HRT observations

[Megan.]

Got the results from my 6-month bloods.

E at 232pmol/L.
No T,  looks like my GP forgot to request it [emoji51]

Also one of my liver function levels was quite above range (ALT 62 U/L), indicating possible liver damage,  that'll probably be all the oral E I've been scoffing! Annoying as I requested patches,  but the NHS GIC clinician just ignored my concerns [emoji853].

I'm seeing my GP next week, so I'll certainly be asking for a different delivery method.

Tonight I'm also in hospital to have the camera up my 'water pipe',  feel like I'm falling to bits! [emoji23]

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[Charlotte F]

Hey Megan

Can't believe you've been riding the E train for six months already!

That level sounds a little bit low to me - not that I'm really any kind of expert but my doctor told me they try and stabilise levels at 300-800pmol/L

I guess if you're concerned about the impact on your liver, perhaps you could take the tablets sublingually?  Hopefully, the high ALT level is just one of those blips though and your doctor will put your mind at rest when you see them next

Good luck tonight with the photo shoot.  My dad had a similar test recently and said it wasn't painful - just a little bit uncomfortable and didn't last too long

My thoughts are with you

[Megan.]

Tnx Charlotte [emoji4].

The NHS have a protocol that ramps it up slowly,  but it should be higher (by their guidelines), so I'll be asking for an increased dose.
I looked into the liver levels and it's only a mild elevation,  so nothing to panic about.

X.

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[steph2.0]

Got the results from my 6-month bloods.

E at 232pmol/L.
No T,  looks like my GP forgot to request it [emoji51]

Tonight I'm also in hospital to have the camera up my 'water pipe',  feel like I'm falling to bits! [emoji23]

I wish the docs would standardize on these things. My endo says they only measure E, and that T isn't important if E is in the right range. So I have no idea what mine is. Apparently low, since things are definitely progressing.

Also, my doc measures levels in pg/dL. Your number for E sounds like what she recommended when measured in those units (around 200 pg/dL). If I convert your 232 from pmol/L (using the calculator here: http://www.endmemo.com/medical/unitconvert/Estradiol.php) it comes out to only 63. Hmmm. [emoji848]

I hope your test went as well as possible. When Charlotte referred to it as a photo shoot, I couldn't help but think, "Yeah, work it baby! Shake it for the camera!" [emoji12]

Steph

[KayXo]

Got the results from my 6-month bloods.

E at 232pmol/L.

VERY low. At that level and no (low) T, most women would feel lousy. What does your doctor say? But, it's possible, E2 (estradiol) levels are higher at another time during the day sooo....

Also one of my liver function levels was quite above range (ALT 62 U/L), indicating possible liver damage,  that'll probably be all the oral E I've been scoffing!

So far, studies haven't shown oral bio-identical E2 to be detrimental to the liver so perhaps it could be something else. Alcohol? Cyproterone acetate? Diet? Let us know what your doctor says...

Also, my doc measures levels in pg/dL. Your number for E sounds like what she recommended when measured in those units (around 200 pg/dL). If I convert your 232 from pmol/L (using the calculator here: http://www.endmemo.com/medical/unitconvert/Estradiol.php) it comes out to only 63. Hmmm. [emoji848]

You are mistaken. It is pg/ml. Check again.

200 pg/dl = 200 pg/100 ml = 2 pg/ml. Range in ciswomen is 20-800 pg/ml during menstrual cycle, up to 75,000 pg/ml during pregnancy.

[steph2.0]

You are mistaken. It is pg/ml. Check again.

Sorry, you're right, of course. I did mean ml. The calculator I referenced did use the correct units.

My endo wanted to see it around 200, and on my last test it was 116, so we bumped up the dosage by 33%. Very happy with the results.

Steph

[Megan.]

KayXo, I can't say I feel bad at all, I've competed in an Olympic triathlon with these levels [emoji4].
I will be asking for an increase in my dose however.
The liver issue could be from the large dose of ciprofloxacin antibiotic I've been on for the last two weeks, but have now thankfully finished.

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[Megan.]

Just got out of my very brief procedure. The surgeon didn't see anything bad but did say there were many narrow points along my plumbing. I have to go back to have these 'stretched',  and then apparently I have to dilate for several months after, not fair given I've still got my OEM equipment.
I did ask if this was worthwhile if I wasn't going to have those bits much longer,  but he's done some GRS procedures before,  and said there would be complications if I didn't do this now.
So a bit of grief to come,  but fundamentally I'm healthy [emoji5]


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[Laurie]

  LMAO Megan, I loved your "No fair" comment and that the news itself was good overall.
Do try to enjoy your practice for the real thing.

Hugs,
   Laurie

[Megan.]

  LMAO Megan, I loved your "No fair" comment and that the news itself was good overall.
Do try to enjoy your practice for the real thing.

Hugs,
   Laurie

Tnx Laurie, I'm really hoping they don't want me to use the same dilators the ladies here use!! [emoji23]

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[Megan.]

