Is it safe or wise to take all HRT pills at once?

[Ltl89]

Hey all,

I apologize for yet another question about maximizing efficency here, but I'm feeling a bit desperate and bummed out about my situation lately.  I was wondering if there is an benefit to taking all hrt pills at once rather than splitting them throughout the day.  According to my therapist, taking them together could mimic the spikes of injections and that intrigued me a bit.  Now, I happen to take it 3 times a day and let it dissolve under my tongue, so I'm not sure if this is wise or safe.  I've currently been taking two at a time in the morning and one in the evening.  Can't I just take all 3 at once?  Is that really bad?  Because we can't discuss doses, I apologize for being vague, though I am on a high dose if that helps.  Thanks.  I really appreciate any assistance because I've been going blind with my hrt regimine foor o long that I'd like to finally be proactive about ensuring everything works. 

[Jessica Merriman]

YES that is bad to do. Take all prescription medications as they are prescribed. No other way at all.

[Ltl89]

I should note that I care more about efficiency of hormones than potential risks or health issues.  After all, I'm not going to live forever, so thats my main focus of these questions.  I've been told that it's okay by others in the trans community that have done it this way, so I'm just seeing if there is any truth to it working better.

[Jessica Merriman]

I should note that I care more about efficiency of hormones than potential risks or health issues.

This scares the stuffing out of me. The reason to take them three times a day is to keep a steady supply in your body and not shock your liver or have severe ups and downs. I have seen people online say it is safe to jump from your roof into a swimming pool as well, but I sure am not going to do it. Your doctor knows what is best for you and has your best interest and development at heart. Listen to him, not the internet.

[kira21 ♡♡♡]

Then separate doses as evenly as possible.  If you have three tablets take them evenly spaced.

[Ltl89]

This scares the stuffing out of me. The reason to take them three times a day is to keep a steady supply in your body and not shock your liver or have severe ups and downs. I have seen people online say it is safe to jump from your roof into a swimming pool as well, but I sure am not going to do it. Your doctor knows what is best for you and has your best interest and development at heart. Listen to him, not the internet.

I've got to be honest in that I'm not sure how much my doctor understands transcare.  They've said questionable things that make me wonder how much they understand about MTF transitioning outside of some basic generalities.  They also never instructed me how to take my hormones other than prescribing them.  All these medications must follow a certain guideline in order for pharmacys to fill them or the insurances to cover it.  That doesn't mean that the dosage itself is invalid or unsafe.  I deal with pharmacys for medical clarification all the time.  I'm going for a second opinion, finally, but I was even told by my therapist who deals with many trans patients that taking two at a time would be fine.  Why not three?  If there is a valid health reason or limitation to the effectiveness than I am willing to listen.  I just asked the question and am trying to learn up on it.  I'll probably switch to injections soon, but I want to see what can be done and whether it should be done.

I know your trying to help Jess, so please don't take my questions here personal.  I'm just trying to educate myself and see if anything can be done at the moment to increase my low levels.

Then separate doses as evenly as possible.  If you have three tablets take them evenly spaced.

I was doing this but I was told that taking them all together could create a spike in my levels like injections and that may help me.  My last two lab results showed low E levels with this method, so I'm trying to see what I can do to remedy this.

[kelly_aus]

I've taken mine both as a single dose and split doses throughout the day.. Over 3 months, there was less than 10% difference in serum levels. My doctor rold me to take them all at once.

And I hate to say this, LtL, some of us just don't react well to E, regardless of delivery method, levels, etc.. I've had quite sub-standard results and nothing my dr and I have tried has made any difference.

[Ltl89]

I've taken mine both as a single dose and split doses throughout the day.. Over 3 months, there was less than 10% difference in serum levels. My doctor rold me to take them all at once.

And I hate to say this, LtL, some of us just don't react well to E, regardless of delivery method, levels, etc.. I've had quite sub-standard results and nothing my dr and I have tried has made any difference.

Thanks for the honest answer.  Yeah, I fear I may be less receptive to E than others.  I'll likely give the 3 pills at once a try and go to a follow up appointment to see about injections.  Somethings got to give at this point.  I've offically been taking E for a year with poor results to show.

[kira21 ♡♡♡]

I've currently been taking two at a time in the morning and one in the evening.  Can't I just take all 3 at once? 

Then separate doses as evenly as possible.  If you have three tablets take them evenly spaced.

I was doing this

No, you have not been doing this. You have been bunching the first two. If you want the best effect, then stabilise the level and split three ways if you have three tablets. You can check that with your Dr. (but I would be very surprised if they did not agree).

[kira21 ♡♡♡]

I know you can't post dosages and really it doesn't matter as its the amount in your blood that counts. What are your T, E and SHBG levels?

[Ltl89]

I know you can't post dosages and really it doesn't matter as its the amount in your blood that counts. What are your T, E and SHBG levels?

My last two E levels were 120 and 70.  Those are both pretty low.  The 70 was probably because I forgot to take my pills before getting my labs done.  My last t level was 16 and somewhere in the 20s the time before that.  I've only started bunching the two pills in the morning more recently in response to this in order to create a spike in my levels; although, I would only space them between about 2-3 hours before then.  I'm wondering if all three at onc could increase my levels to an acceptable range.  I'm probably going to go on injections cause it doesn't seem to be working for me.  I've had response to the hormones but I should be having so much more, especially at 25. 

[Hikari]

I only take one pill for E, for a while I cut it into two so that I could spread the doseage around but, it didn't seem to actually change anything. I now take it all at once, but seeing as they don't even make E pills to my knowledge in doses that would be small enough for your 3 to be less or equal to mine I can only imagine you are taking much more than I am, therefore the response might be different.

