2 Months HRT. Optimal Hormone Levels?

[yuna]

Hi all,

What were your E and T levels before HRT and after starting on full dose? I started in late November last year with 675 ng/dL of total testosterone and 37 pg/mL of estradiol. After 2 months, my recent lab work shows my estradiol level is at 96 pg/mL and total testosterone 112 ng/dL. I really wish I could get some feedback on the lab result, but my next appointment with my endo is in 5 weeks... After searching on the forum I couldn't find enough information on how quickly the hormone levels should fall into normal female range for people who have just started HRT. Thank you all in advance for any comments or suggestions. >_<```

yuna

<Edit: Doseage>

[Deborah]

I started at 826 ng/dl of T and 43.4 pg/ml of E.  After two months I was 158 ng/dl of T and 71.3 pg/ml of E.  that was on a normal transition dosage.  Later, both values changed a lot more.


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

[SadieBlake]

E 700 pg/ml T 12 ng/ml. That was on just injected estradiol valerate.

I hadn't had an evaluation prior to starting HRT but a test back in 2001 had put me at < 10th percentile  T levels, 450 ng/ml.

[KayXo]

Individuals VARY. Some need more, some less. It depends. There is no such thing as an optimal level for everyone as this would imply that everyone is similar which is obviously utter nonsense. I think if you find a regimen that produces some breast growth, good overall feminization, all the changes that are expected to occur on HRT and you feel good, have energy, etc, then that's all that matters. You should also know that hormone levels fluctuate over time so that they aren't accurate. T is highest in the morning, for instance. Also total testosterone which you provided doesn't say much because part of that is not even active (bound to SHBG) and part of it blocked by spironolactone. Free testosterone or bio-available testosterone is a little more accurate.

Just for your info, from various sources I've come across here are the ranges in ciswomen. Notice how wide the range is for estradiol...

20-650 pg/ml during menstrual cycle, up to 75,000 pg/ml during pregnancy

testosterone levels: 8-90 ng/dl

Best of luck.

p.s.: I'm not an expert and these are just my opinions.

[yuna]

Thank you all so much for the information!

[kat69]

I'm always mixed up with the units that are used.  My last results were 1.9 noml/L for T and 308 pmol/L for E.   The endocrinologist said my T was below a cisfemale and that she wanted me to be at 450 to 550 pmol/L for E which is where she said a cisfemale going through puberty would be.  I've got a month before the next blood test, so we'll see.

[Jenna Marie]

My endo doesn't believe in testing E levels, before or after E, but my total testosterone was 190 ng/dL before I started. (At three months, it was 36 ng/dL, and it dropped slightly from there; I want to say it was in the 20s immediately pre-op.) Oddly, I never had any signs of low T, although I did take very readily to HRT and my T was controlled with a very low dose of E only.

[KayXo]

I'm always mixed up with the units that are used.  My last results were 1.9 noml/L for T and 308 pmol/L for E.   The endocrinologist said my T was below a cisfemale and that she wanted me to be at 450 to 550 pmol/L for E which is where she said a cisfemale going through puberty would be.  I've got a month before the next blood test, so we'll see.

1.9 nmol/L T is equal to 54 ng/dl, well into the female range, right smack in the middle. Below a premenopausal female would be less than 8 ng/dl or 0.3 nmol/L.

A cisfemale going through puberty, based on one source, experiences levels ranging between 10 - 605 pg/ml (37 - 2,221 pmol/L). These were the levels observed in pubertal girls as they were going through the 5 stages of breast growth. Pre-menarche (before secretion of progesterone and the onset of periods), levels were lower (less than 200 pg/ml or 734 pmol/L).

In another study, levels ranged anywhere from less than 0.07 pmol/L to up to 1,121.6 pmol/L throughout the 5 stages of puberty.

The problem with trying to emulate female levels during puberty is that you do not have the same history as them nor is your age the same or the growth hormone levels so that your needs may be quite different. Your body is made different, you had previous masculinization and your sensitivity may be less. In my unprofessional opinion, it's best to find what works best for YOU and only you without making comparisons while keeping things safe for YOU.

Levels also fluctuate over time so that even if the levels measured at time A are within "range", had they been measured later or earlier, they might be out of range also. Blood tests only give levels at a given point in time and for this reason, IMHO, they are quite inaccurate in this particular case.

[Michelle_P]

I started with:

Testosterone  620 ng/dL
Estradiol  < 50 pg/mL

I don't have data for 2 months, but at 1 month in:

Testosterone. 251 ng/dL
Estradiol. < 50 pg/mL

At the 3 month point:

Testosterone 7 ng/dL
Estradiol  < 50 pg/mL

At the 6 month point:

Testosterone  6 ng/dL
Estradiol   < 50 pg/mL

I just had an 8 month test drawn a few hours ago.  I am curious as to whether or not repeated adjustments have moved estradiol above the normal male range, as I would very much like to have some feminization effects.  That is a reason we normally do HRT...

