Topic: Hormone Testing

[ramilove]

My eyes popped out and experienced a <I don't understand> moment yesterday when my hormone E2 test results came in at 973 pg/mL 4 to 5 times higher than I was expecting or wanting my E2. I am still waiting on my total serum T levels. All the other typical blood test were normal. I shot off a question to my doctor and waiting for a reply. I have started researching on line why my E2 could be high.  The best I could find was that I was menstruating, I wish. I am thinking that one of my medications and or supplements  must be interfering with the test accuracy or is interfering with my E2 uptake. 
Has anybody else experienced a wild swing in their E2? What steps do I need to take prior to hormone testing to insure the most accurate test results.
On a side note at the time of the blood was drawn for the hormone test I was fasting, experiencing a brain fog which I attributed to lack of sleep, I feel great now. The other factor was at the time of the brain fog I was fasting and everso slightly dehydrated.

[pamelatransuk]

Hello Ramilove

As you say, your E2 Blood Test result is perhaps quadruple the expected figure.

I assume you are aware of necessity for consistent timing for BT - most doctors advise either trough reading like mine to avoid potential spikes in levels.

You may wish to take a quick look at my Comparison of Blood Test Results thread here on HRT Board last updated December 29th in which you will see that I and several other Members have significantly varying readings.

Just a possibility your reading above is an error at the lab.

Hoping you may resolve with your doctor.

Hugs

Pamela xx

[ramilove]

Pamelatransuk thanks.

The other blood tests on this date were normal,  I drew blood 4 full hours after my last estradiol dose sublingual. My doctor left me a message to stop the estradiol for a week. The excess estradiol may explain the brain fog, so I am thinking test results are real? I will keep note of my moods as my E2 levels drop.
 
My only other hormone test was in September when E2 was 36.5 pg/mL. total T 77 ng/dL.



I was looking around for labs to test my hormone levels, in a addition to what my doctor is providing which tied to what insurance will allow. I need some additional data poinst to understand how my body is reacting and will interface with estradiol. I was hoping to have this understanding prior to the administration of a blocker. I did not want to change more than one variable at a time.

I am waiting on my T level from 1/11/2021 blood draw. I was told T labs usually takes a couple of extra days which has been my experience for the two prior times I had my T tested.

[Rakel]

Pamelatransuk thanks.

The other blood tests on this date were normal, I drew blood 4 full hours after my last estradiol dose sublingual. My doctor left me a message to stop the estradiol for a week. The excess estradiol may explain the brain fog, so I am thinking test results are real? I will keep note of my moods as my E2 levels drop.
 
My only other hormone test was in September when E2 was 36.5 pg/mL. total T 77 ng/dL.

Taking your blood 4 hours after your sublingual dose is the reason your blood level is high.

Try taking your blood sample just immediately before your next dose. It makes a big difference.

[ramilove]

Rakel
Thanks for the reply, it was helpful.
After going down the estradiol/grapefruit rabbit hole, which I eventually dismissed because I am taking the estradiol sublingual route which bi-passes the lower intestines where grapefruit can impact absorption rates, I was still scratching my head. It dawned upon me that I was grossly overthinking and ignoring the obvious. The reason my E2 is too high is because I am taking to much E2. I am such an freaking moron.  My E2 was 973 pg/mL. Looking at the various charts on E2 assimilation, search  (estradiol levels chart mtf sublingual administration) I can see that estradiol levels peak one hour after administration and has a half life of 2 hours. Ball park peak values should be about 700 pg/mL, 350 pg/mL at two hours, and somewhere around a 100 at four hours. 973 pg/mL a couple of hours after administration tells me that my dose is too high and I need to cut back, on my dose. Anyways after months of trying, I will be seeing an endocrinologist that specializes in transgender care who should be able to get my dose straight and hormone levels to female range.
Without going into the sordid details I felt a need to share the following, Minimum hormone test regime for HRT needs to be before starting and then every 3 months until your hormone levels stabilize, then once a year unless you experience a problem which you must report to your medical provider. Follow your medical providers instructions. If you do not like or unwilling to follow instructions, ask as many questions as you need to understand what the medical provider is telling you. Remember a question not asked is a question not answered.   If your medical provider cannot or will not answer your questions Find a medical provider that will answer your questions or will direct you to somebody that can answer your questions.