wondering if anything is missing in my lab work

[MichaelaLJ1972]

I don't actually meet with my doctor until Monday the 14th, but I did get the results of my blood work just a couple days ago. I'm not going to go over my complete blood work up, but I'm wondering if everything that should be tested as far as hormones, is being tested... if that makes sense.

Before starting HRT 3 months I had a baseline test done which included these items...

DHEA SULFATE 231  mcg/dL
FSH 5.6  mIU/mL
LH 6.6  mIU/mL
TESTOSTERONE,FR(DIALYSIS) AND TOTAL(LC/MS/MS) SLI TESTOSTERONE, TOTAL, LC/MS/MS 693  ng/dL
FREE TESTOSTERONE 87.3  pg/mL
ESTROGEN, TOTAL, SERUM 201.7  pg/mL

In my pre HRT results, my total estrogen was rated as HIGH/above normal range for a male of my age (43). From what I understand, I was already in the range that endocrinologists shoot for. Am I correct?

Anyway, my 3 month blood work had a few extra things added to the test...

DHEA SULFATE 198
FSH 1.4 mIU/mL
LH 2.9 mIU/mL
TESTOSTERONE, TOTAL, LC/MS/MS 321 ng/dL
FREE TESTOSTERONE 40.8  pg/mL
PROGESTERONE <0.5 ng/mL
ESTROGEN, TOTAL, SERUM 263.8 pg/mL

So this time they tested my progesterone levels. I think they look low compared to where I would want to be, but I could be wrong. I'm on what most would consider a low dose regimen. I am only taking estradiol and spironolactone. I was considering asking my doctor about adding prometrium and finasteride (for help with hair growth) when I talk to her on Monday. I feel as though I am developing quite nicely and think I'll do well with a slightly bumped up dose.

As far as my complete blood work up, everything else looks to be in range. Even my potassium isn't too bad. I was so worried and it seems to be all fine.

[Laura_7]

Here was a discussion on values :

https://www.susans.org/forums/index.php/topic,205886.msg1827645.html#msg1827645


You might ask about bioidentical progesterone ...
it has some anti androgen effects ...
and might help with breast tissue, with rounding ...
many people reported a change in form, less conical ...
it might have fewer side effects than finsateride ...

you might talk it through with your doctor ...


*hugs*

[MichaelaLJ1972]

Am I right that one test is missing though? Sex Hormone Binding Globulin seems to be missing from my results.

I'm definitely going to ask about adding progesterone. The only reason I want finasteride is because it's supposed to help with hair growth. I have some thinning at the temples and crown. I can always wait to see how things look after a year on my current regimen though.

[Laura_7]

Am I right that one test is missing though? Sex Hormone Binding Globulin seems to be missing from my results.

I'm definitely going to ask about adding progesterone. The only reason I want finasteride is because it's supposed to help with hair growth. I have some thinning at the temples and crown. I can always wait to see how things look after a year on my current regimen though.

SHBG seems not to be that decisive ...

Bioidentical progesterone has a few effects ... there are non bioidentical forms called progestins which do not have those effects.

Concerning hair loss quite a few people said they even had some regrowth...

you might also look here:
https://www.susans.org/forums/index.php/topic,203962.msg1814955.html#msg1814955


*hugs*

[KayXo]

You might ask about bioidentical progesterone ...
it has some anti androgen effects ...

Evidence in humans lacking. Negligible. From blood test results, testosterone levels are still in male range and well above female but Spiro may also block some of it. SHBG is unnecessary and as far as I'm concerned, all these values are unnecessary to measure. What matters most is feminization and demasculinization symptoms as well as how you feel.

[Cindy]

You might ask about bioidentical progesterone ...
it has some anti androgen effects ...

Evidence in humans lacking. Negligible. From blood test results, testosterone levels are still in male range and well above female but Spiro may also block some of it. SHBG is unnecessary and as far as I'm concerned, all these values are unnecessary to measure. What matters most is feminization and demasculinization symptoms as well as how you feel.

Let us leave what is necessary or not to the health professionals. Personal opinion is just that. Unqualified personal opinion.

[KayXo]

Opinions may sometimes be helpful as these can then be passed on to the doctor who may agree and act accordingly. Indeed, we are not qualified but some doctors, including mine, do appreciate our feedback as sometimes, they don't even have the time to fully research matters related to HRT in transwomen so our input proves valuable. The doctor, is however, the final authority.

[MichaelaLJ1972]

I'm pretty happy with how well the spiro and estradiol dropped my testosterone. I know I have some more to go, but I think with even just a slight raise in dosage I should do pretty well. Again, as far as I understand, my estrogen levels are actually quite good. So far I am happy with my development, but like most I wish things could happen a little more quickly and with less chaos. I have seen so many transwomen who have had success adding prometrium to their regimen that I am seriously going to talk it over with my doctor. I am correct in thinking that's the bioidentical progesterone?

I'm just trying to be patient waiting for my Monday appointment

[Laura_7]

I am correct in thinking that's the bioidentical progesterone?

Yes.

I'm just trying to be patient waiting for my Monday appointment

Enjoy your weekend.
Time will pass quickly 


*hugs*

[KayXo]

Again, as far as I understand, my estrogen levels are actually quite good.

What is good for one may not be good for another. One cannot set a level for everyone as sensitivity varies from one person to another. There is no study out there showing that a range is ideal for optimum development in transsexual women. Levels are arbitrarily set, without any scientific basis. Question those experts around you, do research and you will see for yourself. Setting levels based on risk is also incorrect as it's not levels, it appears, that determine health risks but rather the route of administration and especially the type of estrogen. If only high levels were indicative of health risks, then we should not see the results we see in some studies and observe what we observe in pregnant women who have extremely high levels, up to 75,000.

The normal range in women can vary anywhere from 20 pg/ml to up to 650 pg/ml during a woman's reproductive age, with levels being in the range of 800-75,000 during pregnancy.

So far I am happy with my development

Isn't this our only goal in the end rather than getting a certain level, that, by the way, also fluctuates from one moment to another so that measurements may not even reflect average level?

Ask your doctor about all these things and you will see for yourself.

[Rachel]

I think talking to your doctor about finasteride is a good move. There are some possible side effects (ED) from finasteride you should also discuss with your doctor. For me, if I had the side effects it would be welcomed at the time. Pretty much a mute point now for me.

I have been on prometrium for a while. I started after 1 year on HRT. There was a reason to wait a year but I do not recall the reason.

I think you made great progress in the 1st 3 months and you are correct to discuss the HRT levels with your doctor.

Good luck tomorrow,

Rachel

[KayXo]

I have been on prometrium for a while. I started after 1 year on HRT. There was a reason to wait a year but I do not recall the reason.

To allow some time for full estrogenic activity as progesterone is slightly anti-estrogenic, perhaps. Or because your doctor wanted to mimic how it is for pubertal girls, thinking the natural approach is probably best for breast development and feminization.