I am controlling my own hormones with some doctor supervision, and when asking questions as for how I should take it so far everyone suggested just taking the pill rather than cutting it up to try and get a more even dose. Like I said thier advice might not be applicable to someone on a higher dose though.

[Sheala]

Honestly what every one else is saying makes purfect sence, I however bunch all my meds at the beguining of my day. I persinoly dont feel the slight ups and downs of the hormone levels. now when i miss a dose or take late then i start to. I can sat the my hormone levels as last checked, just a few weeks ago, showed that my T is low even for a cis woman, and me E is on par if not just a little low but still in normal range.  now this could be the actual medications that i am taking virsus the timing however there is my experiance.

[Sammy]

Btw, I have read that eating an icecream every time You take E pill makes transition process, in general, more enjoyable.

[Ms Grace]

Please describe "poor results". What were you hoping for after being on HRT for a year? I ask because I wonder if you aren't expecting too much. In the scheme of things one year is not much time... most cis girls have to wait two or three years into their puberty to get decent breast growth.

I say this with no medical knowledge at all, but I wonder where this fascination with spiking comes from. When I used to be on injections of Primogen Depot I had minimal breast growth, and the only noticeable effect was that I was an emotional wreck... that's my experience with a form of spiking. These days I'm on regular oral doses and also have an implant - that's a constant stream of E 24/7 straight into my blood - and I've had more breast growth and feel more emotionally stable than under any previous regimen.

[Ltl89]

I only take one pill for E, for a while I cut it into two so that I could spread the doseage around but, it didn't seem to actually change anything. I now take it all at once, but seeing as they don't even make E pills to my knowledge in doses that would be small enough for your 3 to be less or equal to mine I can only imagine you are taking much more than I am, therefore the response might be different.

I am controlling my own hormones with some doctor supervision, and when asking questions as for how I should take it so far everyone suggested just taking the pill rather than cutting it up to try and get a more even dose. Like I said thier advice might not be applicable to someone on a higher dose though.

Thanks for sharing.  Yeah, I'm not sure what to think cause of the dosage difference.

Honestly what every one else is saying makes purfect sence, I however bunch all my meds at the beguining of my day. I persinoly dont feel the slight ups and downs of the hormone levels. now when i miss a dose or take late then i start to. I can sat the my hormone levels as last checked, just a few weeks ago, showed that my T is low even for a cis woman, and me E is on par if not just a little low but still in normal range.  now this could be the actual medications that i am taking virsus the timing however there is my experiance.

Thanks for sharing.  Just took my third for the day, so I'm going to see if I get the same experience.

Btw, I have read that eating an icecream every time You take E pill makes transition process, in general, more enjoyable.

Ice cream and I don't get along well, lol.  It put on way too much weight for my liking, but I'm crazy and only eat dinner.

Please describe "poor results". What were you hoping for after being on HRT for a year? I ask because I wonder if you aren't expecting too much. In the scheme of things one year is not much time... most cis girls have to wait two or three years into their puberty to get decent breast growth.

I say this with no medical knowledge at all, but I wonder where this fascination with spiking comes from. When I used to be on injections of Primogen Depot I had minimal breast growth, and the only noticeable effect was that I was an emotional wreck... that's my experience with a form of spiking. These days I'm on regular oral doses and also have an implant - that's a constant stream of E 24/7 straight into my blood - and I've had more breast growth and feel more emotionally stable than under any previous regimen.

Poor results would be my appearance, lol.  You've seen it, so you should know, lol.  But seriously, my levels are low.  That's a problem and probably why I'm experiencing so much difficulty.  And it's hard to compare because you do have the implant.  Those seem to work very well, so that might be why you are having even more benefits.  But I want the spiking in order to finally have normal levels for a bit. 

[Ms Grace]

But these "normal levels" will only last for a few hours, just after you take the dose. Then you start to go down, probably ultimately lower than if you took it spaced three times during the day.

You're disappointed by your looks, fair enough, I know what that feels like too - but what were you expecting your looks to be looking like. That seems to be as much a part of this issue for you.

[Ltl89]

But these "normal levels" will only last for a few hours, just after you take the dose. Then you start to go down, probably ultimately lower than if you took it spaced three times during the day.

You're disappointed by your looks, fair enough, I know what that feels like too - but what were you expecting your looks to be looking like. That seems to be as much a part of this issue for you.

But isn't this true of the injections as well?  Is there a difference between the injection and pill route is this regard?  I honestly don't know. 

Looks are important to me, but it's not like a beauty contest or anything.  I'm just sick of being seen as a man.  I hate it so much.  It makes me want to just end it all.  Nothing wrong with being a guy or anything, I love men, but being seen as one causes so much internal grief for me and I can't take it anymore.  If I can't pass, that's all I'll ever be in the eyes of society: a messed up man. 

[Sheala]

from my understanding injection is a larger initial dose with a much higher high, bo then tapers off throughout the time untill your next dose. pills have less high and less low.

[Carrie Liz]

The best thing for feminization is a steady, consistent dose that's held up over months and months and months, and one that gets into the blood stream as directly as possible. Screwing with the dosages forces the body to adjust to things all over again, which will mess with your moods, and possibly mess with your body's levels of SHBG which would only stall feminization rather than making it better.

I messed with my own hormones a few times in the very beginning because I was so sure that something was off, that the anti-androgens I was taking weren't enough, that the E pills weren't enough, but my blood tests disproved me every single time.

Just be patient. If you genuinely feel like one E method isn't working, maybe you can talk to your doctor about switching to patches pellets or injections, because those are all more effective. (Not because of dose, but rather because the E is going directly into the bloodstream.) But messing with dosages is almost always a bad idea.