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HRT, Alchohol, and the Liver

Heather Nicole

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Heather Nicole

I don't remember where it was, but somewhere I once came across the information that HRT can be hard on the liver. Obviously alcohol is well-known to be hard on the liver, too.


Not really sure what exactly to ask, but I wanted to look further into this, and see whatever I could find out.

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1 hour ago, Heather Nicole said:

HRT can be hard on the liver.

HRT, depending on the regimen, can be hard on the kidneys too. There are ways to help reduce the stress it puts on these organs. The Estradiol pills for example were at one time swallowed whole and digested normally. Now the pills are placed sublingually under the tongue to be dissolved into the bloodstream at that contact point. Some of the pill is inevitably swallowed so it is not as safe as patches and other methods of absorption into the body.

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When you are on HRT, one of the blood tests that is done routinely is a liver function test and some chemicals produced by the liver's digestive enzyme contributions are also tested for levels.  My liver had made a reasonably good recovery from an Alcoholic relapse 14 years ago by the time I was given oral HRT meds.  I was fine for 6 years, but did develop a blood clot in my leg about the six year time.  I was taken off of the oral meds and they were replaced 6 months after the blood clot was discovered by Patches which I have now had for 5 years without a problem and normal liver function for my age. For the most part it is not the E itself that is the problem but  rather the "vehicle" parts of the pills.  Injections are generally considered the safest, with patches, and gels only a little behind for liver safely. Oral meds have the greatest, but still small chance, of liver problems due to digestion issues.

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Both my gender therapist and doctor were happy that i had stopped drinking about 5 years prior to starting HRT. In fact in several ways sobriety and the fellowship that has helped me learn to live a happy sober life helped me transition as well.  The issues with liver is just one of the reasons why we are so adamantly against self medication.  There is simply too much risk if we don't have regular blood tests and monitoring. 

I seem to have a healthy liver despite a serious drinking history.  Instead it is my heart that took serious damage.  For that reason topical E is the safest for m.  Even with that regular monitoring is necessary!





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  • 1 month later...

Transition is so absolutely wonderful,  adding alcohol to the cocktail provides no upside and many downsides, the risk to the liver being just one.


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1 hour ago, Rami said:

adding alcohol to the cocktail provides no upside and many downsides,

Oh so very true.

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  • 2 months later...

This is all very informative, I guess I need to climb back on the wagon. 😀

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Jackie C.
1 hour ago, BillieB said:

This is all very informative, I guess I need to climb back on the wagon. 😀


That's pretty much par for the course for us older gals. Do everything you can to improve your general health if you want to safely enjoy your HRT. Also, the advice my surgeon gave me before I went under for bottom surgery: Be in the best shape of your life. A lot of positive habits flowed from coming out as trans. Of course they became easier to maintain once I didn't hate myself so much, so win-win, right?



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If i was the kind of person who could have a beer every two months, or a glass of wine at Christmas then i wouldn't worry about alcohol.  There wouldn't even be a wagon to climb on.  The fact is that one is never enough for me.   

Wagons are for those who need a ride to get safely home and i'm one of those.





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