First postop hormone levels - 3 months.

[Susan]

This is for bloodwork done 3 months after my SRS.

All ranges in ()'s are for normal values for Females of my age group. Male Hormones Testosterone Testosterone, Free and Total Testosterone, Serum: 8 (ng/dL:      8 - 48) Free Testosterone(Direct): 0.5 (pg/mL:    0.0 - 4.2) DHEA-Sulfate: 247.7 High (ug/dL: 41.2 - 243.7) Female Hormones FSH & LH LH: 6.8 mIU/mL                     (Adult Female:                                           Follicular phase      2.4 -  12.6                                           Ovulation phase      14.0 -  95.6                                           Luteal phase          1.0 -  11.4                                           Postmenopausal        7.7 -  58.5) FSH: 9.1 mIU/mL                   (Adult Female:                                           Follicular phase      3.5 -  12.5                                           Ovulation phase       4.7 -  21.5                                           Luteal phase          1.7 -   7.7                                           Postmenopausal       25.8 - 134. Estrogen & Progesterone Estradiol:  63.4 pg/mL            (Adult Female:                                           Follicular phase   12.5 -   166.0                                           Ovulation phase    85.8 -   498.0                                           Luteal phase       43.8 -   211.0                                           Postmenopausal     <6.0 -    54.7                                         Pregnancy                                           1st trimester     215.0 - >4300.0                                         Girls (1-10 years)    6.0 -    27.0) Progesterone: 0.1 ng/mL        (Follicular phase       0.1 -   0.9                                          Luteal phase           1.8 -  23.9                                          Ovulation phase        0.1 -  12.0                                          Pregnant                                             First trimester    11.0 -  44.3                                             Second trimester   25.4 -  83.3                                             Third trimester    58.7 - 214.0                                          Postmenopausal         0.0 -   0.1) Other Cortisol: 13.5 ug/dL               (Cortisol AM         6.2 - 19.4                                          Cortisol PM         2.3 - 11.9)

Gonna check with my doctor about the high DHEA-Sulfate. Also gonna ask about boosting my estrogen some, would ideally like to see it around 300-600 personally, and maybe adding some progesterone to my regimen.

[AutumnLeaves]

I would agree about checking with your doctor about the estrogen. To each their own, but if mine drops below 200 I start to feel unwell and lose some of my breast volume. Of course YMMV. Good luck!

[ainsley]

Definitely up the E, if you ask me.  I shoot for 400-600 and I am post-op.  Feminization is still occurring fr me, so I don't want a post-menopausal level. And I am a big proponent of progesterone.

[Susan]

Interesting...

Elevated DHEA-S levels can cause symptoms or signs of hyperandrogenism in women. Men are usually asymptomatic, but through peripheral conversion of androgens to estrogens can occasionally experience mild estrogen excess. Most mild to moderate elevations in DHEA-S levels are idiopathic. However, pronounced elevations of DHEA-S may be indicative of androgen-producing adrenal tumors. In small children, congenital adrenal hyperplasia (CAH) due to 3 beta-hydroxysteroid deficiency is associated with excessive DHEA-S production. Lesser elevations may be observed in 21-hydroxylase deficiency (the most common form of CAH) and 11 beta-hydroxylase deficiency. By contrast, steroidogenic acute regulatory protein or 17 alpha-hydroxylase deficiencies are characterized by low DHEA-S levels.

Even when I was off female hormones for all those years (12), I still had breast and nipple tenderness which suggested the presence of estrogen...

Both hormones are albumin bound, but binding of DHEA-S is much tighter. In gonads and several other tissues, most notably skin, steroid sulfatases can convert DHEA-S back to DHEA, which can then be metabolized to stronger androgens and to estrogens.

This could explain it. I also have some skin issues and the skin is one of the tight binders of DHEA-S

[Susan]

Back on my pre-surgery prescription and dosage for 3 months, so should have decent estrogen levels again!

Sent from my SM-G935T using Tapatalk

[jentay1367]

Definitely up the E, if you ask me.  I shoot for 400-600 and I am post-op.  Feminization is still occurring fr me, so I don't want a post-menopausal level. And I am a big proponent of progesterone.

Is that 400-600 pg/ml. ?  My Doctor has a fit when I'm  >300 pg/ml. The irony is I feel best there and all my test are reference range and bp is 110/70. I think I'm going to tell her I'm willing to take the responsibility.  My life, my transition. I wish there wasfirmer guidlines for these Doctors. It can be so frustrating.

[ainsley]

Is that 400-600 pg/ml. ?  My Doctor has a fit when I'm  >300 pg/ml. The irony is I feel best there and all my test are reference range and bp is 110/70. I think I'm going to tell her I'm willing to take the responsibility.  My life, my transition. I wish there wasfirmer guidlines for these Doctors. It can be so frustrating.

Yes, these are my last several levels.  I argue with her every time they get down close to 200 (like my last one in Feb).  I tell her I feel better around 400-600 and I am still feminizing, so I want the level that high.  She listens.  If not, I will take matters into my own hands.  My body, my transition, and last time I checked I live in a free country.

