Diagnosed with Low T, prescribed for it...but really think I'm Trans...

[BrookeW]

For those that want to skip my story, the questions are at the end

Hi All,

This is a very interesting experience to say the least. Quick Backstory, I'm 34 now. My wife left me last May (for a variety of reasons, mostly she couldn't overcome the grief of finding out she was infertile) and the Divorce was finalized a month ago. At the time she left, I was in such a bad brain fog I could barely understand what was going on. I've always had hypothyroidism (runs in the family on both sides) and had been on armour thyroid for years. But I thought something was wrong so I went to a specialist  in July and he immediately doubled my dose. When the bloodwork came back he told me I had low T (T 199, T Free 5.01, T % Free 2.5, T Bioavailable 122), low DHEA (309.1), and low vitamin D (48.2). I changed my supplements for the Vitamin D to increase absorption (I work in a factory with artificial lighting for 12 hour shifts, about half the year I barely see the sun). He also prescribed me a DHEA supplement and Clomiphene to boost my T.

Now at the time I was thinking okay, so my low T explains everything. Why I'm depressed (you know...not counting my divorce, I had been depressed for years), why I have low energy, why I have brain fog etc. So I've been on it since July and next week I go in for my followup.

To backtrack some more though....

I grew up in a very conservative area of the country, where there were things boys did and boys didn't do. I didn't have internet access until my Sophomore year of HS, and we only had 4 channels of TV (VERY rural Eastern Washington...). So I didn't even know transitioning was a thing until the tailend of highschool. But even before that I thought myself female on the inside, I just thought that was interesting but nothing I could really do about so I ignored it. I tried growing my hair out but was talked into cutting it. For pride week one year I went to school in a dress and wig (with another classmate doing the same). I even had a girl do my makeup lol. So it wasn't until college when I was living off campus by myself that I began to experiment. But I never went very far with it because: I was scared of well everything, I had no one I could tell that would be sympathetic (except maybe my mom, but my dad, especially back then, would have just stopped talking to me), and the resources I found at the time were primitive compared to today (I mean seriously, almost all the info I could find back then was how to dress as either flamboyant crossdressers or businessmen and lawyers dressing in 1960s clothing... nothing wrong with that, but I couldn't find anything that matched what I felt at the time). So I just repressed it. And in my late 20s I told myself that if I didn't get married and trying to have kids by age 30, that I would revisit this and transition. Got married at 28 and for the 6 years I was with my wife, she pushed me to be an alpha male, to live up to this ideal she had for what guys were like. And I went for it because you know "happy wife happy life".

So now that she's gone for good (and given the manner in which she left and how she treated me after, I don't really want her back), I look in the mirror and see myself for the first time in years, and I still don't like what I see (heavy set, thick neck, hairy chest, short legs tall back, and my fairly feminine face is gone).

Ok, back to present. So the clomithene boosted my T to 772, T Free 14.82, T Free % 1.9, T Bioavailable 351. For the first month I felt great, better than I had in years. But since then I've been getting headaches (though that could be sleep apnea, which I might have) and I don't like what its doing: receding hairline, facial changes (not enough to quantify, but I know I don't look the same), mental (I feel my emotions shutting down). I'm overweight (6'2" 220lbs) Especially for my muscle size (I think if I was in shape I would be somewhere around 150). I really want to get down to at least 170, and am working on it. Already lost 12 lbs in the last week and a half. Because I'm overweight I kind of had man boobs to start with, and since being on clomithene my nipples feel more tender and that area seems fuller than before, but I could be imagining it.

During my marriage, my friends moved away and my wife didn't like socializing much so I didn't make new friends. My parents would probably be accepting at some point. My job is at a billion dollar worldwide organization, and I know of at least one Trans person working there (not to mention several gay and lesbian coworkers). I also know my insurance will cover pretty much everything so long as its medically necessary. So I really think that I'm about to say screw it, lets do this!

Alright, questions!

So from what I can gather, my T count would still be high for a woman. If I were to go on HRT would I still need Spiro?

I don't want to go onto HRT and transition right now (ATM there is a 2% chance of me passing, I am finally finished with my divorce and switched my diet up and AM GOING TO get back in shape, I've set targets to reach before even talking to someone about HRT). The clomithene did help with brain fog, but so did giving up alcohol and getting past the worst of my divorce. My doctor says I need to be on it to function properly, but, for me, is it a case of needing to be on one thing or another? Or should I stop the clomithene in the meantime? I want to be healthy after all, one way or another.

Speaking on that subject, I want to lose weight and get back in shape. Would having normal T levels (staying on clomithene) be better to accomplish that than going off of clomithene?

I've set myself a goal date of October (my birthday) to make a decision about transitioning. I want to be happy. I was working on my voice last night and played back the recording and started crying because, for at least a few sentences, I sounded female. But at the end of the day I want be healthy both mentally and physically and don't want to sacrifice one for the other.

Any suggestions? Thoughts?

(Also, anyone from Eastern Washington, any good local resources?)

Thanks All!

