What's up with my blood hemotology?

[Ruth Ruthless]

So 9 months ago, I started HRT. When I came to the endo with my blood work, I was low on B12 and folic acid. My hemotology was also off in seven values. I'd been vegan for a year and a half, replacing meat for mock meat mostly and not making any special health improvements to my nutrition. I never took B12. I was prescribed B12 and folic acid supplements. My iron was fine.

3 months into HRT, the B12 and folic acid levels got better and so did my hemotology.

6 months into HRT, the B12 and folic acid levels got even better but my hemotology went back to what it was before.

And 9 months into HRT, my hemotology is still the same.

The funny thing is, the endo says I'm not anemic anymore. She says these values are what they expect to see in trans women under HRT. So what was sick for me as a male is now healthy for me as a female?

My RBC (Red Blood Cell count), Hematocrit, Hemoglobin and Platelets are low. My Mean Platelet Volume is high. Again, these were better and some in normal range after 3 months HRT, but reverted to pre-HRT levels after 6 and 9 months.

Two values were high before HRT and normalized after HRT: Mean Cell Hemoglobin and Mean Cell Volume.

The normal range stated in the test is for males, so I read the female ranges for the various parameters, and my Hematocrit and Hemoglobin are normal for a female. RBC, Platelets and Mean Platelet Volume are still not normal for females.

In the past two months I've improved my nutrition, eating a lot more fruits, vegetables and legumes so I don't need to take folic acid anymore since I have plenty of folate in what I eat. I'm still taking B12, but less of it per the doctor's recommendation now that my B12 stores are... restored. They found no nutritional deficiency, everything is fine and dandy in my blood test except these hemotology values.

But it seems weird to me, how previously they said to me "you're anemic!"... and I was like, "I don't feel anemic"... and they said "well, maybe you are anemic and got used it"... and I said "okay"... Fixed up my nutrition and I still feel the same as far as strength goes (did help with my belly and digestion though), the blood hemotology is still weird, and now they say "you're perfectly healthy, this is fine, this is what we see in trans women". It's kind of unnerving that the same numbers that said I'm sick now apparantly mean I'm healthy. And I'm worried maybe my GP and endo are telling me everything is okay when it isn't. What do you think?

[Hideyoshi]

You can be anemic and not feel it. I've been struggling with anemia from chronic bleeding for 5 years, and in 2012, I had half the hemaglobin I was supposed to have and I didn't even know it. You can get adjusted to chronic anemia, and it's much different than acute anemia (like if a blood donor donates too much)

Platelet levels being high can indicate anemia from bleeding. My platelet levels are pretty elevated now, as I'm on a pretty bad flareup of inflammatory bowel disease. As far as some of the blood tests being normal now vs before you were on HRT, one explanation might be that they are going off of the female ranges instead of male ranges. Female hematocrit and hemaglobin ranges have a percentage point or two lower threshold than male ranges. This is likely due to the much greater muscle mass that males have.

Really, if you're worried about the doctor's findings, why not get a third opinion? I think you'll be fine.

[Allyda]

I'm not a vegan, but I do avoid red meat in favor of only fish or fowl, and I struggled with anemia and a high white cell count for years before hrt along with low potassium levels and like you, a B12 but also vitamin K deficiency. However, though my white cell count was still high, 3 months on hrt and I didn't need the potassium supplements or vitamin K supplements anymore, and my anemia had vanished. My anemia was so bad at times it made me lethargic.

I'm now coming up on my 9 month mark on hrt and none of my previous problems had returned. And here's the kicker, though I was forced to be a boy growing up by a misguided adopted father I'm intersex, and because of my type of intersex conditions, all my tests throughout my life have been ran in the female range. So there were never tests being ran in the male range nor results being compared to in the male range before hrt, only female ranges. I only mention this because your test results were being compared to the male ranges prior to hrt if I'm understanding this correctly.

So, my hrt pretty much cured my anemia, and both vitamin B12 and vitamin K deficiencies. I feel 100% better, I have boundless energy, and I look younger as a result of finally being for the most part healthy vs how unhealthy I was before hrt. I should mention that I do take a time released iron supplement because I don't eat red meat, and I still do have a slightly high white cell count though not like it was before hrt. I also take both a woman's one a day vitamin and a hair, skin, and nails vitamin.

