Cardiovascular risk of excess oestrogen in men
Sudden death and thrombosis (blood clotting)
Estrogen dominant in women can cause thirty problems. There can be two ways, normal estrogen but too low progesterone or really too high estrogen. Here we zoom into high estrogen with or without low testosterone in men.
Numerous studies link low testosterone (and excess estradiol) with increased heart attack and stroke risk. Testosterone is intimately involved in the reverse cholesterol transport process, which removes cholesterol from the arterial wall by HDL.
Excess estrogen is linked with higher C-reactive protein and a greater propensity for abnormal blood clots to form in arteries, causing a sudden heart attack or stroke. Men should keep their free testosterone in a range of 20 – 25 pg/mL and their estradiol levels between 20 – 30 pg/mL
Men can have higher estrogen than women in the same age range. They are due to conversion of testosterone into estradiol (a form of estrogen) by aromatase enzyme. High estrogen leads to abdominal obesity hence part of metabolic syndrome, diabetic, blood clotting and heart disease.
Dangers of Excess Estrogen In the Aging Male
Long ago, published data showing that estrogen levels are often elevated in aging men and discussed the insidious health risks associated with excess estrogen.
Since it is not difficult for men to correct estrogen overload, it made sense to test for it and recommend the appropriate corrective actions if blood results reveal excessive estrogen.
Research confirmed that excess estrogen in aging men is more dangerous than what we even thought.
Double the Stroke Risk
Stroke is the third leading cause of death and the leading cause of age-related disability. Abnormal blood clotting in the cerebral blood vessels is the most common cause of stroke.
Excess estrogen promotes abnormal blood clots. In a study published just last year, blood levels of estradiol (a potent estrogen) were measured in a group of 2,197 men aged 71 to 93 years of age.
Adjustment for age, hypertension, diabetes, adiposity, cholesterol, atrial fibrillation, and other characteristics were made. During the course of follow-up, men with the highest blood levels of estradiol had a 2.2-fold greater risk of stroke compared with those whose estradiol levels were lower.
This study revealed that estradiol blood levels greater than 34.1 pg/mL resulted in this more than doubling of stroke incidence. There is warning for men to keep their estradiol levels below 30 pg/mL, and this recent stroke study clearly validates the recommendation.
Excess Estrogen in Middle-Aged Men
One way to evaluate the health of the arterial system is to measure the inner and medial wall of the carotid artery using an ultrasound test.
In a study published two years ago, blood levels of estradiol were measured in 313 men whose average age was 58.
Carotid artery intima-media thickness was measured at baseline and then three years later. After adjusting for other risk factors, men with higher levels of estradiol suffered a worsening thickening of their carotid artery wall.
This led the researchers to conclude, “circulating estradiol is a predictor of progression of carotid artery intima-media thickness in middle-aged men.”
Ultrasound measurement of the carotid artery wall provides an accurate prognostic indicator of arterial disease.
The findings in this study show progression of carotid artery intima-media thickness in men with higher estradiol levels. Greater carotid artery intima-media thickness sharply correlates with increased risks of heart attack and stroke.
Estradiol Higher in Male Heart Attack Victims
A study published just last year compared blood levels of testosterone and estradiol in men suffering acute myocardial infarction (heart attack) with those who had previously suffered a heart attack.
Sex hormones were measured in patients presenting with acute heart attack, patients with old heart attack, and patients with normal coronary arteries. The results showed significantly higher levels of estradiol in both groups of heart attack patients compared with those without coronary disease.
As would be expected from numerous prior studies, heart attack victims also had decreased testosterone levels.
The reason many men suffer from excess estradiol and deficient testosterone is that their aging bodies produce less testosterone while more of their beneficial testosterone is converted (aromatized) into estradiol. The pathological result is an altering of the ratio of testosterone to estrogen, creating estrogen dominance.
This imbalance of estrogen overload and testosterone insufficiency is an often overlooked cause of cardiovascular disease.
Fortunately, there are safe methods to block the aromatase enzyme in order to lower excess estrogen while boosting free testosterone levels.
Coronary angiogram is to measure the degree of atherosclerosis present in the arteries feeding the heart muscle. Researchers used angiogram-confirmed cases of coronary atherosclerosis to ascertain the effects of sex hormones and other metabolic factors in a group of men aged 40-60 years.
Compared with healthy age-matched controls, men with coronary atherosclerosis had low testosterone, higher levels of estrone (another potent estrogen), and a low level of testosterone in the presence of a high level of estradiol. These findings led the researchers to conclude their study by stating, “low levels of total testosterone,testosterone/estradiol ratio and free androgen index and higher levels of estrone in men with coronary artery disease appear together with many features of metabolic syndrome and may be involved in the pathogenesis of coronary atherosclerosis.”
High Estradiol Levels Seen in Male Chronic Inflammation Patients
Chronic inflammation is the causative factor for heart disease. Rheumatoid arthritis is a severe chronic inflammatory state that results in increased risks of heart attack, cancer, and stroke. A study of men with rheumatoid arthritis evaluated blood levels of sex hormones compared with healthy controls.
Levels of estradiol in rheumatoid arthritis patients were higher and DHEA levels lower compared with subjects who were not suffering from chronic inflammation.
