Concerns about estrogen level.

[KayXo]

I never take my hormones until after the test, since I am worried about taking them on an empty stomach. Am I doing something wrong?

With estrogen, I don't think it's a problem. I've never had any problems, either way. With other medications, could be. Like Spiro is sometimes better taken with food to decrease stomach upset, if any. Food also slightly improves Spiro bioavailability which is high already. Progesterone (oral, Prometrium) is usually not recommended to be taken with food as sedative effects are increased (drowsiness, sleepiness) but so is the bioavailability of progesterone. Always check with your pharmacist and doctor.

[teeg]

This is a repost from a while ago



I was taking estrogen sublingually and got blood work done three times within three months at different times and had three drastically different levels reported (as pictured). Nothing in my lifestyle changed throughout these tests - medications, diet, activity, etc.

I've now switched to both lowering my dose and swalloing the pill. I haven't got bloodwork done yet, but already I've noticed my mood steady out and even noticed slight changes (positive) in my face and elsewhere.

My thoughts are that taking it sublingually, although bypassing the liver, emits all the estrogen into the blood at once but fades quickly, hugely inconsistent levels. I'm not an endocrinologist, but having c. 400 levels in the morning and c. 100 levels at night (all occurring within only 12 hours) cannot be healthy for the body.

[KayXo]

My T level went from 25 to 16.

Mine is around 15-16 (total testosterone). I'm post-op though.

For now on, I'm going to take one each for morning, afternoon and evening.  Hopefully that will make things more stable.

Not really as long as you take your tablets sublingually.

[KayXo]

Both 25 and 16 are within the cis female range for T (assuming it's the standard values that go along with those sorts of numbers, the range is about 15-80), and I'd say *dropping* T numbers is a solid indicator that the dose is working and even increasing in effectiveness.

But T is also not the whole story. Finding the right dose of E can be tricky and varies according to the individual.

[KayXo]

I've now switched to both lowering my dose and swalloing the pill. I haven't got bloodwork done yet, but already I've noticed my mood steady out and even noticed slight changes (positive) in my face and elsewhere.

My thoughts are that taking it sublingually, although bypassing the liver, emits all the estrogen into the blood at once but fades quickly, hugely inconsistent levels. I'm not an endocrinologist, but having c. 400 levels in the morning and c. 100 levels at night (all occurring within only 12 hours) cannot be healthy for the body.

Good points. I tend to agree with this. Fluctuations can cause ups and downs in mood, negative neurological symptoms. I sort of noticed this on sublingual, very quick ups and downs. Orally, I also found levels to not be where the should be just based on how I felt, something was off. Duration of action of estradiol seemed too short. On injections, I feel better, levels are up for longer, though levels do fluctuate somewhat on them too but not as much, more steady IF taken frequently enough. I just went from every 7 days to 5 days.

[Apples Mk.II]

With estrogen, I don't think it's a problem. I've never had any problems, either way. With other medications, could be. Like Spiro is sometimes better taken with food to decrease stomach upset, if any. Food also slightly improves Spiro bioavailability which is high already. Progesterone (oral, Prometrium) is usually not recommended to be taken with food as sedative effects are increased (drowsiness, sleepiness) but so is the bioavailability of progesterone. Always check with your pharmacist and doctor.

I will ask my endo on my next control (June the 9th). The only one I take on an empty stomach is the dutasteride capsule. Progesterone is just a topical non-prescription cream for me, endo won't prescribe the real deal.

[Ltl89]

This is a repost from a while ago



I was taking estrogen sublingually and got blood work done three times within three months at different times and had three drastically different levels reported (as pictured). Nothing in my lifestyle changed throughout these tests - medications, diet, activity, etc.

I've now switched to both lowering my dose and swalloing the pill. I haven't got bloodwork done yet, but already I've noticed my mood steady out and even noticed slight changes (positive) in my face and elsewhere.

My thoughts are that taking it sublingually, although bypassing the liver, emits all the estrogen into the blood at once but fades quickly, hugely inconsistent levels. I'm not an endocrinologist, but having c. 400 levels in the morning and c. 100 levels at night (all occurring within only 12 hours) cannot be healthy for the body.

You raise an interesting point.  I always hear sublingual is the way to go with pill form hrt, but maybe that's part of the problem with the instability of my levels.  Maybe that will even effect my results too.  For now, I'm going to just make sure I take them at specific times that are at least 4 hours between each other.  But I'm going to look much further into this.

