What were your testosterone levels when you first started estrogens?

[Charlie Nicki]

Don't know if this type of thread is allowed but I'm not talking about dosage or anything like that.

So I've been on spiro for almost 4 weeks, and had medical exams a week and a half ago. My next appointment with my insurance endocrinologist is almost a month and a half away which is too long! So I will probably look for another one and just pay it out of my pocket to get the hormones sooner. Anyways I read my exams and of course I'm no expert but it was pretty self explanatory, this is what it said:

My estradiol levels: 20.83pg/ml (normal range for a biological male my age is between 7.63 and 42.6)
Total testosterone levels: 426.80ng/dl (normal range for a biological male my age is between 218 and 906)

It seems like everything is within range and the T level is still too high! Do you think a doctor will prescribe estradiol with this level or does it need to be lower? Like is it worth it to pay for a quicker endo appointment now or do I have to wait for the other one in August? I know the T levels need to be low enough so the female hormones have a full effect.

[Michelle_P]

I don't think 4 weeks is quite long enough to see testosterone drop out of the Male range.

Here are my levels at a typical dosage for my particular body mass:


A low dose of Estradiol was added about a month in, and slowly ramped up to a low transition dosage over several months.  I finally got to measurable serum levels with the adjustment made in January, as shown on the February test.

E2 pg/mL
6/9/16   <50
9/9/16   <50
12/4/16   <50
2/5/17   115

It takes time to get the levels where we need them to be, and more time for the effects to happen.

[Rambler]

My baseline tests put my testosterone at 798 ng/dl and my estrogen at 3.6ng/dl (not sure why they converted my E on the lab results, maybe just for ease of comparison between the 2?)

My first follow-up blood test was 7 weeks later and my Testosterone had plummeted down to 53 ng/dl, definitely within female range, but im not sure how settled that number is, I'll be curious to see if there is any change for my next test in September. My estrogen had only gone up to 4 ng/dl, might have been because I was taking sub-lingually and I was a good 10 hours past my dose, so any estradiol had probably left my blood stream by that point. I've since switched to weekly subcutaneous injections, so we'll see if that has an effect on the levels/consistency rather than all of that crazy fluctuating.

[Charlie Nicki]

I don't think 4 weeks is quite long enough to see testosterone drop out of the Male range.

Here are my levels at a typical dosage for my particular body mass:


A low dose of Estradiol was added about a month in, and slowly ramped up to a low transition dosage over several months. 

Hi Michelle this is very helpful. So if I read the graphic correctly, your peak T level was in June 2016, and I assume that's when you started the T blockers so it started descending, and by July 2016 you were down to 450 (close to what I am now) and that's when you got your E prescription, correct? It's probably safe to assume then that I might get a prescription from my doctor as well since I'm down to 425 (probably lower now since the test was taken a week and a half ago) right? In that case, getting the quicker appointment seems like a pretty good idea.

I finally got to measurable serum levels with the adjustment made in January, as shown on the February test.

E2 pg/mL
6/9/16   <50
9/9/16   <50
12/4/16   <50
2/5/17   115

It takes time to get the levels where we need them to be, and more time for the effects to happen.

Can you explain this a bit more? What February test? and what do those last numbers mean?

[Michelle_P]

Hi Michelle this is very helpful. So if I read the graphic correctly, your peak T level was in June 2016, and I assume that's when you started the T blockers so it started descending, and by July 2016 you were down to 450 (close to what I am now) and that's when you got your E prescription, correct? It's probably safe to assume then that I might get a prescription from my doctor as well since I'm down to 425 (probably lower now since the test was taken a week and a half ago) right? In that case, getting the quicker appointment seems like a pretty good idea.

Yes, that's correct. The medications were staged to make sure that if side effects were seen we would know what had caused them.  We were effectively changing one parameter at a time and measuring my response.

E2 pg/mL
6/9/16   <50
9/9/16   <50
12/4/16   <50
2/5/17   115

Can you explain this a bit more? What February test? and what do those last numbers mean?

These are the serum estradiol levels.  The minimum sensitivity of the test if 50 picograms per milliliter (pg/mL), so by this particular test the levels were below the minimum detectable from June through December, when I was on a dosage similar to that used for post-menopausal estrogen replacement to supplement the female bodies reduced production at that time.  In my case I wasn't making estradiol at all, so the supplementation dosage was not adequate and I finally convinced the endocrinologist to adjust things again.   That moved my estradiol level in January of this year into the low/normal range for a pre-menopausal woman, confirmed by the February 2017 test, and improved both my mood and physical changes.

[SadieBlake]

340 before I started estrogen, hasn't been above 20 (that was my last measure before GCS) I've never needed spiro to suppress T, my E dosage alone dies that.

[mako9802]

I don't know what my levels are when I started but I just recently had a serum testosterone test done and my results came back at 20ng/dl..yeah! 

[Kara_Rae]

Before I started my Testosterone was at 224 ng/dl.  Kind of low already so I am hoping at my next appointment it will be down a lot.

[Deborah]

Mine started at 826 ng/dl and 60 days later were at 157 ng/dl.  It took another year and a dosage increase to get it to a minimal level.

They started me off with a transition dosage of E, spiro, & progesterone.

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[natalie.ashlyne]

When I went to see my doctor my level was 334 pg/ml of estrogen and my testosterone is 72pg/ml that was before HRT

[Devlyn]

Here are the numbers from my first test on 1/23/17:

testosterone, total 115 ng/dL  250-1100  completed  L  01/23/2017 
testosterone, serum, free 3.0 pg/mL  35.0-155.0  completed  L  01/23/2017
estradiol, serum <15 pg/mL  < OR = 39  completed  N  01/23/2017

The second visit on 5/1/17:

testosterone, total 140 ng/dL  250-827  completed  L  05/01/2017 
estradiol, serum 92 pg/mL  < OR = 39  completed  H  05/01/2017

[kat69]

Within 2 weeks of starting my T was down to 1.9 nmol/L.  Not sure of,the translation of units. 

[jentay1367]

I was 57 years old and it came in at total testosterone of 1018. Leave it to my body to provide me with ample amounts of something I do not want. Consequently, it's taken some pretty serious doses of IM Estradiol, finasteride, and Spiro to bring it down.  I still have issues with it, and will probably continue to until castration. No fun because the side effects of so much HRTcan be anywhere from annoying to debilitating.

[Charlie Nicki]

Mine started at 826 ng/dl and 60 days later were at 157 ng/dl.  It took another year and a dosage increase to get it to a minimal level.

They started me off with a transition dosage of E, spiro, & progesterone.

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Did you start with the estrogen right away?


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[KayXo]

It's important to also consider the fact that spironolactone not only reduces T and sometimes, it doesn't at all, even at high doses in cismen after several months (studies to confirm this) but ALSO BLOCKS T so that even if your levels are still too high, they may not being doing much in the body because spiro blocks most of it.  This is why relying on blood tests alone may not be helpful and even misleading.

[Deborah]

Did you start with the estrogen right away?


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Yes.  I left the office with the prescription on the first visit.


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[Charlie Nicki]

It's important to also consider the fact that spironolactone not only reduces T and sometimes, it doesn't at all, even at high doses in ciswomen after several months (studies to confirm this) but ALSO BLOCKS T so that even if your levels are still too high, they may not being doing much in the body because spiro blocks most of it.  This is why relying on blood tests alone may not be helpful and even misleading.

Good catch! I hadn't thought about that.