Do you wake to take meds?

[LShipley]

So it seems widely accepted that you want to take your HRT at the same time each day for maximum effectiveness and to keep the levels constant...

For information purposes my doctor has me split mine over the day, both e + spiro.

5 days a week I wake for work at 4:00AM and consequently my hrt schedule begins early. On the 2 days off though I like to sleep in but because of the other 5 days I'm forced to use alarms to wake early to keep the times the same.

Do others do this? Anyone else dealing with extreme time differences on off days? I go out of my way to be as precise as possible to keep levels constant but it sure feels like my life is run by a clock now. 5 alarms set to repeat every day not including my wake up alarm! 

[Deborah]

I take my meds around the same time everyday but also am not concerned if I'm a few hours off for some reason.  If it makes any difference I'm sure it's a very small difference.


It is better to be hated for what you are than to be loved for what you are not.
André Gide, Autumn Leaves

[Devlyn]

You know those pill boxes old people have? Don't worry, you'll end up with one, too! 

Hugs, Devlyn

[Lady Sarah]

Yep. I have one of those pill boxes. I take my pills (supplements included) about an hour after waking. It works very well for me.

[JeanetteLW]

 As far as the HRT meds are concerned, my doctor's instructions are once a day for spiro and E. so no problem there. However like most of us old fogies I have 11 more meds to take along with insulin shots.

  Jeanette

[LShipley]

My pillbox is a keychain so I can take it the exact same time every day, no delay

It makes sense if you think about it. If you are off a couple hours your levels will drop from normal, then your late dosage is fighting to get to normal first thereby minimalizing the effects!

At least that's how I see it lol.

[MissGendered]

I prefer injections for many reasons, one of them being that I don't like to have to remember to take my E pills, nor why...

But my endo has me taking 2/3rds of my E in the morning, and 1/3 at night. My understanding is that after a while one builds up a consistent blood level, and that it may lower a bit between dosages, but never back down to zero.

When I was pre-op and on spiro, I took one at a time through out the day, otherwise it made me dizzy. I was on a lot so it seemed like I was popping a pill every 4 hours, ha ha!

Sometimes I do wake up early on my own, and WANT to take my E, even now, lol. I looooves me some estrogen, oh my, yeessss!!! Good stuff, mmhmm...

Missy

[big kim]

Take them along with other meds soon as I wake up

[V M]

I only set an alarm clock if I need to be somewhere at a specific time

It isn't going to matter much if you sleep in a bit on your days off, it won't even really matter much if you miss a day or two now and then

Just be somewhat consistent, I just take mine when I wake up as part of my daily routine 

[LShipley]

A lot of girls swear they started having improved feminizing effects when they were consistent in times of dosage.

I can only speak for myself though and while I've seen improved effects these last 6 months it also coincided with a switch to sublinguals instead of swallowing. Sleeping in for me is a 5-6 hour difference from work days (4 vs 9ish) so it is more like missing a dose on those days if I don't wake up. 2x a week missing or taking a late dose wouldn't be great.

[MissGendered]

I can only speak for myself though and while I've seen improved effects these last 6 months it also coincided with a switch to sublinguals instead of swallowing.

Sublingual dosing made a big difference for me, too. For a while, when I was doing spiro every four hours, I also spread out my E dosages so I could take a little bit with every spiro tablet. I can't say that helped at all, and I kinda felt like having higher peaks twice a day gave me a palpable boost in femininity. But, these are my impressions, I have no data to back me up.

Missy

[Veda]

So it seems widely accepted that you want to take your HRT at the same time each day for maximum effectiveness and to keep the levels constant...

For information purposes my doctor has me split mine over the day, both e + spiro.

5 days a week I wake for work at 4:00AM and consequently my hrt schedule begins early. On the 2 days off though I like to sleep in but because of the other 5 days I'm forced to use alarms to wake early to keep the times the same.

Do others do this? Anyone else dealing with extreme time differences on off days? I go out of my way to be as precise as possible to keep levels constant but it sure feels like my life is run by a clock now. 5 alarms set to repeat every day not including my wake up alarm! 

Something you may be interested in looking into is your circadian rhythm:
https://en.wikipedia.org/wiki/Circadian_rhythm

I do know that a persons metabolism slows down during sleep, and the effects of medication are changed.  It would seem like it would be more beneficial to have a good restful sleep.

[Veda]

Just wanted to add...

I have a similar schedule and I take a melatonin supplement before bed on work days and it helps quite a bit.

[KayXo]

For me, taking the same dose orally vs sublingually made no difference.

[Veda]

For me, taking the same dose orally vs sublingually made no difference.

Now that I think about it I'm wondering if a mix of the two would work better, sublingual in the morning and ingesting before bed...

[JeanetteLW]

      Most data I've read trends towards the sublingual. From a health point of view it is easier on the liver. The other aspect for it is the school of thought that absorption rate is higher  due to more of it going into the blood stream sublingually than when it has been processed through the liver.

   Jeanette

[KayXo]

I have not read, so far, any study showing that bio-identical estradiol is harmful for the liver but indeed those concerns have been associated with high doses of estrogens used in the past in transsexual women which weren't bio-identical and sometimes taken with a high dose of cyproterone acetate, also known to have adverse effects on the liver at higher doses.

Sublingual would have the advantage of affecting clotting factors less because less of it circulates through the portal vein, connecting the intestines' blood flow to the liver. But no studies, I think, have shown this either. You do end up swallowing some when taken sublingually, I think.

Not an expert though, consult a doctor. As always.

[LShipley]

I'll ask my doctor at the next visit what they think concerning waking or not or what is ideal.

From my stint in the hospital though 6AM was 6AM and it didn't matter if I was sleeping or not.

I get your point on metabolism and your sleep cycle but at the same time.. most of your healing and growth happens in your sleep. Also, I pop the pill and am back to sleep in moments. Less disruption than waking to go to the bathroom or your dog waking you to go out!

It is interesting how varied our methods are! Wonder what they will say in 10 or 20 years?

I told my Dr just schedule the orchiectomy if you want me to take spiro sublingually... No way!

[JeanetteLW]

I have not read, so far, any study showing that bio-identical estradiol is harmful for the liver ...

Sublingual would have the advantage of affecting clotting factors less because less of it circulates through the portal vein, connecting the intestines' blood flow to the liver. But no studies, I think, have shown this either. You do end up swallowing some when taken sublingually, I think.

Not an expert though, consult a doctor. As always.

  Thank you KayXo for your response.

  As a result of it, I've reconfirmed my assertions and have provided a  reference to support them.

   Here is a quote from WebMD on oral estrogen

"Because oral estrogen can be hard on the liver, people with liver damage should not take it. Instead, they should choose a different way of getting estrogen"

   Simple google searches yielded many results to support my comments.  I am neither a doctor nor an expert but I do research what I post unless it is purely an opinion.
   I do welcome others opinions and thoughts as I can use those to do further research and thereby continue educate myself.

    Jeanette

[KayXo]

The problem is when they refer to oral estrogen, they tend to include ALL estrogens regardless if they are bio-identical or not. There is a difference between different types of estrogen (studies confirm this) and they will often overlook this. I also tend to not necessarily believe in everything I read but rather try and find out what exactly anyone's assertions are based on. I always dig deeper.

So until I don't actually see studies that show that oral bio-identical estrogen causes liver damage, I'm not convinced. That's just me though.