Serum Levels At Two Months

[Wynternight]

Blood levels are alright to post as long as there's no dosing info, right?

I just wanted to see what people thought of my blood levels from my two month check.

My T is 22 and estradiol 369. I've seen where the Endocrine Society recommends not going above 200 but I've seen other sources say 400+

I'm wondering where I should be on my estradiol levels. Is 369 a good place or too high, too low?

[Cindy]

Sounds OK at two months, the most important measure at that time is probably the SHBG. This tells the endo how much T is being absorbed by the sex hormone binding globulin and what AA to use.

[Wynternight]

Sounds OK at two months, the most important measure at that time is probably the SHBG. This tells the endo how much T is being absorbed by the sex hormone binding globulin and what AA to use.

Thank you Cindy. These labs were drawn from my GP so she may not be familiar with the SHBG. I'll ask her about getting it done next time I see her.

Choices in AA are pretty limited. I'm on Spiro and dutasteride. I think the only other option would be finasteride but the dutasteride seems to be doing fine. My free T was 0.3% so very well below the normal range of 6.8-21.5 PG/ML.

[Cindy]

Sounds OK at two months, the most important measure at that time is probably the SHBG. This tells the endo how much T is being absorbed by the sex hormone binding globulin and what AA to use.

Thank you Cindy. These labs were drawn from my GP so she may not be familiar with the SHBG. I'll ask her about getting it done next time I see her.

Choices in AA are pretty limited. I'm on Spiro and dutasteride. I think the only other option would be finasteride but the dutasteride seems to be doing fine. My free T was 0.3% so very well below the normal range of 6.8-21.5 PG/ML.

GP will be very familiar with SHBG! It's pretty basic medicine.

Free T is the important thing, yours is fine.

[Steph34]

My T is 22 and estradiol 369. I've seen where the Endocrine Society recommends not going above 200 but I've seen other sources say 400+

I'm wondering where I should be on my estradiol levels. Is 369 a good place or too high, too low?

That estradiol level sounds awfully high to me; in fact, it is much higher than the amount a cis female would typically have, and it is not necessary to attain such a high level to feminize. Above a certain level (usually 100-200, but it can vary), there is little or no additional feminizing effect, but the risk of side effects (like stroke and skin problems) is greatly increased. As such, the recommendation of not going above 200 makes sense. My endocrinologist is familiar with feminization and would never let anyone's level rise over 200.

That T level is very good, though. It is in the lower half of the female range, which is where we ideally want to be. I wish my level were that low.

[Wynternight]

That estradiol level sounds awfully high to me; in fact, it is much higher than the amount a cis female would typically have, and it is not necessary to attain such a high level to feminize. Above a certain level (usually 100-200, but it can vary), there is little or no additional feminizing effect, but the risk of side effects (like stroke and skin problems) is greatly increased. As such, the recommendation of not going above 200 makes sense. My endocrinologist is familiar with feminization and would never let anyone's level rise over 200.

That T level is very good, though. It is in the lower half of the female range, which is where we ideally want to be. I wish my level were that low.

That estradiol level is on a fairly low dose. Being intersexed methinks my body is taking to it like water to someone dying of thirst.

[cass]

Do you know what the unit of measurement is for your test results? reason im asking is there isnt just one unit of measurement so you could be comparing apples with oranges, the endocrine society's 200 is in pg/ml, your test results may be in pg/ml or pmol/l, 200pg/ml is 734 pmol/l give or take

[Wynternight]

Do you know what the unit of measurement is for your test results? reason im asking is there isnt just one unit of measurement so you could be comparing apples with oranges, the endocrine society's 200 is in pg/ml, your test results may be in pg/ml or pmol/l, 200pg/ml is 734 pmol/l give or take

pg/ml

[cass]

What form of estradiol are you taking?

[Wynternight]

What form of estradiol are you taking?

Vivelle Dots. Transdermal patches.

[cass]

Thanks, strange its so high, i was expecting you to say injections or pellets tbh, anyway i guess everyone is different

[TSJasmine]

Yours is way lower than mine was :p T wise, I mean. I think at my 2 1/2 month check up while on a low dose of E & no spiro, my T dropped from an average male range for my age (honestly can't remember) to like 68 or something. Then they raised my E to a more moderate dose & my T dropped to 17 by the 6 month mark, which is also when I tricked my doctor into prescribing me spiro. Now it's at 1 (literally). My doctor has never actually told estrogen levels although last time I saw him, he told me they're at normal levels for an adult female. I even convinced him to raise my dosage & I'm assuming my estrogen levels are even higher now. I can see it in my skin because now I seriously never break out, which is insane since acne runs in my family. You're levels seem to be dropping nicely though I wish mine had dropped that quickly haha

[Wynternight]

Yours is way lower than mine was :p T wise, I mean. I think at my 2 1/2 month check up while on a low dose of E & no spiro, my T dropped from an average male range for my age (honestly can't remember) to like 68 or something. Then they raised my E to a more moderate dose & my T dropped to 17 by the 6 month mark, which is also when I tricked my doctor into prescribing me spiro. Now it's at 1 (literally). My doctor has never actually told estrogen levels although last time I saw him, he told me they're at normal levels for an adult female. I even convinced him to raise my dosage & I'm assuming my estrogen levels are even higher now. I can see it in my skin because now I seriously never break out, which is insane since acne runs in my family. You're levels seem to be dropping nicely though I wish mine had dropped that quickly haha

Your body needs some T in it. Natal women have it in small amounts so you don't want it completely gone.