Update:  At 8 months in:

Testosterone  7 ng/dL
Estradiol  115 pg/mL




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[MissGendered]

Hi all,

What were your E and T levels before HRT and after starting on full dose? I started in late November last year with 675 ng/dL of total testosterone and 37 pg/mL of estradiol. After 2 months, my recent lab work shows my estradiol level is at 96 pg/mL and total testosterone 112 ng/dL. I really wish I could get some feedback on the lab result, but my next appointment with my endo is in 5 weeks... After searching on the forum I couldn't find enough information on how quickly the hormone levels should fall into normal female range for people who have just started HRT. Thank you all in advance for any comments or suggestions. >_<```

yuna

<Edit: Doseage>

I was at 775 with T and 2 with E before HRT. My endocrine system was wacked out due to early life medical interventions, so it is unlikely my info is useful for comparison.

On minimal dosages I went to 70 T and mid-300s E in 3 months, if I recall correctly. At 5 months my doc increase E and spiro, and added P, but I was still at about half the usual transition dosages.

There are lots of factors involved, as other mentioned, having to do with genetics, bio-availability, receptor quantities and availability, just to name a few. Timing of blood sampling also impacts results quite markedly.

Generally doctors start low, watch the results, and increase slowly over time. Once they get a feel for how our dosages are impacting us, they generally push the dosages up. I felt E starved, but I was holding back for personal reasons. My levels brought waay more feminization than my dosages were expected to deliver.

Full dosages brought T down below 10 and pushed E into the 500-600 range.

Missy

[yuna]

Thanks again everyone, you are all wonderful. Now I can't help but notice everyone is so different in terms of hormone levels! After reading your responses, I did some research on measuring hormone levels, and it does seem like the levels can fluctuate tremendously during the day. I guess it means with one lab result I can't say much about whether or not I am taking the right dosage.

Since there isn't too much to interpret from my lab result, I'll try to focus on the feminization progress for now instead of getting bogged down by all the numbers. Thanks again. Also please feel free to ask me anything, I'd feel terrible to leech information from you all without giving back. Right now I am still such a newbie, so I've been scratching my head to think of something worth sharing. Anyways, best of luck to all of you. For those of you who are still working on finding the perfect dosage, I have my fingers crossed for you!

yuna


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[MissGendered]

Yuna,

It seems that the 'perfect dosage' is an ever-chnaging thing, too. Cis women's levels fluctuate widely through each day, each day of their cycle, and the stages of life they are in. It seems to me that the best way forward, for me, is to match my dosages with my mental and emotional state, though I have and do sometimes dose with development in mind. But overall, how we feel should be a very important indicator.

One short snippet of hormonal wisdom I heard early on: If I am crying all the time, I am getting too much, if I am angry and impatient, I am getting too little. I know that is pretty broad, but it has in fact been helpful to me to find my upper and lower limits at times.

Good luck, hun!

Missy

[JeanetteLW]

  Prior to starting HRT my total testosterone was:

Test Name:    TESTOSTERONE, TOTAL
Result:    3.7 ng/mL  (370)
Reference Range: 2.8-8  (280-800)
Interpretation:   Note that for women the reference range is: 0.1-0.8 ng/ml

These were my levels at about 6 weeks.


Test Name: ESTRADIOL
Result: 93.0 High
Units: pg/mL
Reference Range: (7.6-42.6)
Interpretation: MALE > 17YRS - 7.6 - 42.6 PG/ML
FEMALE > 17YRS - SEE BELOW:
FOLLICULAR PHASE - 12.5 - 166.0 PG/ML
OVULATION PHASE - 85.8 - 498.0 PG/ML
LUTEAL PHASE - 43.8 - 211.0 PG/ML
POSTMENOPAUSAL - <6.0 - 54.7 PG/ML
PREGNANCY, 1ST TRIMESTER - 215.0 - >4300.0

Test Name: TESTOSTERONE, FREE AND WEAKLY BOUND
Result: 14 Low
Units: ng/dL
Reference Range: (84-402)
Interpretation: FEMALE REFERENCE RANGE: 2 - 29 NG/DL

Test Name: TESTOSTERONE, TOTAL
Result: 0.7 ng/mL (70) Low
Reference Range: (2.8-8) or (280-800)
Note that for women the reference range is:
0.1-0.8 ng/ml (10-80)

Your lab work indicates:
    Normal hormone levels while on estrogen

[yuna]

Thanks so much Missy and JeanetteLW!


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