Hopelessly low estradiol level, even on injections

[Steph34]

My feminization in recent months has been rather poor, leading me to be concerned that it is because my level is not where it should be.

This is really weird. When I saw the doctor, she told me my level was around 800. I could have sworn it was only near 30. After looking it up on the computer, it appeared they changed the blood results. The "initial result" for estradiol was 31, but the "corrected result" was 808. The estrone result was raised as well. My doctor also found that confusing, so she ordered a repeat test and decided to keep me on the same regimen pending the results. It kind of makes me wonder if the lab suspected that I am trans and decided to report a fake, high level in an attempt to prevent me from getting HRT. Has anyone else seen their blood results modified after the fact?

I asked my doctor why she prefers subcutaneous injections when EV is typically given as an intramuscular injection. The response was that subcutaneous injections produce a steadier level, unlike IM injections which produce a high peak level that crashes to near nothing. She said it is absorbed just as well, but more stable over time.

The doctor even claimed to be considering writing a paper about injecting it subcutaneously, but it was unclear if that comment was serious. If the claim of steadier release is true, that would be beneficial for me given my tendency to quickly metabolize what is already in my blood. I guess I just need to wait for the new result. I intend to switch to twice weekly injections anyway because I usually feel quite low by the weekend after injecting on a Monday.

[Mariah]

It's not uncommon for blood results to be changed or corrected. I would doubt the people who ran the test would have any idea that your transgendered beyond the codes they used to authorize the test in the first place and that isn't taken into account when doing the lab work. The only thing that they do use is if your chart with them shows male or female and only comes into play as to what the normal levels are for many different blood tests. It's good that your doctor is  having it done again to clear up any doubt in concerns to those numbers. Good luck and hugs
Mariah

[KayXo]

When I saw the doctor, she told me my level was around 800. I could have sworn it was only near 30. After looking it up on the computer, it appeared they changed the blood results. The "initial result" for estradiol was 31, but the "corrected result" was 808. The estrone result was raised as well. My doctor also found that confusing, so she ordered a repeat test and decided to keep me on the same regimen pending the results. It kind of makes me wonder if the lab suspected that I am trans and decided to report a fake, high level in an attempt to prevent me from getting HRT. Has anyone else seen their blood results modified after the fact?

I'm as perplexed as you. 

I asked my doctor why she prefers subcutaneous injections when EV is typically given as an intramuscular injection. The response was that subcutaneous injections produce a steadier level, unlike IM injections which produce a high peak level that crashes to near nothing. She said it is absorbed just as well, but more stable over time.

The only thing that personally worries me is that levels that are too steady might desensitize receptors over time whereas some fluctuation might keep them more responsive as with anything that you take. To avoid too much fluctuation, one can decrease frequency of injections; I take them every 5 days, for instance. And on a personal note, I've noticed better response when my hormone was injected in an area where there was less fat vs. more, so that muscle seems to give, at least for me, better bio-availability than if some is perhaps also injected in fat (subcutaneous) because of the thick layer of fat on top of the muscle; i get injected in the butt area!

But, to each their own, and if it works for you and your doctor prescribes it that way, then I have no say, of course. Just sharing with you my own experience and knowledge on the subject.

[Steph34]

The only thing that personally worries me is that levels that are too steady might desensitize receptors over time
whereas some fluctuation might keep them more responsive as with anything that you take.

That makes sense. When I was on weaker products, I did seem to feminize better when I took a few days off occasionally. However, a level that peaks in the thousands and dips to near zero would give me some pretty wild mood swings, and I doubt it would be beneficial given my fast metabolism.

to avoid too much fluctuation, one can decrease frequency of injections; I take them every 5 days, for instance.

My doctor plans to write a prescription for twice per week, although subcutaneously, to stabilize my level.

And on a personal note, I've noticed better response when my hormone was injected in an area where there was less fat vs. more, so that muscle seems to give, at least for me, better bio-availability than if some is perhaps also injected in fat (subcutaneous) because of the thick layer of fat on top of the muscle

I really do not have a choice because the needle I will be given is too small for intramuscular injections, and I would like to give subcutaneous a chance first anyway. You also reported better feminization with progesterone, while I found it masculinizing, so who knows?