232.10 pg/mL
Date: Feb 17, 2017 12:35 p.m. CST

1037.00 pg/mL
Date: Aug 24, 2016 06:00 p.m. CDT

201.00 pg/mL
Date: Nov 20, 2015 09:55 a.m. CST

627.70 pg/mL
Date: Mar 27, 2015 12:09 p.m. CDT

311.90 pg/mL
Date: Jan 09, 2014 07:35 a.m. CST

[Barb99]

Is that 400-600 pg/ml. ?  My Doctor has a fit when I'm  >300 pg/ml. The irony is I feel best there and all my test are reference range and bp is 110/70. I think I'm going to tell her I'm willing to take the responsibility.  My life, my transition. I wish there wasfirmer guidlines for these Doctors. It can be so frustrating.

I've had levels anywhere from high 100's to 850 (pills vs injections) I feel best at 600 and up so I aim for 600. I'm also post op and still feminizing. My doctor would like to see me under 500 so we compromise, I won't stay at 700 and she won't make me go down to 500.

[jentay1367]

I keep hearing these high numbers from women here who report feeling great and I haven't heard anything about strokes, or DVT or liver or kidney failure. So you just have to wonder why these Doctors are willing to let you hover in the low hundreds range and be constantly suffering with Night sweats, hot flashes and mood swings. It's just stupid. And it's frustrating......and ...oh yeah, it kind of makes me

[KayXo]

You need to share the studies with your doctors or else, nothing will ever change. I saved several studies that show that high levels don't pose much risk. Anywhere from 100 to up to 3,000 pg/ml, in men, in transwomen prescribed high doses of injectable estradiol and in ciswomen, sometimes as old as 92 yrs old. One study even concluded that high levels in men reduced cardiovascular and thrombosis risks.

Also...think of pregnancy. Levels can go as high as 75,000 pg/ml, in many orders greater than even the highest levels we ever achieve and yet, the risk of DVT is 0.1% while the risk of pulmonary embolism is 0.01%. Need I really say more?

Do the research, understand it, gather it all up for your doctor and share. The rest will take care of itself...word of mouth, etc. But, it needs to begin with US, YOU!

[jentay1367]

You need to share the studies with your doctors or else, nothing will ever change. I saved several studies that show that high levels don't pose much risk. Anywhere from 100 to up to 3,000 pg/ml, in men, in transwomen prescribed high doses of injectable estradiol and in ciswomen, sometimes as old as 92 yrs old. One study even concluded that high levels in men reduced cardiovascular and thrombosis risks.

Also...think of pregnancy. Levels can go as high as 75,000 pg/ml, in many orders greater than even the highest levels we ever achieve and yet, the risk of DVT is 0.1% while the risk of pulmonary embolism is 0.01%. Need I really say more?

Do the research, understand it, gather it all up for your doctor and share. The rest will take care of itself...word of mouth, etc. But, it needs to begin with US, YOU!

You're right Kay. I'm going to assemble as much of this anecdotal information from real life patients as well as some of the studies proofs I have found and then do some Physician education. What can it hurt after all? She's a lovely woman but could definitely use some different perspective. And you know?  in actuality, it may help the next girl that goes in. Maybe it'll boot up my Karma.  At any rate....it sure can't hurt anyone. Well, maybe my pocket book for printer ink.... Thanks Kay...I got a mission.

[KayXo]

Try and gather mostly scientific data. Read the articles fully, and be sure to understand them. Remain objective, critical and open-minded. Anecdotes don't mean much to most doctors and for good reason. Best of luck on your mission!

[Gail20]

Warning!   I injected high levels of Estradiol Cypionate each week for a couple years.  Everything I read, and was told, indicated the body would just slough off the excess. I had near pregnancy levels of Estrogen in my system. NOT! My Thyroid, sensing that it did not need to regulate as much due to the excess, slowed production; permanently! :-(  Now I'm taking a daily Thyroid supplement Rx for the rest of my life. . . 

[KayXo]

I inject Estradiol Valerate since THREE YEARS now, every 5 DAYS. My levels are quite high, within early pregnancy range. No signs of thyroid slowing down and feeling quite healthy.

[Gail20]

My point was that since there is no benefit at all to high Estrogen levels, and there is a potential downside, why risk it. . . .

[KayXo]

Some women may need higher estrogen levels to feel good and have decent physical results. It depends. The risks of higher estrogen levels appear to be very low if the estrogen is bio-identical and especially, if it is taken non-orally. There are studies and observations that support this in cismen, ciswomen and transwomen. In your case, causality cannot be established and large randomized controlled studies have never shown high estradiol levels to be conducive to a thyroid gland dysfunction. We need to remain as scientific and as objective as possible, I think.

[jentay1367]

The risks of higher estrogen levels appear to be very low if the estrogen is bio-identical and especially, if it is taken orally. 

So correct me if I'm wrong but it seems like time and time again you've stated that injection to be safer than oral administration and here you seem to contradict that previous information. Which provides the safer protocol for maintaining higher E levels, IM or oral?

[KayXo]

Was a typo, should have read "and especially, if it is taken NON-ORALLY". My apologies. I amended my post.

[Gail20]

Bypassing the liver function as much as possible is the safest way to take Estrogen. Intramuscular injections apparently bypass the liver but you can also bypass the liver by letting the Estrogen tabs dissolve under your tongue. I used to do injectibles but the last few years I've let the Estrogen tabs dissolve under my tongue to by pass my liver.