This corresponds to studies showing that high estrogen levels (in women) can increase C-reactive protein, which is an accurate marker for systemic inflammation. Elevated C-reactive protein is an independent risk factor for coronary heart disease in healthy individuals.
Another Lethal Mechanism of Excess Estrogen
The number one cause of death in persons over age 50 is the development of an abnormal blood clot (thrombus) in an artery that blocks blood flow to a critical region of the body such as the heart, lungs, or brain. Elevated estrogen predisposes people to these lethal thrombotic events.
It has been found that men admitted in hospitals with myocardial infarcts have elevated estradiol and lower testosterone levels. This was shown in an interesting study done on men admitted to the hospital with acute heart attacks whose levels of sex hormones were evaluated.
Compared with control patients, estradiol levels in these heart attack patients were 180% higher, while bioavailable testosterone levels were nearly three times less than those of control patients.
These findings reveal the higher heart attack incidences associated with high estrogen and low testosterone. It is possible, however, that these low levels of testosterone and high levels of estradiol occurred in response to the heart attack itself.
Estrogen Levels and Risk for Sudden Cardiac Death
Tests reveal higher concentration of the sex hormone in women and men. Higher levels of the hormone estrogen are associated with an increased risk of sudden cardiac death in men and women, a new study suggests.
Sudden cardiac death can occur when the heart suddenly and unexpectedly stops beating (sudden cardiac arrest). Each year in the United States, more than 350,000 people die of sudden cardiac death.
But levels of testosterone were much lower among men in the sudden cardiac death group compared to those with coronary artery disease, according to the study. The researchers also found that estrogen levels were much higher and the testosterone-to-estrogen ratio was lower in both men and women who suffered sudden cardiac death.
This did not, however, prove a cause-and-effect link between higher estrogen levels and sudden cardiac death.
Thrombosis or blood clotting is known risk of high estrogen
Two disorders involving arterial thrombosis are:
• Heart Attack
• Ischemic Stroke
Two disorders involving venous thrombosis are:
• Deep Vein Thrombosis (DVT)
• Pulmonary Embolism
Low-dose aspirin is recommended to inhibit platelet aggregation, a major factor involved in arterial thrombosis, leading to a heart attack or ischemic stroke.
Recent studies show that arterial thrombosis occurs more frequently than previously thought. Therefore it is important to protect against arterial thrombosis, but far less effectiveness for venous thrombosis.
The Surgeon General of US published a report showing that deep vein thrombosis (and subsequent pulmonary embolism) may cause 100,000-180,000 deaths each year in the US. To put this in perspective, pancreatic cancer is estimated to kill more than 41,000 Americans in 2016. Pancreatic cancer has a decidedly deadly reputation, yet the public is largely unaware that deep vein thrombosis (and subsequent pulmonary embolism) poses a greater overall health risk.
People often take for granted that blood effortlessly flows through their arteries and veins like water moves through a hose.
For example, platelets play an important role in “plugging” holes in our circulatory system, helping to reduce bleeding in conjunction with other clotting factors.
Conversely, when platelets abnormally aggregate (clot) inside a blood vessel in response to arterial plaque and/or endothelial damage, the result is stoppage of blood flow to the affected part of the anatomy. An abnormal blood clot in a cerebral artery can lead to ischemic stroke, whereas a thrombus (clot) that forms in a coronary artery can result in a heart attack.
Role of Inflammation in Both Arterial and Venous Thrombosis
Inflammation is a responsible in a sequence of events that can lead to arterial and venous thrombosis. Oestrogen directly induce clotting tendency and indirectly by inducing abdominal fat synthesis that leads to metabolic syndrome and later also causing heart disease through insulin toxicity. (Insulin is considered toxic, hyperinsulinism is the true cause of heart disease)
Epidemic of Deep Vein Thrombosis
Deep venous thrombosis and pulmonary embolism are major causes of disability and death. Each year, as many as 900,000 Americans may be affected by venous thromboembolism. Of those diagnosed, up to 30% will die within one month, and the first symptom will be sudden death in about 25% of those who have a pulmonary embolism.
Venous thrombosis is the formation of a blood clot inside a vein that can obstruct flow in the localized affected part of the venous circulatory system.
When a venous blood clot dislodges from its primary location and travels to block circulation in another body part, this is referred to as a venous thromboembolism. When a deep vein thrombosis dislodges and travels to the lungs, this worrisome and potentially life-threatening condition is called a pulmonary embolism.
How Arterial and Venous Clots Differ
There are distinctions between the processes that cause arterial and venous thrombosis.
Arterial thrombosis largely involves platelet aggregation forming around clogged/jagged points in the arterial system, or in response to irregular heart beat (atrial fibrillation) or an artificial heart valve.
Deep vein thrombosis typically occurs due to hemostasis (reduction in venous blood flow) and hypercoagulability (tendency of the blood in veins to clot due to genetic, cancer or lifestyle factors).
Test your estrogen and get it treated if too high. Treatment is not difficult.
One of chelation therapy benefit is “polishing” rough and ulcerated endothelium of blood vessel that prevent blood clot formation on the damage endothelium that can trigger heart attack and stroke. It is less beneficial for venous thrombosis.