[TSJasmine]

Your body needs some T in it. Natal women have it in small amounts so you don't want it completely gone.

Seems like I'm doing fine with practically none. My doctor hasn't said it was a problem so I'm assuming I'm fine. He's an insanely cautious doctor. I had to lie to him to even get on spiro & he didn't raise my dose until I was 14 1/2 months on HRT. Still has yet to prescribe me progesterone, too! >.< I wish he would just give it to me without me having to convince him so much.

[Allyda]

Seems like I'm doing fine with practically none. My doctor hasn't said it was a problem so I'm assuming I'm fine. He's an insanely cautious doctor. I had to lie to him to even get on spiro & he didn't raise my dose until I was 14 1/2 months on HRT. Still has yet to prescribe me progesterone, too! >.< I wish he would just give it to me without me having to convince him so much.

My T the last time it was checked was something like 1.1. That was over 6 months ago, and my E has steadily increased so my Endo doesn't even order the tests for T anymore. Also, since all my documents, SSA, and DL's gender markers have been corrected to show me as female it would create problems for their lab cause he'd be ordering a T level check on a female, or so Quest diagnostics says anyway. In any case I'm on a full transition dose and I seem to be doing fine on very little T. I just had new bloodwork done last Friday, and I see my Endo on the 4th so I'll let y'all know how it turns out.

Ally

[BreezyB]

After 5 months on Spiro my T level is unmeasurably low I am told. And so we're trying to get this up now. Never thought I would hear myself say that  but having no T I do notice it with energy levels and sex drive. So I'd like a little please ... We've dropped the Spiro to a very low dose and now trying Cyproterone. Starting to think I've done some damage down there because even Cyproterone is a very low dose. E is at the higher end of female which is great, don't remember the exact reading though but all good. It's just T I'm working to change now

[Wynternight]

After 5 months on Spiro my T level is unmeasurably low I am told. And so we're trying to get this up now. Never thought I would hear myself say that  but having no T I do notice it with energy levels and sex drive. So I'd like a little please ... We've dropped the Spiro to a very low dose and now trying Cyproterone. Starting to think I've done some damage down there because even Cyproterone is a very low dose. E is at the higher end of female which is great, don't remember the exact reading though but all good. It's just T I'm working to change now

That's the issue I'm having; the lack of energy and fatigue. Having some T, in the female range is OK.

[KayXo]

I'm wondering where I should be on my estradiol levels. Is 369 a good place or too high, too low?

Me and my doctors don't care about blood levels because they don't necessarily imply greater health risks or better/poorer feminization. What counts most is the patient's general health, well-being and feminization and what dose/combination meets this. Last I checked, just out of curiosity, my levels were close to 4,000 pg/ml three days after my injection. When you compare to the maximum sometimes reached by cisfemales during pregnancy, up to 75,000, it's not that much. Since being on injections, I'm doing VERY well. Seeing my endo in two days for check-up.

That estradiol level sounds awfully high to me; in fact, it is much higher than the amount a cis female would typically have, and it is not necessary to attain such a high level to feminize. Above a certain level (usually 100-200, but it can vary), there is little or no additional feminizing effect, but the risk of side effects (like stroke and skin problems) is greatly increased. As such, the recommendation of not going above 200 makes sense. My endocrinologist is familiar with feminization and would never let anyone's level rise over 200.

Cisfemales typically reach levels up to 650 during their menstrual cycle (mid-cycle peak) and up to 75,000 during pregnancy. If indeed such high levels were harmful, we would see the death rate of females be MUCH greater than males which is clearly not the case. My own situation actually is quite the opposite. On levels below 1,000, my feminization was poor, I didn't feel good and now on levels much higher, I feel 1000% better, my blood tests are coming back normal, everything is just great. My skin has markedly improved, my face is fuller, body is more curvaceous. There was also a study that followed men with prostate cancer who were treated with non-oral bio-identical estradiol and levels reached up to 700. No complications were noted, even after one year of treatment and this is in an older population that is is sick. In fact, they noted that the treatment could prevent the onset of thrombosis, was protective. Interestingly, also, pregnant women who experience VERY high levels tend to have a lower rate of breast cancer incidence, the more pregnancies, the lesser the rate although we can't, for sure, infer a cause and effect relation but still...if really, high levels were dangerous, we should not observe this.

