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The Doctors Blood Test?!?

Started by DanielleA, March 29, 2016, 03:30:07 AM

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DanielleA

Hi everybody. I had a blood test done a couple of weeks ago to see were my hormone levels are at. My GP isn't really trained in trans medications so she asked me to take some printouts of the results to this other doctor who is trained in my needs. I intend on seeing this doctor about my results but I was curious to know what the people on here think.   

DHEAS - 16.0 umol/L
Testosterone - 9.9 nmol/L
Oestrogen - 206 pmol/L

I have a feeling that testosterone should be lower but when I take too many antiandrogen pills, it makes me sick.
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AnonyMs

Wikipedia has some nice charts of blood levels.
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Ms Grace

Sorry, my endo tells me my levels every time I visit and they go whoooosh right over my head. He generally sounds happy so I have never paid much attention to what any of it means.
Grace
----------------------------------------------
Transition 1.0 (Julie): HRT 1989-91
Self-denial: 1991-2013
Transition 2.0 (Grace): HRT June 24 2013
Full-time: March 24, 2014 :D
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Anna R

Quote from: DanielleA on March 29, 2016, 03:30:07 AM
Hi everybody. I had a blood test done a couple of weeks ago to see were my hormone levels are at. My GP isn't really trained in trans medications so she asked me to take some printouts of the results to this other doctor who is trained in my needs. I intend on seeing this doctor about my results but I was curious to know what the people on here think.   

DHEAS - 16.0 umol/L
Testosterone - 9.9 nmol/L
Oestrogen - 206 pmol/L

I have a feeling that testosterone should be lower but when I take too many antiandrogen pills, it makes me sick.

Hi, my latest after 41/2 months are Testosterone-9nmol/L, Estradiol -124pmol/L, she is happy with that at this point.
Aim is T level of 2, E level between 200-400.
Hope this helps.
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DanielleA

It sounds like my testosterone levels are still too high. My DHEAS is also a bit high and Upon googling DHEAS it seems like it is somehow responsible for body hairs , which might explain why it is taking so long to remove my facial hair. Is there any forms of antiandrogens that might not make me sick? I take spironolacitone.
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KayXo

Quote from: DanielleA on March 29, 2016, 03:30:07 AM
DHEAS - 16.0 umol/L
Testosterone - 9.9 nmol/L
Oestrogen - 206 pmol/L

I have a feeling that testosterone should be lower but when I take too many antiandrogen pills, it makes me sick.

DHEAS in ug/dL is 331, higher end of female range in young females, middle range in males under 50. Overall, still somewhat high.

Testosterone in ng/dl is 285 so above female range (under 100) but at low end of male range (can go as high as 1,000).

Oestrogen, which I'm assuming is estradiol and not oestrogen which is the sum of estradiol and estrone (please clarify, just to be sure), is 56 pg/ml, which is the low end of female range, going up to 650 pg/ml during a menstrual cycle. It's slightly higher than male range (10-40).

What anti-androgen are you taking? Are you taking estrogen and how so? oral, patch, gel?

You need to also understand that levels of these hormones will fluctuate over time so for this reason, are not always reliable. They may be significantly higher or lower at another given point in time.

Testosterone is also not a completely accurate indicator as it comprises bound testosterone (to SHBG) which doesn't bind to androgen receptors so best is free testosterone, or bio-available T. If you are taking an anti-androgen that is also blocking testosterone, then you may have high levels but some of this is blocked so perhaps it's ok after all.

Finally, one cannot just based on numbers predict how you will do. It may well be the case that you are quite sensitive and respond well to these levels so perhaps your doctor doesn't need to change a thing, AT THE MOMENT. BUT, usually (or always), doctors will aim for testosterone levels that are at least inferior to 100 ng/dl (3.47 nmol/L) and perhaps ideally around 30-60 ng/dl (1.04-2.08 nmol/L). I am post-op and my levels are 0.3 nmol/L!