Just sharing with you my own experience and knowledge on the subject.

Always welcome

[KayXo]

However, a level that peaks in the thousands and dips to near zero would give me some pretty wild mood swings, and I doubt it would be beneficial given my fast metabolism.

Over exaggeration. This could perhaps be the case if you injected every 3-4 weeks, even with a fast metabolism, but on a weekly basis, this shouldn't occur and I personally have not suffered from wild mood swings due to injections. On the contrary, I feel better, more stable than on pills taken 2-3 times daily.

Enjoy our conversations, as always, Steph and best of luck. I hope you feel better and you deserve it.

[Steph34]

I had awful mood swings on pills taken multiple times per day; the ups and downs were overwhelming, and my feminization was nonexistent. That (and the high estrone level, which I fear could interfere with estradiol) is why I wanted to switch to injections. Still, it has been my experience throughout life that people tend to underestimate my metabolism. Even my doctors were often perplexed by how low my estradiol level was.

[Steph34]

My repeat blood test showed that my level was indeed over 800. I find that very surprising, given that I was on a fairly low dose and my levels have always been lower than predicted, not higher. It does make me wonder about the integrity of the lab, especially given the initial report of 31 for the prior test. I have since received a decrease because a level over 800 is too high for me. An abnormally high level may cause photosensitivity and candidiasis, both of which I have suffered from for a long time, but much more so since switching to injections. Too high a level can also end the development process faster; my doctor says that higher levels only produce more feminization in the short term and not in the long term. I am reluctant to decrease too much, though, because I want to feminize, after all. I think I have reasonably good sensitivity to estradiol, so I should not need an abnormally high level. I will discuss it again with my doctor the next time I see her.

[kaitylynn]

My levels crossed over 100 using patches and I can say that results are pretty obvious.  The constant delivery of the transdermal method has really brought my moods in to a manageable swing and no complaints thus far.  I usually get tested on a Tuesday when the current patches have been on for 3 days, so they are only delivering marginal doses and things are still feeling fine.  Might be worth discussing with your doctor.

[KayXo]

I usually get tested on a Tuesday when the current patches have been on for 3 days, so they are only delivering marginal doses

Patches supposed to be worn every 3.5 days are guaranteed to deliver the same amount of estradiol daily. After 3.5 days, there is no longer any guarantee and this is why it is advised to change patches. Hence, by 3 days, amounts delivered into the blood are still the same.

[Steph34]

My levels crossed over 100 using patches and I can say that results are pretty obvious.  The constant delivery of the transdermal method has really brought my moods in to a manageable swing and no complaints thus far.  I usually get tested on a Tuesday when the current patches have been on for 3 days, so they are only delivering marginal doses and things are still feeling fine.  Might be worth discussing with your doctor.

This was an old topic; I have since switched to patches and I love them! My levels range from 110-220 and I agree that the steadier flow helps with mood swings. I still do have swings because I am an emotional person and levels are not totally steady; I would not want that anyway due to fear of desensitization. My physical results are as good as with any other method and I feel better.

Patches supposed to be worn every 3.5 days are guaranteed to deliver the same amount of estradiol daily. After 3.5 days, there is no longer any guarantee and this is why it is advised to change patches. Hence, by 3 days, amounts delivered into the blood are still the same.

I am not so sure. I have usually received blood tests 1 day after applying a new patch. Once my blood was drawn 2 days after application, and my level was about 40% lower.

[kaitylynn]

Patches supposed to be worn every 3.5 days are guaranteed to deliver the same amount of estradiol daily. After 3.5 days, there is no longer any guarantee and this is why it is advised to change patches. Hence, by 3 days, amounts delivered into the blood are still the same.

That has not been my experience.  When testing with 3 day old patches, my levels were markedly lower than testing the day after applying fresh ones.  The results are individual.

[Rachel]

The normal female T range is 36 to 150 ng/dl. The test I take goes down to 3. I have below 3 ng/dl. (this is on IM with spiro and prometrium).

When I was on pills and everything else the same my T was 22-36 ng/dl.

Your T level could be high. I take a high level of E IM every 10 days.

How many trans does your endo treat?