Mine is around 15-16 (total testosterone). I'm post-op though.

Not really as long as you take your tablets sublingually.

I'm pre-op, but I'm also on sprio.  That's probably why my T level is low in conjunction with my low levels prior to starting hrt. 

Is sublingual really that bad?  Am I hurting my results by taking it this way?  Pills are really the only way I can afford and mentally handle hrt at the moment, so I got to go down this route.  Even if injections work better, I literally can't emotionally handle getting injected on a frequent basis.  I do want to try the pellets at some point when I can afford it.  Still, I'm only able to take pills at the moment, so I want to maximize their effectiveness. 

[Satinjoy]

I will know more in about a week and a half on the sub vs oral serum change.  I had actually tracked hour by hour for sub, drove myself crazy, was a daily roller coaster ride.  Doesn't work for me, will be very interesting to see the new baseline.

What I will say is I feel good on orals, no crashes.  And as far as I can tell, the body is doing what is always does on E.

My T is 35 last test.

The endo is the one who said sub wasn't working and he changed the dose method and timing, one last chance before needles.

To get what I need for estro, I would do needles in a heartbeat.  Its the dollars that worry me, and I don't want any more crashes, nor do I want liver issues.

So its all for the endo to figure out, he has treated many, many trans before.  Me being non binary is interesting for him, not too many of us out there I guess.  Very nice man.

[KayXo]

Progesterone is just a topical non-prescription cream for me, endo won't prescribe the real deal.

Why?

[KayXo]

To get what I need for estro, I would do needles in a heartbeat.  Its the dollars that worry me, and I don't want any more crashes, nor do I want liver issues.

If taken frequently enough for you, you won't experience crashes. Best to usually take weekly, I take them every 5 days now. Since injectables bypass the liver and deliver estradiol in much the same way as genetic women get them, liver should not be compromised. There was no change in liver function or clotting from studies on men afflicted with advanced prostate cancer who were given injectable bio-identical estradiol. 

[KayXo]

One thing I also disliked about sublingual was the inconvenience of it, having to put it under the tongue, wait until it dissolves and do this several times daily.

[luna nyan]

LTL,

You will find that the levels peak higher on sublingual and vary more.  If you're making good progress, I wouldn't be too concerned.  Everyone is anxious to have the boob fairy visit overnight. =)

If your mood is good, T levels are down, then that's a good baseline to go from.  On 3 doses a day, you should make progress regardless.  On the injection thing, it's a common phobia that many people have to get over (think about type 1 diabetics) - if the benefits to you are big enough, I'm sure you'll manage!

I agree with others about the inconvenience of sublingual - it just took too long to dissolve, and I kept on thinking I was having an angina attack sucking on them.  I do like my pellet (scarring be damned!)

[KayXo]

I do like my pellet (scarring be damned!)

That's why I would never go this route, the scarring. I don't heal well. I'd rather injections as they leave absolutely no scar. And I heard that perhaps, too constant levels of E on pellets could desensitize cells to E.

[Ltl89]

LTL,

You will find that the levels peak higher on sublingual and vary more.  If you're making good progress, I wouldn't be too concerned.  Everyone is anxious to have the boob fairy visit overnight. =)

If your mood is good, T levels are down, then that's a good baseline to go from.  On 3 doses a day, you should make progress regardless.  On the injection thing, it's a common phobia that many people have to get over (think about type 1 diabetics) - if the benefits to you are big enough, I'm sure you'll manage!

I agree with others about the inconvenience of sublingual - it just took too long to dissolve, and I kept on thinking I was having an angina attack sucking on them.  I do like my pellet (scarring be damned!)

Yeah, I definitely having results but I 've been on estrogen since June so it's been about a year (well, not really cause my current dose started in October).  It's possible that it could have stopped being as effective, though I doubt that is the case as I've been seeing things improve as of late.  I just worry to much sometimes.

I never had a problem with taking pills sublingually.  The pills always dissolved under my tongue fairly quickly.  In any case, my phobia with needles is very unlikely to go away, lol.

That's why I would never go this route, the scarring. I don't heal well. I'd rather injections as they leave absolutely no scar. And I heard that perhaps, too constant levels of E on pellets could desensitize cells to E.

That's a good point I haven't thought of.  I keep hearing that pellets are amazing and have been considering switching to that in a few months (mainly because of cost issues) but I know nothing about it and the downsides to it.