When to check E and T levels?

[kelseygal]

I am a little over a month and a half in to taking estrogen via mylan patches, and almost 3 months into taking Spiro. My question is, at what intervals should I be thinking about having T and E levels checked? I am oh so curious to see what those numbers look like. What would be pretty normal for say 2 months? I know results can vary, but I just want to make sure I am on the right track, you know?

Just to be clear, I am being treated under Doctor supervision. Had new basic metabolic done yesterday, and I am just as healthy on the higher dose, so that's good

J

[Jessirules]

Why wouldn't you just ask your doctor?

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[Rachel]

My doctor wanted to have my blood done every 3 months the first year then every 6 months from there.

Check with your doctor.

[kelseygal]

Why wouldn't you just ask your doctor?

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Probably the same reason you felt compelled to not give any meaningful feedback. Irrelevant.

[Jessirules]

Nice

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[kelseygal]

My doctor wanted to have my blood done every 3 months the first year then every 6 months from there.

Check with your doctor.

Totally, my doctor and I talked about the same timing but not exactly what tests. Trying to crosscheck what is normal before I talk to her.

[kelseygal]

Nice

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Sorry I snapped at you, it wasn't a cool thing to do. I just get frustrated when people get off track and don't contribute to the thread topic. I made sure it was clear that my doctor is involved, but wanted to know what Is 'normal'. There isn't necessarily a 'normal' which is exactly why I wanted to hear more annecdotes from people here first.

[Jessirules]

Got it

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[KayXo]

I am a little over a month and a half in to taking estrogen via mylan patches, and almost 3 months into taking Spiro. My question is, at what intervals should I be thinking about having T and E levels checked? I am oh so curious to see what those numbers look like. What would be pretty normal for say 2 months? I know results can vary, but I just want to make sure I am on the right track, you know?

What matters most to you?: your health, psychological well-being and feminization OR E/T levels? There is no ideal range for everyone, no one really knows but some pretend they do and if you ask them what they base themselves on, they wouldn't be able to provide solid arguments.

E levels vary in time, and vary greatly among ciswomen and even between different labs. The range is VERY wide. T levels have a narrower range but even within than range, sensitivity varies among individuals, some of the T may be blocked by the anti-androgen in question and some of it may not be bioavailable if total T is measured. These tests won't tell you anything you already know, that the regimen you are taking is working or not for you...you'll see it and feel it with your own eyes and mind.

We aren't at school where the higher the mark, the better. In this context, measuring E/T levels provides very little information to the patient but gives the illusion, both to the doctor and patient, that if levels are within a certain arbitrarily chosen range, everything is good when it may not be necessarily so.

I'm not a doctor but to me, it just makes no sense to know levels. Studies have also shown that E levels, in no way, reflect health risks but rather it is the type of estrogen that is taken, that plays a more crucial role.

Have a talk with your doctor and see what they say.

[kelseygal]

Thank you for your input. My method with most things is to see it, believe it, verify with numbers. I know numbers don't tell a story, and I know that observations are limited by our perception.  A healthy dose of the two always seems to be a good way of making the right choice. I can see this is not a good topic for here, so I'll poke around elsewhere and talk to the good doctor

J

[KayXo]

But you should ask yourself, I think, that if ciswomen have levels that range from 20-650 pg/ml, how would you decide which level in that range is good for you, which level you are happy with? If you say any number within that range, but have poor feminization and don't feel good, what then? Also, say you measured levels 2, 6, 12 hours later, who's to say your levels wouldn't be significantly different (higher or lower)? See the problem with E levels?

As to T, yes, the range is narrower (8-90 ng/dl) but still who's to say a lower or higher level isn't better or worse for you? Would T be the same 12 hours later? Is that T all binding to receptors or some of it not bio-available or blocked by anti-androgens? There are still so many other question marks and wouldn't how you feel and actual physical results be more revealing to you as to if current regimen is effective for you?

Food for thought...

[WendyA]

Thank you for your input. My method with most things is to see it, believe it, verify with numbers. I know numbers don't tell a story, and I know that observations are limited by our perception.  A healthy dose of the two always seems to be a good way of making the right choice.

I have no real time input, just wanted to let you know my clinician doesn't check E or T levels because she says the numbers only serve to drive folks nutty.  She does have predetermined upper dose limits but until those limits are reached dose is strictly derived by feedback from the patient and adjusted if the regular blood work indicates any concerns.

[KayXo]

She does have predetermined upper dose limits

Ask her why. Levels of up to 700 pg/ml in men aged 49-91 yrs old were found to have no deleterious effects on health. Levels of up to 75,000 pg/ml in ciswomen during pregnancy don't appear to pose a significant health as otherwise population would have not risen as much it would have in the world AND risk of thrombosis remains low during this period, less than 0.2%, the risk being higher post-partum when levels drop significantly. Breast cancer is also inversely associated with the number of births AND women, in general, suffer less than men from cardiovascular problems.

Am J Obstet Gynecol. 1993 Dec;169(6):1549-53.
Fibrinolytic parameters in women undergoing ovulation induction.

"As serum estradiol levels increased throughout each phase (maximum mean estradiol 739.8 pg/ml)"

"Down-regulation of the fibrinolytic system was observed as estradiol levels increased. However, thrombin formation did not change, thus suggesting that elevated circulating estradiol alone does not predispose to a thromboembolic event."

Br J Obstet Gynaecol. 1990 Oct;97(10):917-21.

"There is some anxiety about the possible harmful sequelae of supraphysiological estradiol levels but no data are currently available to show any deleterious effects of these levels on coagulation factors, blood pressure, glucose tolerance or the occurrences of endometrial or breast cancer (Hammond et al. 1974; Thom et id. 1978; Studd B Thom 1981; Armstrong 1988)."

[Floritine]

My E & T levels have been getting checked every 3 months since I started HRT many years ago along with other blood levels that my endo requests and I always ask for a copy for me and my regular GP.

Cheers Tracy