HRT blood results

[Roxy]

Blood test results -
What does it mean when your testosterone levels are low ( in female range )
But free testosterone and free androgen are both high and over the normal range

[Rachel]

Hi,

I am not a doctor and the best advise is to call your doctor.

With that said, the total normal T range for females is 36 ng/dl to 150 ng/dl. The total male normal range is 150 to 849. My T is less than 3 and I take prometrium ( metabolizes to T)at night . So if you share  with us your numerical values and units it would be helpful.

[Roxy]

Blood results

FSH:    3.1 IU/L ( 2.0 - 12.0 )

LH:    4.0 IU/L ( 2.0 - 9.0 )

Prolactin:    333 mIU/L ( 50 - 350 )

17b Oestradiol:    309 pmol/L ( < 190 ) HH

Testosterone:    2.6  nmol/L ( 0.5-2.7 )

Free Testosterone:    57  pmol/L ( <50 ) H

Sex hormone binding globulin:    24  nmol/L ( 20-90 )

Free Androgen index:    108 ( <80 ) H


the testosterone is low but the free testosterone and free androgen are high , which is confusing .
I take progynova ( estrogen ) , spricolontane , and Progesterone

[KayXo]

I take prometrium ( metabolizes to T)

Fertil Steril. 2002 Jun;77(6):1125-7.
Effect of oral micronized progesterone on androgen levels in women with polycystic ovary syndrome.

"To determine whether the use of oral micronized progesterone (OMP) to induce withdrawal bleeding in women suspected of having polycystic ovary syndrome (PCOS) alters circulating androgen levels. »

"Eight reproductive-aged women with PCOS."

"Blood was sampled before (week 0) and weekly after (weeks 1 to 4) the administration of OMP (Prometrium, Solvay Pharmaceuticals, Marietta, GA)(...)" (Not a small dose either)

"The mean values of TT, FT, SHBG, DHEAS, A4, and 17-OHP did not change with OMP administration. However, a higher 17-OHP level was observable at the completion of OMP administration (week 2)."

"We conclude that the administration of OMP (...) to induce withdrawal bleeding in women with PCOS does not significantly alter circulating androgen or 17-OHP levels, and can be used to time blood sampling in these patients."

TT = total testosterone
FT = free testosterone

Blood results

FSH:    3.1 IU/L ( 2.0 - 12.0 )

LH:    4.0 IU/L ( 2.0 - 9.0 )

Prolactin:    333 mIU/L ( 50 - 350 )

17b Oestradiol:    309 pmol/L ( < 190 ) HH

Testosterone:    2.6  nmol/L ( 0.5-2.7 )

Free Testosterone:    57  pmol/L ( <50 ) H

Sex hormone binding globulin:    24  nmol/L ( 20-90 )

Free Androgen index:    108 ( <80 ) H


the testosterone is low but the free testosterone and free androgen are high , which is confusing .
I take progynova ( estrogen ) , spricolontane , and Progesterone

Your E is quite low. Are you sure you are taking BIO-IDENTICAL progesterone?

The important thing is you're healthy, feeling good and feminization. If you are concerned about any of these, please see your doctor.

[Roxy]

Yes the progesterone I take is bioindentical progesterone.  My other hormones are cheap but my progesterone costs because factor insisted I use only bioindentical progesterone.

Interesting you say my e levels are low when the lab rates list them as very high "HH" - the ranges are listed next to my numbers. Note you country may use different units to measure numbers.
Had another trans lady tell me her e level are only 190 with twice as much estrogen dose and orchi.
Than other trans lady told me totally different numbers for ideal e range for trans ladies ( slightly different from cis gender females as we have no cycle )

But my concern was my t levels are low and in female range,  but my free t levels and free androgen levels are high , which seems really odd considering my t is level is low. Can anyone explain this ?

[AnonyMs]

There's a wide range of what doctors consider the correct estrogen blood levels. Personally 309 pmol/L would be very bad for me and I wouldn't be seeing a doctor who did that. Others seem happy, so I've no idea if they have nothing to compare it to or its just different for different people.

I wrote a bit about it here
https://www.susans.org/forums/index.php/topic,207756.msg1843224.html#msg1843224

[Soli]

But my concern was my t levels are low and in female range,  but my free t levels and free androgen levels are high , which seems really odd considering my t is level is low. Can anyone explain this ?

my understanding of this is that essentially spiro blocks the androgen receptors so that the T that is produced by your testes (or other) cannot go and bind to the receptors since they are jammed with spiro. So therefore, the T has nowhere to go and is free. And it does nothing. It doesn't bind to the receptors so it does nothing. My doctor does not check it. I would like her to check DHT though, and FSH, she agreed to the latter but couldn't see the point in checking DHT levels. Also, the process, again as I understand it, is that you should produce over time less and less T since it cannot bind, body adjusts to needed levels, I don't know what is the time frame though.

about your levels, they're similar to mine, well 376 E and  2.5 T were my levels 3 months ago. Been on hrt 6 months. I notice that your LH level is at 4.0 and mine at 1.7, which is still normal according to my lab (1.5 - 9.0). In the process of making T and E, like upstream, there is LH and FSH, and... I'm not sure how it works, does higher LH bring more T? 

[KayXo]

Interesting you say my e levels are low when the lab rates list them as very high "HH" - the ranges are listed next to my numbers. Note you country may use different units to measure numbers.

Units in my country are also in pmol/L. Your lab rates it as high because it's comparing them to the MALE range while if it used female range, it would be in the lower range, as it can be anywhere from 73-2,400 pmol/L, depending on the lab.

Than other trans lady told me totally different numbers for ideal e range for trans ladies ( slightly different from cis gender females as we have no cycle )

No such thing as ideal levels.

But my concern was my t levels are low and in female range,  but my free t levels and free androgen levels are high , which seems really odd considering my t is level is low. Can anyone explain this ?

Because your SHBG is LOW and binds T so the more SHBG, the more T is bound and the less free or bio-available T there is.

my understanding of this is that essentially spiro blocks the androgen receptors so that the T that is produced by your testes (or other) cannot go and bind to the receptors since they are jammed with spiro. So therefore, the T has nowhere to go and is free. And it does nothing. It doesn't bind to the receptors so it does nothing.

Spiro also reduces the testosterone production.

Been on hrt 6 months. I notice that your LH level is at 4.0 and mine at 1.7, which is still normal according to my lab (1.5 - 9.0). In the process of making T and E, like upstream, there is LH and FSH, and... I'm not sure how it works, does higher LH bring more T? 

High LH = low sex hormones and forces gonads (ovaries or testicles) to produce more sex hormones. The more E you take, the lower LH and FSH are. Progesterone, cyproterone acetate, LHRH agonists also decrease LH and FSH.

My E levels are very high, LH is under 0.1.