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HRT Dosage Concerns

Started by Noah, September 27, 2012, 05:43:03 PM

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Noah

I have been on hrt for 6 weeks! I am so happy. I have seen my nipples begin to grow, and feel those tender achey buds forming...very pleased. I saw my doctor today and she reviewied my testosterone levels with me. She said they have gone down and are below the male range, I think...so thats good. She also said that Estrace was on backorder so we had to change my medication to Premarin...

I have two concerns:

My doctor has me on very low dosages, and she doesn't want to raise them yet. I believe in medically supervised HRT, so I trust her...But I feel like my spiro is just too low, am I being crazy? The dosage I am on doesnt seem to be a dosage any MTF would use...

I am worried Premarin won't work. I am scared that my low Spiro coupled with Premarin will give me no benefits or progress and that nothng will happen in the next two months before our appointment. I dont see her again until December!

Any experience with these things? I'm all worried about it, but realize my doctor knows what shes doing...its just sometimes I don't know what to think because peope online have so many things to say about different meds...
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Stephe

Quote from: Noah on September 27, 2012, 05:43:03 PM
I have been on hrt for 6 weeks! I am so happy. I have seen my nipples begin to grow, and feel those tender achey buds forming...very pleased. I saw my doctor today and she reviewied my testosterone levels with me. She said they have gone down and are below the male range, I think...so thats good. She also said that Estrace was on backorder so we had to change my medication to Premarin...

I have two concerns:

My doctor has me on very low dosages, and she doesn't want to raise them yet. I believe in medically supervised HRT, so I trust her...But I feel like my spiro is just too low, am I being crazy? The dosage I am on doesnt seem to be a dosage any MTF would use...

I am worried Premarin won't work. I am scared that my low Spiro coupled with Premarin will give me no benefits or progress and that nothng will happen in the next two months before our appointment. I dont see her again until December!

Any experience with these things? I'm all worried about it, but realize my doctor knows what shes doing...its just sometimes I don't know what to think because peope online have so many things to say about different meds...


Patience my dear. Most of what you read online in people self medicating and trying to get final results in 6 months. In another thread I wrote how these drugs should be taken in the lowest dose that produces results. If you are feeling what you say already, sounds like it's working fine. And yes Premarin will work fine, but would rather get back on the other when it becomes available again.

Again be patient, you were only given one body. You don't want to break it dumping too much meds thru it!
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Asfsd4214

If your testosterone levels are within the female range (not the same thing though as being below the male range), then your dosage of spironolactone is likely adequate. If they're still a bit above female range, might be worth waiting until you're on estrogen to see if that drops it any further, if not, ask your doctor about maybe increasing your spironolactone dosage.

As for premarin, it's not exactly ideal but if it's just a temporary measure until estrace is available it should suffice.

EDIT: Just wanted to add, only just noticed your avatar, I don't know if that's you but you look pretty passable from just that photo to my eyes already. Just thought I should mention it.  :D
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ShawnaB

The dosages aren't as important as the levels later on.  I started on basically a full dose of everything and quickly couldn't breath properly, had severe fatigue problems, and it was just miserable.  Since then, cut my AA dose in half, doubled my E dose and dropped P completely.  My T levels are half of what they were on a full dose and at the bottom end of the normal female range. My E leves are the same average as any woman if her levels where averaged over her cycle. All the mood crap associated with P is gone. I had the same nipple stuff going on about then too and 3 months in, the girls are definitely there. And I can breath properly again and do things without needing to take a nap after 20 minutes of anything.

I know people with hugely different prescriptions to mine and they're fine too.

Medical supervision good and in this area your mileage really does vary it seems. Speaking of supervision, time to go pick up the form for my next set of bloods.
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sandrauk

I was on Premarin for many years. I did get results initially but the results tailed off.
It may actually be beneficial to have premarin and then estrogen, as now I'm on estrogen it seems to be working well.
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Asfsd4214

Quote from: sandrauk on September 28, 2012, 04:39:13 AM
I was on Premarin for many years. I did get results initially but the results tailed off.
It may actually be beneficial to have premarin and then estrogen, as now I'm on estrogen it seems to be working well.

Estrogen isn't actually a substance, it's a class of substances of which there are many members including the active ingredients of Premarin.

