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Blood test

Started by Natalia, April 16, 2014, 07:17:55 AM

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Natalia

I know I can't post dosages here, so I'll try to explain it without referring to any dose.

Until now I couldn't see an endocrinologist...just a regular doctor, but she only works with trans people, and she is following my progress.

Here things take a looooong while to happen. I am almost 7 months on HRT and only yesterday I had the results of my blood test revealed. The blood was taken one month ago.

Testosterone level is 32 ng/dL (Female range: <48ng/dL / masculine range: 249-836ng/dL)
Free testosterone level is 17 pmol/L (Female range: 2,4-37pmol/L / Masculine range: 131-640pmol/L)
Prolactin level is 27,17ng/mL (Female range: 5,18-26,53ng/mL / Masculine range: 3,46-19,4ng/mL)

The test with the estrogen level wasn't concluded yet (grrrr!!!)

Everything else was fine. I am in perfect good health. Liver, kidneys, everything fine.

After looking at my exams she asked me to reduce spironolactone for half the dose I am taking (I am with a "usual" dosage, not too high, nor too low) or to change it for cyproterone acetate... and she also told me to stop taking progesterone (I started progesterone without medical recommendation).

Should I follow her recomendations? I am just afraid of seeing my testosterone level rising again...and I don't even know my estrogen level yet!

Also, my prolactin level is a bit high, but she ignored it completely...
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KayXo

I think you should follow your doctor's recommendations but if you don't feel good after change or notice any negative results, let the doctor know immediately and discuss with her what can be done. If you are worried right now, the best person to share your concerns with is the doctor. Be open, frank with her. :)

Were you taking bio-identical progesterone? Why did she say you should stop it? What were her reasons?
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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Natalia

Quote from: KayXo on April 16, 2014, 11:48:48 AM
I think you should follow your doctor's recommendations but if you don't feel good after change or notice any negative results, let the doctor know immediately and discuss with her what can be done. If you are worried right now, the best person to share your concerns with is the doctor. Be open, frank with her. :)

Were you taking bio-identical progesterone? Why did she say you should stop it? What were her reasons?

No, it's not bio-identical progesterone, but I didn't experience any side effect with it. She told me to stop taking it because "just estrogen is enough" and "taking more estrogens can only bring you side effects and no benefit at all". This was the same argument she gave me for reducing spironolactone or changing ir to cyproterone acetate, because she thinks that my dosage is high enough to give me side effects instead of benefits.

I know there is a huge divergence if progesterone is benefical or not...but the thing is: I am not experiencing side effects and all my tests were normal...so, why change the dosages?

It's hard to make contact with her. My next appointment will be in June...
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KayXo

I'm not a doctor and can only go by my own experience and the studies I've come across.

For me, the addition of bio-identical progesterone has been quite beneficial overall. It has helped with breast growth, improved my mood and skin tone. For others, it may do nothing.

Tell your doctor the benefits you get from taking it and maybe she will change her mind. What exactly are you taking then? If it is medroxyprogesterone acetate, do realize that it is associated with several potential side-effects not typically seen with bio-identical progesterone or some other progestins. So it's important to be aware of this also. Final decision should be made in agreement with your doctor.

Everything else, do as she says and see what happens or share your concerns with her now. Be open with her, honest. This will help you if she is good doctor. ;)
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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KayXo

Also, if you are concerned about your testosterone rising, then perhaps switching to cyproterone acetate, as she suggested, could help as it is a potent (very strong) anti-androgen that not only strongly reduces testosterone at  quite low doses but also blocks it. But, as always, there are also side-effects with it like an increase in prolactin occasionally leading to a pituitary tumor, incidence of depression in some, increase in coagulation and some effect on the adrenal gland (similar to corticosteroids) although of the studies I came across, the effect seems negligible but still seems to take place in certain populations.

The rule with estrogen is the lowest effective dose and that may vary from one person to another. Some need more, some need less to feel good and have good feminization. This should be determined by you and your doctor based on how you respond. I personally think how you respond and feel is a more accurate indication than levels. Levels can't in advance guarantee that you will respond favorably or feel good nor can it really be an accurate measure of risks as there are more important factors, namely the type of estrogen and the route of administration. 

