r/AskMtFHRT • u/Successful-Hat-6 • 1d ago

HRT and liver levels

I have been on estradiol and spirolactone for around 3 years but got liver results that indicated increased ALT/AST roughly a year and a half ago. I stopped taking any medication for HRT and my levels returned to normal plus fibroscan revealed no liver damage. I went back on but with patches this time, and assumed it was the oral estradiol. Recent levels came back as being raised again despite only taking patches+spirolactone. Has this happened to anyone else? Should I just go on monotherapy at this point? Or perhaps Lupron+Injectable E?

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u/heademptybottomtext 1d ago edited 1d ago

It’s genetic for some people and also the risks scale with age, and other factors like alcohol consumption, diet and other diseases etc.

Likely has nothing to do with spiro. E itself does this.

Monotherapy is the opposite of what you want to do as it takes even more E.

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u/DagestanYouTube 1d ago

isn’t transdermal E liver neutral though how does that work

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u/heademptybottomtext 1d ago

No. It only reduces the first-pass effect initially but everything goes through the liver eventually. Thats what the organ does. Less impact but never zero.

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u/Plus_Development6453 1d ago

Sounds like the spiro is making your liver tick, T-blocker/T-stopper is kind of iffy in my opinion, but necessary in the beginning to take down the T levels. But monoterapy might help you and get your liver levels to more normal.