Not trying to criticize your post, it's just a little vague.
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sandrauk

I know, but as I understand it premarin is different being conjugated estrogen..and to be pedantic you said "wait until you're on estrogen" :)
I agree about the avator. If she's already passable the changes are likely to be hard to see
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Asfsd4214

Quote from: sandrauk on September 28, 2012, 05:17:55 AM
I know, but as I understand it premarin is different being conjugated estrogen..and to be pedantic you said "wait until you're on estrogen" :)
I agree about the avator. If she's already passable the changes are likely to be hard to see

OOooh touché.

Though as I said, wasn't trying to be pedantic, I was honestly curious which estrogen you were referring too, I assume estradiol or a prodrug of estradiol.

But yes I'm guilty of the same mistake.  ;D
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sandrauk

The estrogen I've been getting better results with is progynova.
Currently trying estrofem as I reckon if there's a difference (like I found with premarin) I might as well see if one works best.
Just for completeness though, I ought to state that on premarin I was smoking a lot and the difference may be just due to that, But I'm not going to start smoking again to prove the point :laugh:
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Stephe

I've been on a "normal" trans dose of spiro for 18 months and E for 9, my T levels never dropped from starting levels of around 200 and I now have 34B breasts.  Spiro on some people doesn't lower their T level in a blood test but it does block it from doing much of anything. I would not crank up meds based only on blood test levels of T or E.  If I did I would be on insane amounts of meds and I'm not sure it would change my blood level readings, it would just put my health at higher risk. We don't all fit into some cookie cutter recipe of how meds change our body chemistry in specific blood testing. I think people mentally get obsessed with: Female levels in my blood test = I am now female.

Anyway 6 weeks is far too short a time to evaluate where you are.
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Noah

Thank you everyone for sharing your experience wth me - this place always helps me out when I need it to...feeling great! x
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LizMarie

Quote from: Stephe on September 27, 2012, 09:51:06 PM

Patience my dear. Most of what you read online in people self medicating and trying to get final results in 6 months. In another thread I wrote how these drugs should be taken in the lowest dose that produces results. If you are feeling what you say already, sounds like it's working fine. And yes Premarin will work fine, but would rather get back on the other when it becomes available again.

Again be patient, you were only given one body. You don't want to break it dumping too much meds thru it!

Emphasis added! Very true, Stephe! Hormones are both miraculous and potentially dangerous substances. Trust your doctor, get blood tests as required, and talk to your doctor if you have questions. Most will be happy to answer those questions.
The meaning of life is to find your gift. The purpose of life is to give it away.



~ Cara Elizabeth
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judithlynn

Hi Noah;

When I first transitioned I was in my late 20's then early 30s. My endocrinologist first put me in Stilboestrol, but soon moved me onto estradiol and then over time to Premarin. The GIC started me on really low dosages and in those days no T Blockers. I reckon it must have been 6 months with virtually no progress except skin changes, emotional changes and of course no erections. Then I was sent abroad. I had my letters from Dr Russel Reid and the GIC and presented them to my endocrinologist in Australia. She was shocked how little growth I had achieved after so long on E. She immediately put me onto Injections of Primogyn Depot weekly in the thigh. I had to go to my GP for them. After 1 month I was already seeing breast buds, then she doubled my dose on the injections and made the injections once a fortnight. I would then feel  an euphoric hit about 2 hours safter the injection with a flood of estroggen in my system and from then onwards my breasts, hips and bottom all started to blossom with curves. My nipples became large and erect She also put me onto a 21 day cycle of Progesterone and after one month, my breasts start to lactate. She advised the use of a breast pump (both breasts) as that would increase lactation an in the process build the milk producing lobuli. It rreally worked although the amount of milk I produced was very small for the effort involved, although in fact quite pleasurable. Unfortunately when I got back to the UK, my my local endocrinologist put me back onto the Premarin although a much bigger dose, but she was worried about the Progesterone so I wouldnt give a Prescription for that.18 months later I was back in Australia and luckily  my OZ endocrinologist put me back ontro the Injections which I continued until I decided to de-transition . 

I was never on T Blockers, but all my blood tests always showed a low level of T anyway.