Just got back from my GP. They were happy to increase my E again,  to get it up into the preferred range. We discussed my slightly elevated liver levels,  and agreed to recheck them a month after my new dosage level. Patches will be a fallback plan if my liver gets any worse,  but I'm sticking with oral E for now.
Given the emotional super-wobble I had when I last increased my E,  I'm a little wary about another increase, though I'd like to think I've passed over the worst of the emotional road bumps,  we'll see! X

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[KayXo]

Hoping things will actually even out on the higher dose and in a month from now, that liver enzymes come back normal. Cheers Megan!

[josie76]

Megan, good to hear everything is good. Hopefully you are right and the liver enzyme levels are from the antibiotic then. Is your E tablets Estrace(brand name) aka micronized estradiol? If so taking them sublingually will get it into your blood stream without the liver pass. I have not heard of liver issues from bioidenticle estradiol tablets but taking by the digestive route means the liver will convert a large amount to estrone. The body can use estrone as a storable form and convert it back to estradiol as needed but many argue that the liver pass conversion will make your HRT less effective. The only thing I know for certain is that estrone does increase thrombosis risk while estradiol does not. (Estrone and estriol both increase thrombin activity while estradiol does not)

[Bari Jo]

Just got back from my GP. They were happy to increase my E again,  to get it up into the preferred range. We discussed my slightly elevated liver levels,  and agreed to recheck them a month after my new dosage level. Patches will be a fallback plan if my liver gets any worse,  but I'm sticking with oral E for now.
Given the emotional super-wobble I had when I last increased my E,  I'm a little wary about another increase, though I'd like to think I've passed over the worst of the emotional road bumps,  we'll see! X

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I kind of like the emotional road bumps.  When do you get your increase Megan?   My next is Jan 11.  I'm already counting the days.  Let's compare after.

Also you mention you might have to go to patches, depending on liver function.  Is pellets an option?

Bari Jo

[Megan.]

I picked up my new meds this morning,  but still have 6 days of the previous batch,  so soon! Could be a bumpy Xmas hehe

I asked about pellets,  but my local GP clinic does not offer them,  so I'd have to go the local hospital. I'm fine with oral for now. It gives me some finer control if I need to take a break for surgery etc...

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[KayXo]

The only thing I know for certain is that estrone does increase thrombosis risk while estradiol does not. (Estrone and estriol both increase thrombin activity while estradiol does not)

Has cause and effect been established unequivocally? Is the risk not increased because the estrogen is taken orally instead of the high levels of estrone (and estriol)? Don't be so certain, critical analysis is of utmost importance.

Estrace is indeed micronized estradiol.

[Laurie]

Hi Megan,

  "Damn the torpedoes, full speed ahead!" or if you prefer "Ramming speed!" Congrats on the increase. It is possible your emotional ride could get a few more curves added. I think it did in my case though I have no concrete data to substantiate it. It has even been posited that my depression swings may be affected in part to the hormones. I personally do not think that is the case though it is possible I guess. Should you find yourself having difficulties and feel a need to talk, you know you have many here to talk with. You know where I can be found anytime I am online.
  I say sit back and enjoy the ride if you can.

Hugs,
   Laurie

 

[Megan.]

For those interested here is my level history to-date:

*17-may-2016 (before any HRT)
E 124 pmol/L
T 16.4 nmol/L

*01-jul-2016 (low dose E trial)
E 149 pmol/L
T 18.9 nmol/L

*29-jul-2016 (end of low dose trial)
E 115 pmol/L
T 15.3 nmol/L

*11-oct-2017 (on oral E and GnRH blockers,  already had one E increase)
E 237 pmol/L
T 0.3 nmol/L

*06-dec-2017
E 232 pmol/L
T 0.4 nmol/L

You can see the GnRH blocker (Decapeptyl) really works! My E should be in the 300-400 pmol/L range according to NHS GIC protocol,  but they like to ramp it up over several months to get best development. In 6 days my E dosage will be increased,  I'll be getting new levels in about a month. X

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[Megan.]

Hi Megan,

  "Damn the torpedoes, full speed ahead!" or if you prefer "Ramming speed!" Congrats on the increase. It is possible your emotional ride could get a few more cures added. I think it did in my case though I have no concrete data to substantiate it. It has even been posited that my depression swings may be affected in part to the hormones. I personally do not think that is the case though it is possible I guess. Should you find yourself having difficulties and feel a need to talk, you know you have many here to talk with. You know where I can be found anytime I am online.
  I say sit back and enjoy the ride if you can.

Hugs,
   Laurie

Tnx Laurie. This will be my second increase, so I'm hoping the ride will be a little smoother [emoji5]

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[Jayne01]

Hi Megan, I just spent the last couple of hours getting all caught up on this thread. Firstly, I am very glad that your recent heath scare with the blood in your plumbing turned out to be nothing serious.

I really enjoyed reading this thread. I first started low dose E back in June. My dosage was ramped up over 2 months but then I had a major meltdown and stopped taking the meds for a month. I started full dose E and Spiro 6th September, so that is what I am counting as my official HRT start date. Reading your posts all one after another was like reading a timeline of just about everything I have experienced. It's amazing how similar the effects HRT has had on us all. I didn't even realise some of the effects until I read your posts.

Thanks for sharing your experiences.

Jayne