Our herbalists are assembling accessible information on supportive herbs for cross-sex hormone therapy for transgender folks.  In particular, we want to help people understand:
  • what potential impacts, if any, FtM and MtF hormone therapy might have on our livers,
  • what herbs can be safely used to support the liver while using supplemental hormones and drugs.


A Workshop
We are creating a workshop on the topic, which we were honored to present at the Philadelphia Trans Health Conference in June, 2014.  As we continue to develop this workshop, we'd love to come to your area to share what we've found, answer questions, and hear about people's experiences with hormone therapy and with herbs.


To summarize our research so far, we've found that:
  • Most of the hormones and hormone therapy drugs pose few risks to the liver in and of themselves, in the recommended dosages.
  • There are a few notable exceptions -- use of some oral forms of testosterone, and all of the anti-androgens appear to carry some risks.
  • Despite their overall good safety records, taking supplemental hormones and pharmaceuticals can make the liver work extra hard, especially if it's under strain from conditions such as hepatitis, or if it's taxed from drinking alcohol, smoking, or from exposure to toxic substances.
  • Many herbs are safe to use in conjunction with hormone therapy, without a likely impact on the hormones or drugs.
  • There are herbs that definitely impact the way the liver breaks down hormones in a way that may be undesirable.
  • Many other factors, such as exercise, stress, dietary choices, smoking, alcohol, and many other drugs can also have a significant impact on the way hormones and anti-androgens are processed by your liver.
  • If you're doing hormone therapy, it's ideal to work with a medical practitioner to make sure the levels of hormones in your blood are right, particularly when starting out, changing dose, or making other life changes.



Next Steps
Our next steps will be to make the presentation more accessible and concise, and to assemble what we know into a zine and online resource.  You will be able to find any resources we create here, and all materials will always be free.

We are also putting together a survey to gather information about how trans folks use herbs, particularly for liver support, and what kinds of effects you've observed.  This survey will be available here when it's complete.


Information from our Philadelphia slideshow:
(please bear with us as we get all our information online)


Metabolic pathways for hormones and anti-androgens:
CYP450 1A2: Estradiol
CYP450 2C9: Testosterone
CYP450 2C19: Testosterone, Progesterone, Nilutamide (anti-androgen)
CYP450 3A4: Testosterone, Estradiol, Progesterone, Finasteride (anti-­androgen)


Herbs covered:
  • Herbs that have demonstrated effects on the relevant metabolic pathways in clinical studies: st. johnswort, schizandra.
  • Herbs to support the liver, where there's no current research pointing to effects on the metabolism of hormones and drugs: burdock, turmeric, artichoke leaf, milk thistle.
  • Herbs that are wonderful liver-supporting herbs, but may not be ideal in conjunction with some forms of hormone therapy: reishi, dandelion, licorice.

We'll be posting up more information about each of these herbs soon, including relevant research, how to use them, and where each one might be applicable!




Resources for learning about herbs or finding studies about them:



Books:
These are mostly technical books for herbalists, to learn more about herbal safety, drug-herb interactions, and liver health.
  • Herbal Contraindications and Drug Interactions, 4th ed. Francis Brinker.
  • The Essential Guide to Herbal Safety. Simon Mills, Kerry Bone.
  • American Herbal Products Association's Botanical Safety Handbook, 2nd ed. Zoë Gardner, Michael McGuffin.
  • Principles and Practices of Phytotherapy. Simon Mills, Kerry Bone.
  • Medical Herbalism. David Hoffmann.
  • Herbs for Hepatitis C and the Liver. Stephen Harrod Buhner.
  • Herbal Medicine, Healing and Cancer. Donald Yance.

Some places to get herbs online:
Pacific Botanicals - large farm and distributor of high quality herbs
Mountain Rose Herbs - large distributor of herbs
Banyan Botanicals - specializing in Ayurvedic herbs
Herbalist & Alchemist  -  producer of herbal extracts
Good Fight Herb Co. - local grower, wild-harvester and medicine-maker in the Hudson Valley, NY
Dandelioness Herbals - local herb producer in Central Vermont