August 22, 2007

Estrogen Decreases IR!

This showed up in the medical news today, confirming what I'd learned anecdotally:
Estrogen Receptors in Hypothalamus Region Play Role in Regulating Weight Gain

The key finding in this study is that when estrogen levels drop women become more insulin resistant and start gaining weight like crazy. Not just women with diabetes but all women.

That certainly was my experience.

As readers of this blog might remember, I decided to stop my estrogen supplementation last January, as I was concerned that I'd been on it long enough that heightened cancer risk might be an issue.

At the time I quit, my weight had been rock solid steady for 4 years. I'd actually lost a couple pounds when I switched to insulin but they had come back thanks to holiday dining.

I've never taken much estrogen. About 4 mg a month compared to the 18.6 most doctors prescribe. I was taking .3 mg of Menest, the estrogen NOT made from horse urine, every other day, with five days off at the end of each month to simulate natural cycling. Most women take .6 every day.

For the first month or so off Estrogen, I felt fine. But almost immediately after quitting I started to gain weight. I utilized the appetite suppression that I experienced on Januvia to go on a 1,150 calorie a day diet, and I stuck to it religiously for a month, weighing portions and using software to calculate intake. At the end of the month it wasn't clear if I'd lost any real weight at all! Once off the diet, the weight continued to rise and I felt bloated all the time.

My blood sugar, which had been perfectly controlled for a year with 2 -3 units of R insulin per meal deteriorated too. I was up to using 5 units per meal at one point without getting as good numbers as I had last year. And even with good control of meals my fasting bg shot up from the 80s to about 105 mg/dl.

My blood pressure, which had been so good I no longer need blood pressure meds shot up too, as did my pulse.

And finally 6 months after I stopped estrogen I started hot flashing AND developing dryness places where dryness is most definitely NOT anything you want to experience.

Fortunately, yet another reassessment of the Women's Health Initiative hormone study was published recently, which suggested that women who have been taking estrogen since the start of menopause can take estrogen safely until 65, and that, in fact, it appears that when estrogen is taken by women at the very start of menopause it prevents the development of calcification in the arteries. It is when estrogen is started in women who are in their mid 60s and have been menopausal long enough to have already developed hardened arteries that estrogen appears to enhance heart risk.

Since there is no history of estrogen sensitive cancers in my family, and since my doctor has done ultrasounds that show no build up of tissue in my uterus thanks to the very low dose of estrogen I'm taking, I came to a conclusion:

A drug that lowers my blood sugar, lowers my blood pressure, keeps my arteries from calcifying, keeps my weight controllable, and keeps me from feeling like crap all the time is a GOOD drug.

So I started back on it three weeks ago.

Here are my results so far.

1. Blood sugar is back to where it was last year. Fasting high 80s-mid-90s. I'm using 2 or 3 units of insulin, not 4 or 5 and getting great numbers. And what makes this really interesting is that I stopped taking Metformin a couple months ago and am still off it! So it seems to be the estrogen that was lowering my IR mostly, not the metformin!

2. Blood pressure is down, too. Pulse is much slower.

3. No more hot flashes.

4. Sensitive tissues are no longer dried out.

5. Weight has stabilized about 5 lbs over where I started last January, but I'll be working on getting it down soon.

Oh, and I'm taking a bit LESS estrogen than before, alternating between taking one pill every other day and one every third day.

I ams starting to wonder if the main problem with estrogen therapy is that they were doing the "One size fits all" dosing thing and giving a lot of smaller women like me far too much estrogen. I started doing the regimen I do now because the standard dose made me feel like crap and I worked the dose down to where it still took care of symptoms without making me feel chemical.

BOTTOM LINE: If you are a woman with diabetes with no family or personal history of estrogen sensitive cancers, taking estrogen at the beginning of menopause at doses that are much lower than what doctors usually prescribe might prevent an increase in insulin resistance and prevent high blood pressure. Discuss this with your gynecologist as I've found that family doctors tend to have a knee-jerk "estrogen is poison!" response. A good gynecologist who keeps up with the research (as mine does) may be more helpful to you.

Copyright Janet Ruhl 2007. If you are NOT reading this on the content has been STOLEN.


Rachel... said...

Yep, both times I went off the pill (for mental health reasons), I gained a ton of weight. Don't know how that ties in with my thyroid, though.

As far as estrogen replacement, no thanks, when the time comes. My mother-in-law has NO family history of breast cancer and developed it within three years of estrogen replacement therapy. And since I don't know half my family history, I'm not taking chances.