average safe hrt estrogen levels

[brandyh08505]

I am on spironolactone and estradiol and was reading on the forum about what other members test levels were And my thoughts were is there a average safe estrogen level or does it depend on each person what is a safe estrogen level  Also just to share with you I am doing really good with everything I go back Thursday

[Dena]

Depending on a number of factors, estradiol can be very high in the human body but most doctors use a upper limit of 200 pg/ml as that's a normal level in a woman at some point in the month. Averaged out over the month, it's more than a woman would see. On the other hand, I am currently at 51 pg/ml and I am still developing though slow so a low level will still feminize. The chart will give you some idea why the level is used.

[Deborah]

My level was 152 pg/ml last time and my NP was happy with that.  She wasn't very enthused with my idea of increasing my dosage though.  So that stayed the same.  So I'm guessing that somewhere between my 152 to Dena's 200 is a reasonable target.

It did take a long time, 14 months, on a constant dose for mine to get that high though.

[brandyh08505]

Thank you  Dena and Deborah for the input plus the level chat was very helpful 

[Beth Andrea]

My typical E level was around 400...the range that I saw was 350-450. I kept that for the first 3 years or so, then my new endo wanted to reduce my E dose, get it around 200.

He told me to reduce the dose to x (just a small reduction), and come back in a couple months. I didn't want my E reduced, so a couple weeks before returning for bloodwork I cut the dose almost in half...success! My E was about 230, which made the doc happy, and kept my higher dose.

All bloodwork shows normal, btw.

Don't judge me. I honestly could barely function (severe emotional distress) at the lower dose, I'd have hated to suffer with a lowered prescription.

[JLT1]

The MDs and Endos I have spoken with genetally like to have patients run somewhere in the 80-300 range.  None have ever given me a technical reason for the dosages they prescribe other than "its safer, higher dosages carry increased risk".  I think they guess a lot.  I did get one to say "we really don't know".    THAT, is the truth. 

What ever the level you go to, there should be physical changes and you should be able to function as a normal woman. I do well in the 230 range.  If I'm lower, I feel lethargic and if I'm higher, I don't sleep well.  Your level needs to fit you.

Hugs,

Jen

[SadieBlake]

The MDs and Endos I have spoken with genetally like to have patients run somewhere in the 80-300 range.  None have ever given me a technical reason for the dosages they prescribe other than "its safer, higher dosages carry increased risk".  I think they guess a lot.  I did get one to say "we really don't know".    THAT, is the truth. 

What ever the level you go to, there should be physical changes and you should be able to function as a normal woman. I do well in the 230 range.  If I'm lower, I feel lethargic and if I'm higher, I don't sleep well.  Your level needs to fit you.

Hugs,

Jen

Interesting, yes as I've reported in my own hrt thread, starting at the generic dose of IM injected estradiol valerate my estrogen was at 700 for about 4 mknths, then reduced to 350 by halving the dose and now down to 225 after again halving the dose.

I hadn't observed problems with sleep at the higher level and never lethargic, albeit needing more sleep some nights.

The only problem with levels has been my endocrinologist closely questioning at each step about whether I was measuring out my dosage correctly, seemingly assuming that as a trans patient I must be intentionally upping my dose :-(.

[JLT1]

Interesting, yes as I've reported in my own hrt thread, starting at the generic dose of IM injected estradiol valerate my estrogen was at 700 for about 4 mknths, then reduced to 350 by halving the dose and now down to 225 after again halving the dose.

I hadn't observed problems with sleep at the higher level and never lethargic, albeit needing more sleep some nights.

The only problem with levels has been my endocrinologist closely questioning at each step about whether I was measuring out my dosage correctly, seemingly assuming that as a trans patient I must be intentionally upping my dose :-(.

We are all different.  I've got sleep issues from the start. 

Estradiol valerate is an interesting form of estrogen from a metabolic point of view.  It behaves differently depending on metabolism, fitness and fat level.  I'm on a combination of one patch and one estradiol valerate pill.  For me, levels are remarkably stable 24/7.  It took a couple years to get there....

Jen

[Mohini]

I have a suspicion on something about blood testing...  I would think that if you want an accurate level of what is in your body, not just in the blood stream, you would probably need to get biopsies in various places where the estradiol levels are known to exist.  I come at this because of experience with vitamin B-12 (I am vegan, long-term).  I have to wonder how accurate a blood test is as a reflection in the blood stream of the actual levels inside the body tissues away from the bloodstream - are the tissues absorbing and utilizing the nutrients correctly, or is there a problem with the transmission of nutrients across the cell walls into the cells themselves?  What if, for instance, a high calcium count doesn't necessarily mean that you are getting enough calcium, but that half the calcium in the bloodstream might be coming from your food, and the other half from your own bones?  Of the calcium from your bones, is there any detection that it has been bound to acids to neutralize then for safe elimination from your body?  Then that calcium already used for buffering is no longer usable to the body and excreted.

[Dena]

I think that testing if done properly is a good way of measuring the lower level. I am on pills and my test needs to take place 24 hours after my last dosage. At that point the conversion from estrone to estradiol is taking place and any surge from the dosage should have leveled out. With injections, levels are checked shortly before the next injection. If you measure close to the time of dosage, the levels will be higher and not an accurate indication of the normal levels.