What levels are ideal for one may not be ideal for the other. Strokes and such have usually been observed with progestins not bio-identical (like Provera) and the use of oral non bio-identical estrogen. I think it's important to specify this.

I'm followed by my family doctor and by an endocrinologist (treating TS patients for more than 20 years) who approve of my current regimen and who, so far, see no problems with this.

Your body needs some T in it. Natal women have it in small amounts so you don't want it completely gone.

I personally question this because how then do people who are completely insensitive to androgens (CAIS) survive and they seem to do quite well too, appear healthy, etc. Personally, I think it's important to have just enough of either hormone in our bodies to feel and look good...how much varies from one person to another obviously. I'm not a doctor, of course but these are my thoughts...

After 5 months on Spiro my T level is unmeasurably low I am told. And so we're trying to get this up now. Never thought I would hear myself say that  but having no T I do notice it with energy levels and sex drive. So I'd like a little please ... We've dropped the Spiro to a very low dose and now trying Cyproterone. Starting to think I've done some damage down there because even Cyproterone is a very low dose. E is at the higher end of female which is great, don't remember the exact reading though but all good. It's just T I'm working to change now

I find that post-op, with very little T but with high levels of E, I have lots of energy, libido, etc. No problems. Cyproterone sometimes tends to kill libido too much because I think it lowers dopamine on top of aggressively blocking/reducing androgens.

[Steph34]

Cisfemales typically reach levels up to 650 during their menstrual cycle (mid-cycle peak) and up to 75,000 during pregnancy.

My comparison was to the average cis female level over the course of a typical month; I am well aware that it varies.

If indeed such high levels were harmful, we would see the death rate of females be MUCH greater than males which is clearly not the case.

Not necessarily, for two reasons: 1) T has been linked to heart attacks and strokes, so it stands to reason that the higher death rate of males could be explained by their higher T levels, not lower E levels. Even if E were bad (which I am certainly not implying), it could simply be that T is even worse. 2) Such high levels exceed the amount that females typically live with long-term, so while E may be good in moderation, it could still be dangerous at excessive levels.

On levels below 1,000, my feminization was poor, I didn't feel good and now on levels much higher, I feel 1000% better, my blood tests are coming back normal, everything is just great.My skin has markedly improved, my face is fuller, body is more curvaceous.

The problem with strokes is that everything really is just great until the day they happen.
Even at a relatively modest level (near 60), my skin became drier and more sensitive to sunlight, and I saw a couple of new flat moles. It is hard to see how having 20 times as much would be good for skin, when having even this much has caused my skin to deteriorate in every way except softness. E does soften skin, but when it is burning and aging with little provocation, that is mild consolation.

In fact, they noted that the treatment could prevent the onset of thrombosis, was protective.

Well of course, high doses of E will be protective in men because they suppress androgens; this probably signifies the harmful effects of T more so than the protective benefits of E.

Interestingly, also, pregnant women who experience VERY high levels tend to have a lower rate of breast cancer incidence, the more pregnancies, the lesser the rate although we can't, for sure, infer a cause and effect relation but still...if really, high levels were dangerous, we should not observe this.

The informed consent form I signed for HRT required me to acknowledge that it could induce breast cancer. The legal experts seem concerned.

What levels are ideal for one may not be ideal for the other.

I agree; some people are more sensitive to its effects. However, if most doctors are unwilling to prescribe it at such high levels, and their professional associations warn against doing so, then they are obviously concerned about serious risks, and such concern among medical professionals does not arise without good scientific evidence.

Strokes and such have usually been observed with progestins not bio-identical (like Provera) and the use of oral non bio-identical estrogen. I think it's important to specify this.

The Endocrine Society does not seem to think bio-identical hormones are any safer, and there seems to be a lack of large-scale studies to prove otherwise.

I personally question this because how then do people who are completely insensitive to androgens (CAIS) survive and they seem to do quite well too, appear healthy, etc. Personally, I think it's important to have just enough of either hormone in our bodies to feel and look good...how much varies from one person to another obviously. I'm not a doctor, of course but these are my thoughts...

I agree with this. Ideal levels should be based on individual needs, and the assumption that some T is necessary is overly simplistic. I would personally love to see how I would respond to a T level that is low by female standards.

I find that post-op, with very little T but with high levels of E, I have lots of energy, libido, etc. No problems. Cyproterone sometimes tends to kill libido too much because I think it lowers dopamine on top of aggressively blocking/reducing androgens.

Dopamine is also important to mood, and mood affects energy. Anti-androgens like cyproterone and spironolactone also can cause dehydration, which reduces energy. Therefore, it would be wrong to assume that a decline in energy from taking such a medication would necessarily be because of their anti-androgenic effects. There are many other factors also affecting energy, like sleep, diet, and exercise. There are plenty of people who feel good without much T.

[awilliams1701]

I was just thinking about how we're still supposed to have some T.
If you've had the surgery does your T level zero out or do you still produce low levels (like a ciswoman)?