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Do I need to undergo HRT?

Q: I am 42 years old and had fibroids in my uterus. I got my uterus and ovaries removed five months back. My doctor did not suggest me HRT. Presently, my doctor is in USA and may not be available for the next one month. However, before going he suggested I get my blood test done. My blood report shows CHO-207, LDL-108, HDL-85, and TG-72. The thyroid function tests are normal; serum calcium -10.1 mg%; sugar - 84 HGB (PP); and 11.4 g/dL (PP); and HCT-35.9%. Do I need to consult any other doctor or can I wait for my doctor to return? Do I need to undergo HRT? Recently, I have started getting a sharp pain in my neck, but it might be due to the hectic schedule of travelling 40 km (up and down) in a bus daily. The orthopaedic doctor has ruled out spondylosis. Kindly advise.

A:The first question is in regard to Hormone replacement Therapy (HRT). This is prescribed primarily for prevention of menopausal symptoms. If you do not have them, you do not require this treatment. HRT is no longer recommended for bone loss or heart disease prevention. Taking calcium 1200 mg daily and Vitamin D 400 to 800 units daily is recommended. Your total cholesterol is mildly elevated but all the parameters are normal so no drug therapy is required. All your other labs are normal so you can wait for your physician to return. I cannot comment on your neck pain without seeing you. If you carry a heavy bag over your shoulder or in your hand you might think of carrying a lesser weight. You might find the following information helpful: Adequate calcium intake is important to prevent osteoporosis (weakening of the bones). Fractures/broken bones involving the spine, hip and forearm are common complications of osteoporosis which affect a large percent of the female population and usually do not cause any symptoms until the disease is quite advanced. It is recommended you increase your calcium intake to a total of 1200-1500 mg elemental calcium per day. One cup of milk or yoghurt each provide 300 mg of calcium. One and a half ounces of cheese also has 300 mg of calcium. Cheese however, is also high in fat, and if you have a history of a high cholesterol level, then cheese should be avoided. If you are not able to reach the above goals of calcium intake from dietary intake alone, you should begin taking a calcium supplement. Calcium supplements are available over the counter. The product you choose should also contain vitamin D, which helps in the absorption of the calcium. (Calcium citrate is commonly recommended as it is well absorbed with or without food, does not increase calcium oxalate kidney stones, and the citrate in the urine tends to make the urine less irritating for the vulva.) Calcium may be a mood stabiliser in women with PMS and may help lower blood pressure. Excessive doses of calcium and calcium containing antacids are to be avoided. High blood cholesterol is a known factor in the development of coronary heart disease, the leading cause of death in the United States. Cholesterol comes from two sources: your body makes its own and it also comes from the foods you eat. Total cholesterol is made up of two components - HDL (good cholesterol) and LDL (bad cholesterol). If your cholesterol and HDL values are within normal limits, it is not necessary to repeat this screening test for 5 years. Please follow a low fat, low cholesterol, Mediterranean diet rich in vegetables, fruits, whole grains with at least 2 servings of omega 3 fatty acids per week like salmon, tuna, or flaxseed. Avoid simple sugars and excessive sweets. Please consider substituting 25 grams of soya protein in place of animal protein like soya milk or soya nuts. Stop any transfatty acids use (partially hydrogenated oils and margarine), use extra virgin olive oil as your main cooking fat, and exercise regularly.

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