Transdermal Estrogen in Women With Anorexia Nervosa

Exclusion Criteria

• •1. Diseases known to affect bone metabolism, including untreated thyroid dysfunction, vitamin D deficiency, Cushing's syndrome, diabetes mellitus or renal insufficiency (eGFR \< 60)
• •2. Personal history of venous or arterial clot
• •3. History of stroke or myocardial infarction
• •4. History of hypercoagulable disorder
• •5. Personal history or history of a first-degree relative with breast cancer
• •6. History of hereditary angioedema
• •7. Any medication known to affect bone metabolism, including systemic glucocorticoids within three months of the baseline visit, depot medroxyprogesterone within 6 months of the baseline visit, oral bisphosphonates within one year of the baseline visit or IV bisphosphonates within three years of the baseline visit
• •8. Bone fracture within the prior 12 months
• •9. Serum potassium \< 3.0 meq/L, serum ALT \> 3 times the upper limit of normal or Hemoglobin \< 10 g/dL
• •10. Fasting serum triglyceride level \> 150 mg/dL
• •11. Pregnant or breastfeeding (or desiring pregnancy within the next 18 months)
• •12. Active substance abuse
• •13. Elevated PTH level
• •14. 25-OH vitamin D level \< 20 ng/mL
• •15. Low phosphorus level