Hormone Therapy / HRT (Estrogen)
Common brand names: Premarin, Prempro, Climara, Vivelle, Estrace, Prometrium
Three nutrients listed against this medication. The most severe is marked critical.
At a glance
None of the three is marked well documented. Each row carries its own evidence level.
At a glance
- Vitamin B6 (P5P)Critical · Moderate evidence
- MagnesiumModerate · Traditionally cited, limited evidence
- ZincModerate · Traditionally cited, limited evidence
Color shows how serious each listed effect is. The label beside it shows how strong the evidence is. The cards below explain each one and show its evidence.
Nutrients it can lower
Mechanism, Estrogen increases tryptophan oxygenase activity, diverting tryptophan away from serotonin and rapidly depleting B6. Explains mood changes and depression in estrogen-treated women.
Common signs, Depression, anxiety, irritability, nausea, peripheral neuropathy
Estrogen therapy shares the B6-lowering effect documented in oral-contraceptive users (Adams et al., Lancet, 1973; PMID PubMed ID: the permanent number the US National Library of Medicine gives a published paper. Each one links to that paper's record on PubMed. 4123835); no HRT-specific trial has measured B6 directly.
P5P (pyridoxal-5-phosphate, the active form) 25–50 mg daily is a range in common use, not from a trial cited on this row. The cited trial studied pyridoxine and depression in oral-contraceptive users, and no hormone-replacement trial has measured B6 directly.
Mechanism, Estrogen increases intracellular magnesium uptake from serum, reducing circulating levels. Particularly pronounced with synthetic estrogens.
Common signs, Migraine, blood clot risk, anxiety, muscle tension, hypertension
Prasad et al. (Am J Clin Nutr, 1975; PMID 1119434): a study of oral contraceptive agents and mineral status that found no magnesium change. The depletion claim is not supported.
Magnesium 300–400 mg daily is a range in common use, not from a trial cited on this row. The cited study of oral contraceptive agents found no magnesium change, and no cited source studied migraine.
Mechanism, Estrogen increases ceruloplasmin, elevating serum copper and competitively inhibiting zinc absorption. The copper:zinc ratio becomes imbalanced, elevated copper is associated with anxiety and estrogen dominance symptoms.
Common signs, Anxiety, hair loss, impaired immune function, elevated copper symptoms
Estrogen raises copper and lowers plasma zinc in oral-contraceptive users (Prasad et al., Am J Clin Nutr 1975; PMID 1119434); direct measurement in menopausal HRT is lacking.
Zinc picolinate was used at 25–30 mg daily. Additional copper is avoided in HRT users, since copper is already elevated.
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It prints or saves as a single page. Whether to add a supplement for a nutrient this medication may lower is a decision for your prescriber.
Disclosure
These statements have not been evaluated by the Food and Drug Administration. Any grade on this page describes the strength of published human trial evidence in the populations studied. It is not a recommendation for any individual and is not medical advice. Starting, stopping or changing any supplement or medication is a decision for your physician.
Grades move when new trials publish. A free monthly email lists every grade EBL moved, with the reason and the trial behind it: the sign-up is on the Evidence Log →