Dr. Douglas Lucas
speaker
736 appearances
1 recordings
1 series
first heard Jul 2026
last heard 28 Jul
Dr. Douglas Lucas’s voice in public audio — every appearance, attributed to the second.
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And then we also measure CTX and P1 and P. And we should see CTX drop by 40, 50% if it's actually saturating the bone receptors for estrogen.
And we could see P1 and P rise, or it'll drop a little bit less than CTX, again, changing that ratio so that we're favoring bone builder.
I used to.
And so we had this, we used 60 as sort of our threshold cutoff.
There's literature to support that.
But what we realized is that I had women who were on very low doses of transdermal estradiol where I would not expect to see much systemic exposure.
You wouldn't expect to see high levels and we wouldn't.
But yet we would see FSH suppression and I would see CTX come down, meaning that I can't make an argument actually to increase her dose if that's what we're aiming for.
So sometimes we see it be effective at less than that.
But then the opposite is also true.
I have women that hit 60, 80, 100, and their CTX is still 800, right?
It just doesn't seem to have had an effect on the bone yet.
And so we will have women who will push that.
It gets more challenging.
We have to talk about how to protect organs and the uterus and breast tissue, et cetera.
But women that have pushed that into the 100 to 200 range, and then you see the CTX drop.
So I think there's a receptor challenge that we can't measure effectively.
So I've stopped using estradiol alone as a goal.
It's going to depend on the phase of the cycle.
So this is one of the really cool things that I learned about starting to treat women in perimenopause, which is if you understand what's happening with the cycle, you can understand what's happening with bone metabolism really well, right?
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