Topic: Unexpected blood test results

[Iztaccihuatl]

About a week ago I had my annual physical checkup with my primary care physician. I am not on HRT (yet), but out of curiosity I asked the doctor to also get the T and E levels checked, expecting them to be in the normal male range for my age since I am not on hormones yet. The T levels came back at 524 ng/dL, which is definitively in the male range, so no surprises here. The E levels, well, that’s a whole different story; they came back at 187 pg/mL, which is way above the male range (which I believe should be 40 pg/mL or less) and which puts me straight in the middle of the normal female range. Needless to say that I am totally excited about this unexpected finding.

I have to mention that this lab result is total estrogens, so I don’t really know if it is Estradiol, Estriol or Estrone or any combination of them that they measured. And I haven’t had a chance yet to discuss this with my doctor, since the results came in after I had my appointment, but the fact that they haven’t called me indicates that they are not too concerned about this test. And this seems to be completely natural, because I don’t take any hormones nor do I eat phytoestrogen-rich foods nor do I do anything to manipulate my E levels.

Now here comes the hard part: what to make of this new and exciting insight? There are a bunch of questions / thoughts running through my mind:

(1) Is this the cause of me being trans? On the one hand I am aware that this is just one single measurement which could also be off and I don’t have any historic E levels, so this doesn’t prove anything. On the other hand, the most common theory of why we are trans is the one of a hormonal imbalance during fetal development, so If I have female E levels now, it seems to be possible that I could have had female E levels before I was born.

(2) I assume that this makes me somewhat comparable to somebody on a low dose HRT. Is this the reason why I am not experiencing a lot of dysphoria? After all, many folks on low dose HRT have reported a lessening of their gender dysphoria when starting hormones.

(3) Where are my boobs? I.e. If I have female hormone levels, why didn’t I develop breasts? My theories on this one are either that the E levels are not always in the female range, or that the high T levels don’t let the E do its thing. Which kind of reminds me of an episode during my puberty, where one day I discovered a circular swelling, like a ring or donut, behind my nipples. It wasn’t visible from the outside, but when touching them I could feel it. That swelling went away after a year or two and I never thought much of it nor do I know if this is normal for a boy at that age. Now, after this new revelation, I am thinking: could it be that this was the E starting to merrily do its thing, but then the T kicked in a year later, dominated the scene and overruled the E?

(4) Does that mean that all I would need to transition is taking an anti androgen, like spiro? Or are they typically trying to spike the E for the first few years of HRT and I would still need to take E supplements?

(5) And why do they measure the T in nanograms per deciliter, but the E in picograms per milliliter? I just doesn’t make sense to me…

Well, so many questions and no answers. I guess all I can do is lean back and enjoy the knowledge that not only mentally, but also hormonally there is already a woman inside me…

Heidemarie

[Rakel]

Hormones are a very complex topic.

If your lab values are correct, this is very unusual and there must be a cause specific for you. Further testing by your doctor may help discover what is exactly going on. Whatever the cause, how do you see yourself in your own mind? Are you happy as you are or do you need to make a few changes. There may be some relationship to any gender issues or maybe not. This is a big unknown for now.

As for units of measure, 1 nanogram = 1000 picogram. The units used just make it a convenient way to express what your blood levels are without adding too many zeros to the lab report. Not confusing at all. The metric system is the most sensible way of measuring everything.

[pamelatransuk]

As for units of measure, 1 nanogram = 1000 picogram. The units used just make it a convenient way to express what your blood levels are without adding too many zeros to the lab report. Not confusing at all. The metric system is the most sensible way of measuring everything.

Thank you Rakel. I thought that was the reason but just needed your confirmation!

As you know precisely the same applies for International Units where T is measured in nmol/L  but E measured in pmol/L.

Hugs

Pamela xx

[Devlyn]

Keep your metric system away from my food, though.

Nobody wants a 0.3048 metre long hotdog.  Or a 0.113 kilogramer with cheese.

[Northern Star Girl]

@Devl:yn
Dear Devlyn
Since you did indeed voluntarily relocate from the USA to the UK .... you are now fully and "hopelessly" immersed in the Metric system.

For better or for worse!!!! Your choice. 

HUGS,
Danielle
 ....

Keep your metric system away from my food, though.

Nobody wants a 0.3048 metre long hotdog.  Or a 0.113 kilogramer with cheese.

[Devlyn]

@Devl:yn
Dear Devlyn
Since you did indeed voluntarily relocate from the USA to the UK .... you are now fully and "hopelessly" immersed in the Metric system.

For better or for worse!!!! Your choice. 

HUGS,
Danielle
 ....

Keep your metric system away from my food, though.

Nobody wants a 0.3048 metre long hotdog.  Or a 0.113 kilogramer with cheese.

Whoa, now, not so fast!

The road signs here are not in metric.... they're holding on to the old traditions
quite well, thank you very much! 

[Oldandcreaky]

Heide, like you, my body produces estrogen. I transitioned to the female role about 35 years ago and after GCS, I no longer needed to take estrogen. However, in my mid-fifties, my estrogen levels did drop into the low normal range. My doctor wasn't concerned and so I wasn't concerned. If you undergo GCS, it'll be nice for you to not need HRT.

[Laura1951]

@Devl:yn
Dear Devlyn
Since you did indeed voluntarily relocate from the USA to the UK .... you are now fully and "hopelessly" immersed in the Metric system.

For better or for worse!!!! Your choice. 

HUGS,
Danielle

 ....

oh, @Danielle is throwing a little "shade" today. She must be feeling better.

Laura

[Rakel]

Keep your metric system away from my food, though.

Nobody wants a 0.3048 metre long hotdog.  Or a 0.113 kilogramer with cheese.

I am not going to touch that comment with a 3 meter pole.

UK people invented the imperial system then abandoned that monstrosity.

When I was in Pharmacy school, I had to learn the metric system, imperial weights and measures, and apothecary system of weights and measures. We had to convert from one system to another by memory. What a pain in the neck.

[pamelatransuk]

Rakel

Do you happen to know why there are 2 forms of measurement for HRT when BOTH are metric please?

What is the thinking for using nano/picomoles as opposed to nano/picograms? I assume there is a separate logical reason for each?

Thanking you

Hugs

Pamela xx

[Rakel]

Rakel

Do you happen to know why there are 2 forms of measurement for HRT when BOTH are metric please?

What is the thinking for using nano/picomoles as opposed to nano/picograms? I assume there is a separate logical reason for each?

Thanking you

Hugs

Pamela xx

I am sure there is a reason, but nobody let me in on the big secret. 

Generally speaking, the initial research team calls the shots and everybody else follows. When similar research is done both in the US and Europe at the same time, you might get different ways of expressing the same thing. This was more common in the days before the internet, but not so much now. So, what we have here is a failure to communicate. Kind of like a famous quote from a popular movie. 

[pamelatransuk]

Thank you Rakel

Hugs

Pamela xx