What I have now is A Cup - to small B- Cup breasts with large pink aureola and very erect nipples, a rounded bottom and a slight hips.  My nipples are also very evident as they are very firm under a tight T-Shirt. Luckily I never these days have erections.  But unfortunately when you stop the E you start putting weight back onto the Abdomen.

So the message - give it time
Hugs
JudithLynn
:-*
Hugs



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Janae


I can't say much more than everyone else has. I will say that I've been on HRT for almost 3 weeks and my doc started me on a low dose of Spiro and Estrace. I've noticed a slight change in my left breast more than the right but it's getting there. I was self medicating for a short period almost 10yrs ago with Delestrogen no Spiro. I had very noticeable changes within days. I'm waiting for blood work and plan to get back on Delstorgen. But yea it's pretty standard to start of with low dosage in the beginning. Just take your time and marvel about the slow changes.


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Stephe

I think too we have to remember born females don't just one day go from low/no estrogen to super high levels either. It slowly increases, for them over a few years. I know everyone wants to go to bed a guy then wake up a woman and HRT seems like it should do that. It helps but it's not something that happens in a few weeks nor should it.
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Nicolette

Russel Reid put me on a full dose of oestradiol immediately and then some months later cyproterone acetate. No negative side-effects were experienced.
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Azusa John

All medications pose risks for bad reactions.  I have had to change blood pressure meds a number of times because of bad reactions to higher doses.  It seems to be that at a low level I have no bad responses but at a level in which it works, I get some distracting reactions.  So it is a matter of being sensitive to the higher dose.  People sometimes have bad reactions to something at a low dose as I did with Bextra an powerful anti-inflamatory.  So they start you off low to see how effective it is and if you have any bad reactions. Then they work up the doses to find a level that works without creating difficulties and bad reactions.
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PrincessDayna

Quote from: Azusa John on August 20, 2013, 04:54:58 PM
All medications pose risks for bad reactions.  I have had to change blood pressure meds a number of times because of bad reactions to higher doses.  It seems to be that at a low level I have no bad responses but at a level in which it works, I get some distracting reactions.  So it is a matter of being sensitive to the higher dose.  People sometimes have bad reactions to something at a low dose as I did with Bextra an powerful anti-inflamatory.  So they start you off low to see how effective it is and if you have any bad reactions. Then they work up the doses to find a level that works without creating difficulties and bad reactions.

Old post dig up but thank you! I'm about midway through month two hrt as of midnight, and don't see my doc till next month, and was also wondering why I'm on such a low dose of spiro but a high high end of EV....it seems possible they could also do low dose spiro to reduce risk of side effects of that med, while using higher amounts of estrogen to combat T along with it.  Whatever they are doing, it's def working! My areola have triple in diameter, and nipples are very erect and much larger in size as well, down there is drastically different, skin softened, hair growth has slowed, and face *seems* softer, asside from all that the whole ways more sensitive and intuitive emotional aspect.  If he ups my iro I'll be happy, but so far things seem ok.  I don't get too much looks in public, so hey, and I am kinda on the tall range for a female! But hey, good and bad are combined good.  As for my face?  I somewhat notice changes, but others see em more.  Then again I'm always always in the mirror for whatever purpose lol. Hey, I'm vain, oh well lol.  Idk though, to me I don't seem passable, but to others, I do, so something's going right!
"Self truth is evident when one accepts self awareness.  From such, serenity". ~Me  ;)



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Jamie D

One should not worry too much about being "passable" just six weeks into HRT.

It's very early yet.
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PrincessDayna

Quote from: Jamie D on August 20, 2013, 07:57:59 PM
One should not worry too much about being "passable" just six weeks into HRT.

It's very early yet.

If u mean me? I'm on my 10th weekly shot, but ya still early.  I just live full time, dove right in like I used to :) it's a worry, but hey, life has em, and it's an insignificant one compared to living male further as that was destroying me from the inside out lol. Worth that trade.  I'm just wondering how well this is going to effect me in say another year, really.  Guess well see then but counting down the shots none the less :) one a week! It's wayyyy easier then counting the spiro, I'm on my third month of that :)
"Self truth is evident when one accepts self awareness.  From such, serenity". ~Me  ;)



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