Before hrt, I felt my anemia and deficiencies, badly. I was so lethargic some days I wouldn't even get out of bed except to feed my cats and use the bathroom.

How do you feel Ruth? Are you having symptoms of any kind? If not you may be okay. Your body is transforming and a lot of hrt Doc;s will discontinue certain blood testsHowever if you are having symptoms you should let your doctors know so they can try to find out what is causing your hemoglobin count. I my case I pretty much feel okay so my Doctors just keep an eye on my high white cell count.

Best wishes

Ally

[Ruth Ruthless]

Physically I'm fine. Emotionally, I'm a wreck. But this was the case both before and after HRT.

[Ruth Ruthless]

As far as I know, relative to my own experience, I have no signs of physical fatigue. Nothing like what you described. The closest I can say is that sometimes when I get up suddenly from lying down or sitting for a long time I might get dizzy for a few seconds. I run 3 times a week and every time I do my heart seems to be able to handle longer and faster runs, as measured by RunKeeper on my phone and as measured subjectively by how much my heart does not feel strained. The running helps with the depression most of the time, until there are specific triggers that are hard for me to handle.

[Allyda]

As far as I know, relative to my own experience, I have no signs of physical fatigue. Nothing like what you described. The closest I can say is that sometimes when I get up suddenly from lying down or sitting for a long time I might get dizzy for a few seconds. I run 3 times a week and every time I do my heart seems to be able to handle longer and faster runs, as measured by RunKeeper on my phone and as measured subjectively by how much my heart does not feel strained. The running helps with the depression most of the time, until there are specific triggers that are hard for me to handle.

If your running that much and are generally as active as your describing you are prolly okay especially if your heart doesn't feel strained. Of course check with your Doctors and express to them your concerns. How you actually feel sometimes is the best indicator of how healthy you are. Other tell tale signs of how healthy you are can be your hair and nails. Splitting and cracked/chipped fingernails often indicate vitamin deficiency. how healthy are your nails?

Ally

[Ruth Ruthless]

My nails have always been great but I don't let them grow very long. My hair is gone since 21 and I'm 34.

[Allyda]

My nails have always been great but I don't let them grow very long. My hair is gone since 21 and I'm 34.

Sorry to hear about your hair. You seem to be doing okay though. You look great in your Avatar pic.

Basically if your blood hemotology is within the normal female ranges and you feel okay, then you prolly are okay. Just, please voice your concerns to your Doctors, and I think you'll be fine. You are female, so it's only logical your blood test results would be within the normal female ranges.

Best wishes

Ally

[Ruth Ruthless]

Thanks, the wigs help me a lot in front of people but since they itch if I wear them for too long, most of the time I have to be without them to give my scalp time to recover, so most of the time I look completely masculine in my eyes and that makes things hard for me that it's impossible for me to feel I'm living full time, unless I feminize so drastically that I'll look feminine even without hair.

This is a picture of me without hair from yesterday so you get an idea how much the hair makes a difference in my case...
https://www.facebook.com/ruthless.band/photos/a.628694403854079.1073741845.575969969126523/784461314944053/?type=1&theater

Some of the values are in female range, 3 of them are not in normal range, neither male nor female normal range.

Anyway, I'm seeing another endo tomorrow since my regular endo is on maternity leave. So I'll be getting that third opinion. Thanks for the feedback!

[Allyda]

Thanks, the wigs help me a lot in front of people but since they itch if I wear them for too long, most of the time I have to be without them to give my scalp time to recover, so most of the time I look completely masculine in my eyes and that makes things hard for me that it's impossible for me to feel I'm living full time, unless I feminize so drastically that I'll look feminine even without hair.

This is a picture of me without hair from yesterday so you get an idea how much the hair makes a difference in my case...
https://www.facebook.com/ruthless.band/photos/a.628694403854079.1073741845.575969969126523/784461314944053/?type=1&theater

Some of the values are in female range, 3 of them are not in normal range, neither male nor female normal range.

