squirrel71]

I am interested in low dose Estradiol patches to retain bone density while on ADT but In a video by Snuffy Myers he says that vegetables such as cabbage, kale and broccoli should be avoided as they stimulate the pathway to liver absorption. Did I understand this correctly? I understand that sulfurophanes are an important supplement and these vegetables are a key part of my diet.

[Hidden]

I’m interested in this also. I’ll see what the heads say about this. I too eat cabbage , kale and broccoli . Good luck

[Tall_Allen]

Was Snuffy talking about transdermal estrogen.

[LearnAll]

Did Dr Myers tell more about mechanism of liver absorption ? Just saying liver absorption increases by said vegetables is not enough to clearly understand this issue.

[pjoshea13]

He did indeed say that. Skip to 2:50 minutes in [1].

My interest in transdermal estradiol is in the lowest-dose patch that many men on ADT need to achieve an estradiol level in the 12-20 pg/mL range, to prevent or counter treatment-emergent osteoporosis.

Studies on estrogen levels & bone health generally look at estradiol [E2] - not estrone [E1], & indeed, the much weaker E1 is generally not found in estrogen-targeted cells; so E2 looks like the important estrogen for bone health.

The 17β-Hydroxysteroid dehydrogenase (17β-HSD) family is responsible for the conversion of DHEA to androstenediol, androsenedione to testosterone and estrone to estradiol . Estrone itself is aromatized from androstenedione, while estradiol is aromatized from testosterone. {So Arimidex, which inhibits the enzyme aromatase can be used to limit both E1 & E2.}

Oral estradiol leads to high levels of estrone, but this does not happen with transdermal estradiol.

I'm sure that many here are familiar with DIM (3,3'-Diindolylmethane) - particularly with BR-DIM. DIM is found, to varying degrees, in cruciferous vegetables. E2 can be metabolized to 2-OHE1 or 16α-OHE1. What DIM does is to push E2 down the benign "2-" pathway, away from the "16α" pathway that creates pro-cancer metabolites of E2.

PCa cell study: DIM "increased 2-hydroxyestrogen and decreased 16α-hydroxyestrone" [2]

{I have only used BR-DIM for 15 years. Nalakrats has a longer history & has had a long-term dialog with its creator.}

While E2 can be converted to E1 and high levels of "cabbage, kale and broccoli" will speed E2 metabolism, I doubt that E1 will increase. It doesn't need to be tracked IMO.

I say, eat as much Brassica as you can stomach, but check that E2 is where you want it. Adjust the transdermal dose accordingly.

-Patrick

[1] youtube.com/watch?v=KBpg_SE...(Not working as expected?)

[2] ncbi.nlm.nih.gov/pmc/articl...

[Break60 in reply to pjoshea13]

I’ve been on estradiol patches since February 2019. I had been utilizing intermittent ADT but fast doubling times after stopping ADT and subsequent scans when psa neared 2.0 found one or two bone mets which I treated with SBRT . This proved to me that I needed full time ADT. But I hated it and switched to estradiol patches . Since then my psa has been minimal and in fact undetectable for nearly two years , then increased to .2 in Feb 2021 and again was .2 on May 25.

I’ve been using (3) .1 mg. patches per week after starting out with 4 as per the PATCH trial.

I was startled to hear Dr Meyers say he used .025 and .05 mg patches (I believe I heard that correctly!) so I wonder if I can cut back drastically on my dosage since my total testosterone is <3 and estrogens are over 300!

I’ve developed peripheral neuropathy in feet and wonder if my hormonal imbalance might be the cause?

Any comments would be appreciated!

Bob

[pjoshea13 in reply to Break60]

Hi Bob,

There is often confusion when I mention estradiol [E2] patches. There are two situations where a patch is called for - & one size does not fit both!

In classic ADT (such as with Lupron), castrate testosterone [T] can lead to very low levels of E2. A low-dose E2 patch is all that is required to provide the small amount that men need for healthy bones. The E2 target is 12-20 pg/mL, and more is not better (>30 pg/mL should be avoided in this case.)

In the other situation, a massive dose of E2 will lead to castrate T. For decades, the synthetic estrogen DES [Diethylstilbestrol] was the only alternative to physical castration. Bone loss due to castration does not occur with E2 or DES. (The 30 pg/mL E2 limit does not apply when E2 is used as castration therapy.)

-Patrick

[Squirrel71 in reply to pjoshea13]

Hi Patrick

I have been trying to get my M.O. to prescribe low-dose transdermal estradiol patches for a long time but I keep getting refused as he says that even low-dose estradiol can lead to veinous thromboembolism in women. Can you direct me to any studies that support or refute this in men with prostate cancer to counter the effects of ADT?

Thanks

Joseph

[pjoshea13 in reply to Squirrel71]

Hi Joseph,

If he has a problem with low-dose E2, then he would certainly have a problem with the levels used to induce castration, as in the PATCH trial.

pubmed.ncbi.nlm.nih.gov/335...

"Long-term data comparing tE2 patches with LHRHa show no evidence of a difference between treatments in cardiovascular mortality or morbidity."

pubmed.ncbi.nlm.nih.gov/156...

"not associated with thromboembolic complications or clinically important changes in several coagulation factors"

Also, see:

pubmed.ncbi.nlm.nih.gov/155...

pubmed.ncbi.nlm.nih.gov/295...

Richard Wassersug might be able to point you to other studies. His member name is "Wassersug". Send him a private message. He is very approachable.

-Patrick

[Squirrel71 in reply to pjoshea13]

Thank you Patrick this is very valuable.

I will use these articles to try to get buy-in from my MO.

I had communicated with Wassersug in the past independent of Health Unlocked but it’s good to know he is on this forum.

Regards

Joseph

[j-o-h-n]

And keep away from banana peels..............(when walking)....

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 04/25/2021 6:31 PM DST

[Hidden in reply to j-o-h-n]

I hate that stepping on a banana peel gag. What a pain in the butt

[j-o-h-n in reply to Hidden]

Yep and then you're not peeling well.........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 04/25/2021 6:59 PM DST

[Hidden in reply to j-o-h-n]

I just got that response...my Filipino is rusty.

[j-o-h-n in reply to Hidden]

fenalty shot..........

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 04/25/2021 9:36 PM DST

[Hidden in reply to j-o-h-n]

Too punny

[j-o-h-n in reply to Hidden]

Please passively, playfully, protectively, passionately promote pretty, people...

Good Luck, Good Health and Good Humor.

j-o-h-n Sunday 04/25/2021 9:49 PM DST

[Hidden]

Dear Squirrel , per my Nat doc I eat kale cabbage and broccoli ..He was more adamant about no sugar no animal proteins . All veggies, knock yourself out! Imho