I recently had my hormone levels checked (at my request because I was having night sweats for a couple of days) for the first time in several years, because my PCP took the auto pilot approach to my HRT with a typical dosage regimen for trans women.
My serum testosterone results came back a day later <3, so I anticipated that my estrogen level was probably high, so I decided to suspend HRT until I knew my estrogen results, which came back 4 days later at a whopping 2700; needless to say I was freaking out as I had no idea how long it had been that high (I did however have an injection the day before the blood draw, and a sublingual tablet the morning of, so I was hoping that my high level was just a spike) so I went directly to my PCP's office to request another test; my results came back at 500, which is still high, but a lot better than 2700!!!
I went to an endocinologist who did another lab, and we are suspending my HRT until the results come back and I meet with her in a couple of weeks; she is on point and will be doing regular labs to check my levels; my options were limited when I started going to my PCP so I basically was just happy to have HRT, but these days we don't have to settle, there are endocrinologists that treat trans people, and will be proactive in our treatment.