Anyway, I'm seeing another endo tomorrow since my regular endo is on maternity leave. So I'll be getting that third opinion. Thanks for the feedback!

Keep us posted how things turn out. your so thin. I wish I could be that thin in the waist.

Ally

[Ruth Ruthless]

It's thanks to my whole plant foods nutrition.

[Allyda]

Saw your Facebook page. Pretty cool! I used to play drums, and later taught myself keyboards guitar, and bass. I had my own PA, and a bunch of equipment. But it all ended when my 91 accident cost me fingers off my dominant left arm, and messed my back and left leg up.

It was only a hobby for me tho. On drums I'm mostly influenced by Niel Peart.

Ally

[Ruth Ruthless]

Sad to hear about your accident. I would really hate it if I couldn't play music! What do you like to do? I am trying to get myself into high gear and release some music. The more I occupy myself the less I will be bummed out by things that aren't working out for me.

[Ruth Ruthless]

Just came back from the endo, she said the numbers are okay because the test often counts two cells that are next to each other as one big cell and that because my other numbers in the test are okay there is nothing to worry about health wise and I shouldn't regard the numbers that are off to be accurate in the context of the rest. So it's nice to get an explanation for why I need not worry about my health.

She was shocked I am now 60 instead of 65 kilograms since the last time I had a checkup 3 months ago. I told her all I did was cut the Coca Cola and fatty junk food, stopped limiting my meals and ate a lot more fruits and vegetables, and healthy whole cooked foods like rice and legumes cooked without oil. As far as I know, I've been eating more calories, mostly in the form of fruit. She said that's impossible. That it's all about total calory count and usage and that I should feel free to eat more calories. Not that I've been limiting them anyway since I switched to eating this way.

She also said my breast, though small, has a fully developed shape now. Is it possible for a breast to be Tanner 5 and still be less than an A cup?

We also spoke about the Estrofem pills, how I have been raising the dose to no effect on my estrogen levels and it's already dangerously high, so we are switching me to Oestrogel.

I asked her about bicalutamide instead of the Androcur, which I was also recommended to try here in the forum and she said they don't have it available in my country and have no experience with it.

That's the update so far 9 months. Wonder what will happen after a year.

I'll also have my first meeting in November with my country's local sex reassignment commitee which will hopefully help me get some operations.

[Allyda]

Sad to hear about your accident. I would really hate it if I couldn't play music! What do you like to do? I am trying to get myself into high gear and release some music. The more I occupy myself the less I will be bummed out by things that aren't working out for me.

pm incoming so as not to derail the thread.

Ally

[Allyda]

Just came back from the endo, she said the numbers are okay because the test often counts two cells that are next to each other as one big cell and that because my other numbers in the test are okay there is nothing to worry about health wise and I shouldn't regard the numbers that are off to be accurate in the context of the rest. So it's nice to get an explanation for why I need not worry about my health.

She was shocked I am now 60 instead of 65 kilograms since the last time I had a checkup 3 months ago. I told her all I did was cut the Coca Cola and fatty junk food, stopped limiting my meals and ate a lot more fruits and vegetables, and healthy whole cooked foods like rice and legumes cooked without oil. As far as I know, I've been eating more calories, mostly in the form of fruit. She said that's impossible. That it's all about total calory count and usage and that I should feel free to eat more calories. Not that I've been limiting them anyway since I switched to eating this way.

She also said my breast, though small, has a fully developed shape now. Is it possible for a breast to be Tanner 5 and still be less than an A cup?

We also spoke about the Estrofem pills, how I have been raising the dose to no effect on my estrogen levels and it's already dangerously high, so we are switching me to Oestrogel.

I asked her about bicalutamide instead of the Androcur, which I was also recommended to try here in the forum and she said they don't have it available in my country and have no experience with it.

That's the update so far 9 months. Wonder what will happen after a year.

I'll also have my first meeting in November with my country's local sex reassignment commitee which will hopefully help me get some operations.

Happy to hear your doing okay. I had the same problem on the pills, less than desireable estrogen levels. At it's highest, 168 pg/ml., so my Endo switched me to injections to hopefully bring my E levels up to where they should be for full transition.

Good luck with the committee!

Ally