To resume, blood levels, in this case, may not reveal much. How you feel and how you respond (feminization, breast growth, hair, skin, fat distribution, etc) will allow you to best gauge whether what you are taking at the moment is working out for you. Much more than numbers. :)

Quote from: Anna R on March 29, 2016, 05:37:08 AMAim is T level of 2, E level between 200-400.

No sense in aiming for levels because of all the reasons cited above. Some women also may need higher levels of E to respond properly and feel good, some lower levels of T, it DEPENDS on the individual. There is no study that has shown a certain level or range works best for all transgendered women. It was arbitrarily set without justification. Even in women, levels fluctuate greatly, from as low as 73 pmol/L - 2,386 pmol/L during one single menstrual cycle.

Quote from: DanielleA on March 29, 2016, 07:04:18 AM
Upon googling DHEAS it seems like it is somehow responsible for body hairs , which might explain why it is taking so long to remove my facial hair.

DHEAS is the inactive form of DHEA which is a WEAK androgen which later converts to more potent androgens such as testosterone and DHT. So one should instead focus on those stronger androgens, especially DHT which is the reason why body hair grows thick and scalp hair sometimes dies. Facial hair, if properly treated (best is electrolysis as it's proven to be permanent) should not regrow, regardless of androgen levels. But, if you are seeing new hairs grow on your face or thinner hairs turn into thicker ones, then yes, lower T and DHT would be best and you should discuss this with your doctor.

QuoteIs there any forms of antiandrogens that might not make me sick? I take spironolacitone.

Taking spironolactone with food sometimes helps. You need to drink enough (pure) water and eat enough salt to avoid side-effects like muscle cramping, tiredness, dizziness, heart palpitations, dryness, headaches. Also limit high potassium stuff.

Other anti-androgens include cyproterone acetate (I personally wouldn't take it due to potential side-effects), bicalutamide (Casodex) and LhRh agonists like Zoladex, Lupron and Synarel. Estrogen can also be taken alone (usually by way of injections) and will, in high enough doses, reduce testosterone levels as the more E there is, the less T the body will produce.



I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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DanielleA

Thankyou for all that info :) . when I began on hrt I was told to take twice as much of my pill as I do now. Back then it puffed up my skin and mum said ( and I quote ) "I looked like a snake!" And then I started getting stomach cramps. But I am so not going to have male range testosterone and will speak to this new doctor. My oestrogen is actually oestradoil ( zumenon 2mg )and my antiandrogen is (spiractin 100 ), sorry I just generalised. My body has feminised a lot since starting hrt. I almost never get called male these days but the menapausal symptoms were really distracting. Menopausal symptoms stopped after recently upping the zumenon pill intake.
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KayXo

Quote from: DanielleA on March 29, 2016, 03:44:20 PM
Thankyou for all that info :) . when I began on hrt I was told to take twice as much of my pill as I do now. Back then it puffed up my skin and mum said ( and I quote ) "I looked like a snake!" And then I started getting stomach cramps. But I am so not going to have male range testosterone and will speak to this new doctor. My oestrogen is actually oestradoil ( zumenon (...) )and my antiandrogen is (spiractin (...)), sorry I just generalised. My body has feminised a lot since starting hrt. I almost never get called male these days but the menapausal symptoms were really distracting. Menopausal symptoms stopped after recently upping the zumenon pill intake.

You should remove dosages as these are not allowed. Try taking Spiro with food or milk. Spiro makes the skin very dry due not only to lower T but also because of increased water/sodium loss (drink water and enough salt). It might help. Spiro increases metabolization of oral estradiol (enzyme CYP3A4) and might decrease overall concentrations of estradiol in the blood, requiring higher doses.

Bio-identical progesterone helps make the skin less dry as it increases skin's production of oil.

I am not a medical doctor, nor a scientist - opinions expressed by me on the subject of HRT are merely based on my own review of some of the scientific literature over the last decade or so, on anecdotal evidence from women in various discussion forums that I have come across, and my personal experience

On HRT since early 2004
Post-op since late 2005
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