Good luck with everything! I don't know if you follow soccer or not but hope Brazil wins the next world cup, I like them too. :)

I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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Mirian

Kay, I'm so happy to see they finally let you write again here :)

The problem with "overdosed" E is simply one: if EVEN some people could potentially have benefits
from a non-physiological level of E (say, in the 1000 pg/ml range) they might never know of it, unless one
goes the experimental DIY route (unsuggested) or her endocrinologist is accepting to do such a test.
My endo for example thinks that I shouldn't go over 150 pg/ml, and that my current level of 400 is
still too high in her opinion.
  •  

Natalia

Quote from: KayXo on April 16, 2014, 03:21:22 PM
Also, if you are concerned about your testosterone rising, then perhaps switching to cyproterone acetate, as she suggested, could help as it is a potent (very strong) anti-androgen that not only strongly reduces testosterone at  quite low doses but also blocks it. But, as always, there are also side-effects with it like an increase in prolactin occasionally leading to a pituitary tumor, incidence of depression in some, increase in coagulation and some effect on the adrenal gland (similar to corticosteroids) although of the studies I came across, the effect seems negligible but still seems to take place in certain populations.

The rule with estrogen is the lowest effective dose and that may vary from one person to another. Some need more, some need less to feel good and have good feminization. This should be determined by you and your doctor based on how you respond. I personally think how you respond and feel is a more accurate indication than levels. Levels can't in advance guarantee that you will respond favorably or feel good nor can it really be an accurate measure of risks as there are more important factors, namely the type of estrogen and the route of administration. 


Thanks for your imput KayXo. I'll probably switch for cyproterone acetate...but I think I'll keep the progesterone, at least until my next appointment. Since I started with it I've noticed that my breasts got fuller...

I am with medroxyprogesterone acetate...but so far I couldn't notice any side effect. Of course, I've been experiencing severe depression and even suicidal thoughs...but this is because I've lost my mother recently (one month ago)...but I am starting to recover from the loss now...I'm not feeling that bad anymore.

About the feminization...since the last month I think I reached that awkward phase where nothing seens to be happening...it is strange.

Quote from: KayXo on April 16, 2014, 03:21:22 PM
Good luck with everything! I don't know if you follow soccer or not but hope Brazil wins the next world cup, I like them too. :)


Hmmm you may not believe, but I am hoping that we lose this World Cup.

I really don't like soccer and the last thing we needed here was to host a World Cup. We have other priorities and we would be much better if the money was spent with health and education. Our public hospitals are crowded and most are of terrible quality. Our schools are even worse. Here in São Paulo things are better than average, but even here nothing works right.

And...oh, perhaps the worst is that the money was not even correctly spent with the World Cup. Corruption here rules. And the stadiums? pfff some are not even concluded yet.

This World Cup will be a total fail... shame.

Quote from: Mirian on April 17, 2014, 07:09:29 AM
The problem with "overdosed" E is simply one: if EVEN some people could potentially have benefits
from a non-physiological level of E (say, in the 1000 pg/ml range) they might never know of it, unless one
goes the experimental DIY route (unsuggested) or her endocrinologist is accepting to do such a test.
My endo for example thinks that I shouldn't go over 150 pg/ml, and that my current level of 400 is
still too high in her opinion.


I don't know yet my estrogen level. It was the only blood test that wasn't concluded by the time I've met my doctor.

Judging for my very low testosterone level, I believe my estrogen level is not too high, or it would be converted to testosterone, right?

It probably isn't too low either, or I should be experiencing andropause and probably osteoporosis. My ionized calcium level is within normal range (4,74mg/dL - reference value: 4,50 - 5,40mg/dL), so no bone loss.
  •  

KayXo

Estradiol cannot convert to testosterone, only the opposite. So there is no risk of increased androgen from high levels of estrogen.
I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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Mirian

Natalia, I agree with Kay's suggestions.
Well CPA is ways better than Spiro (spiro on me never did so much when I was pre op)
As for soccer I also quite hate it :b And note that I'm Italian, here people seems to be caring of
soccer only and nothing else !!!
But when you told me your blood was drawn one month ago and you still haven't your E result, I
can once more agree with you: corruption, waste of money... you're not alone, believe me...
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