Thrombosis. A scary word. This is the term for a formation of a blood clot, and is the ONE remaining significant risk of MTF hormone treatment with modern forms of estradiol. Blood clots have been known to travel to the heart, lung, or brain, causing damage in the form of Ischemia - reduced blood flow, which can be crippling or lethal. In the past, the risk of thrombosis was heavily linked to "conjugated estrogens" - also known as the trademarked drug Premarin, a mix of horse estrogen metabolites obtained from pregnant mares, or forms of Ethinyl Estradiol, a synthetic estrogen.
Additional minor risks have been associated with taking estradiol or estradiol valerate in pill form. But even if Premarin and Estinyl are avoided, and estradiol in pill form is avoided, there is still a theoretical risk of thrombosis, because estradiol always has at least a slight effect on clotting time. Many have advised (your doctor, perhaps, or a friend) taking baby aspirin daily to assist you with reducing that risk. There is reason to believe that strategy may have some limited benefit for transsexual HRT. But in this article I will outline use of RUTIN for that purpose -- quite possibly a superior method.
The discovery dates from May of 2012. The Harvard researchers knew that clotting was moderated by Protein disulfide isomerase (PDI), so they began a search for inhibitors of that substance. They knew that PDI inhibitors would do two things - reduce platelet based clotting (clots in arteries are mostly platelet-based), and also reduce fibrinogen based clotting (clotting in veins is dependent more on Fibrinogen than platelets). That's better than Aspirin, which does only ONE of these - increasing the platelet-based clotting time. Aspirin is useful in preventing some types of heart attacks. But aspirin does little for Deep Vein Thrombosis (DVT), the killer of some transsexual women on HRT.
The researchers designed a test which checked thousands of substances for their ability to inhibit the Protein Disulfide Isomerase (PDI). Several interesting substances were identified, but it was Rutin, a simple plant based extract, that was most interesting of the PDI inhibiting substances. Flavonols similar to or containing Rutin had already been shown to confer protection against myocardial infarction and stroke, proportional to their dosage, but
Rutin exceeded all previously known substances as a PDI inhibitor.
Harvard lead investigator Robert Flaumenhaft said, “It’s not always fully appreciated that the majority of Americans will die as the result of a blood clot in either their heart or their brain. Approximately half of all morbidity and mortality in the United States can be attributed to heart attack or stroke... Rutin proved to be the most potently anti-thrombotic compound that we ever tested.” Their game-changing article is entitled, “Protein Disulfide Isomerase Inhibitors Constitute a New Class of Antithrombotic Agents.” published in Journal of Clinical Investigation.
Transsexual women have suffered weak and compromised HRT for decades based on their doctors belief that estrogen-caused thrombosis was the overriding risk, forcing them to administer a low estradiol dose, aided by antiandrogens such as Spironolactone.
However, there is evidence today that antiandrogens contribute to anxiety, depression, and cognitive impairment in trans women, and may indirectly cause an increase in self harm, suicide, and addictive behavior in this highly stressed patient population. Also, antiandrogens have been shown to sabotage success in full feminization, fat mobilization, and breast development, the key goals of HRT.
From studies of male prostate patients we know that HRT with higher levels of estradiol, but without any antiandrogen, is highly effective in suppressing testosterone and producing feminizing effects, but of course, some doctors still feared that high estradiol levels would outweigh their benefits. But now, with easy access to a potent anti-thrombotic treatment, it is to be hoped that more patients can experience the benefits of HRT using parenteral estradiol alone, at levels which are highly effective at feminization.
Rutin seems destined to become a mandatory adjunct in HRT. It is a simple low cost supplement which can be bought at local vitamin stores or online. It is FDA recognized as a safe herbal supplement. Rutin occurs naturally in buckwheat seeds, teas, many fruits and fruit rinds. Doses of 200-600mg daily, taken once or twice a day, are appropriate for anti-thrombotic uses. I take it every day -- perhaps you should too. Many online vitamin distributors offer Rutin, but be sure you rely on reputable vitamin manufacturers. And, why not tell your friends. Even for men, and women not taking added estrogens, Rutin may offer life-saving benefits.
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health