[Dena]

Welcome to Susan's Place. For starters, the male T range is 270 - 1100 so conceivably you could have your T levels much lower and still be in the male range. This might slow the changes but I don't know if it would prevent any changes. That said, things like hair loss are reversible if you discontinue T soon enough so a decision sooner than latter would be better. As low as your T levels are, it's likely the estradiol could suppress your T levels even farther. We have members on the site who used a blocker at first to get their levels down and then tapered off the blocker while retaining low T levels. This is something you should discuss with your doctor as soon as possible and well as seeing a gender therapist as the more changes, the more work to reverse them. I also have two links you might find useful. The first is our WIKI where you will get a better idea of what transgender is and "the transition channel" which might help you understand your feelings.

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[MeTony]

Welcome!

I have no answers to your questions, just wanted to welcome you to the site.


Tony

[Anne Blake]

Hi Brooke,

A few brief comments:

- Losing weight and getting in shape is a good thing, no matter what. Depending upon your intentions, using weights for tone and fitness rather than building bulk is good. Using cardio; bicycling, running, etc. has been best for me getting my weight in alignment.

- Finding a gender therapist will help you process where you may want to go in the future. And, if you do at some point want to begin hrt, the time with the therapist will help short cut that process.

- For me, the best surprise of hrt was the change in my emotional view of life. I found a joy that had not been visible to me ever before. HRT does induce physical changes that I enjoy but the improvement of head space was a life changer.

- Several years ago, tests showed that I also had low T and the doctor worked with me to begin a regiment of testosterone injections. This gave me more energy which was good but it also greatly increased my body hair and reduced my head hair while at the same time boosting muscle mass. I also believe that the t contributed to anger and frustration in daily life. Those trends are reversing but they set back my feminization quite a bit. The changes weren't total road blocks but the muscle mass of my shoulders and receding hair line produced images in the mirror that brought me to tears many a time.

Good luck with whatever path you choose for your journey!

Tia Anne

[BrookeW]

Thanks! No matter which direction I go, I definitely want to get back in shape. That part is win win for me. My work pays for 5 free counseling sessions per year, I think I'm going to call after I meet with my doctor on Thursday. My biggest problem is motivation, always has been with a lot of things. But I think this feels different this time, like I really am turning my life around.

[Gertrude]

A while back I went on T for my wife because of ED. It happened after a bought of the flu and my t was down to 134. My thyroid became slow too. I went on t IM and it went up to 910. It was like going through puberty again. I put on weight too, mostly fat. Sure I was hornier, but I was more aggressive, sleep apnea worsened as did dysphoria. I got off it about a year ago and lost about 15lbs. In June I started a ketogenic diet I learned about from a member here. Since then I've lost 93lbs. 49lbs to go to a point where I'll be 20% body fat. If I can, I may try an additional 10lbs loss for 15% body fat. Hopefully I'll be off my meds or reduced greatly. I'm on two bp meds too. I have been using a CPAP machine for the last year and it helps a lot. The key is finding what works for you and being accountable to it.


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[Asakawa]

Just want to say that 6'2" and 150lbs is a really skinny frame for a guy. For female too I would say. Also, not sure if you have small, medium, or large bone frame. If anything bigger than small I would say 150 is going to be really skinny! About the receding hairline I have read in some male forums for hair loss that for healthy males a dutasteride is an option in that even if they have healthy T levels stopping the DHT stops the hair loss and the recession, so this is something you could talk to your doctor about. About HRT, I personally do not think you would need spiro or any other T blocker if you are going to be on T still. If you are not, you'd still likely not need it because you already have low T. Talk to your doctor of course, but once you get on HRT either patches on injections your T will drop more because external administration of E or any other steroid will shut down the axis that controls the production of testosterone from the testis. Can't recall the name of it right now

"The production and release of follicle stimulating hormone is regulated by the levels of a number of circulating hormones released by the ovaries and testes. This system is called the hypothalamic–pituitary–gonadal axis."

Ok, there it is. So, once you are placed, by your doctor, on injectables or patches this administration will 'naturally' shut down your small production of testosterone. Spiro is a water retention pill and to be honest it will just place stress on your body and your kidneys. It's not needed the T will shut down once you start to provide the estradiol. If you don't believe me research the relationship of hormone administration and how it affects the hypothalamic–pituitary–gonadal axis. There is a reason why body builders need to administer another med to get their testicles to produce T after being on a steroid cycle.

Anyway, talk to your doctor.

Oh, and even if your T is not fully shut down women have T too. In some cases a woman's T can be as high as 100ng/dL, but more commonaly around 75ng/dl. So don't hate your T. Some Transgender women are prescribed T because their T is too low and this is the truth.

[BrookeW]

I put on weight too, mostly fat. Sure I was hornier, but I was more aggressive, sleep apnea worsened as did dysphoria. I got off it about a year ago and lost about 15lbs. In June I started a ketogenic diet I learned about from a member here.

That sounds like what happened to me (except the hornier part, but its been a very emotional last few months, I think that part of it is all mental while I re-find myself). Could you tell me more about this diet you're on? Sounds interesting. Right now my M-F Diet consists of an orange at 800 (my first break, get up for work at 330), carrots, celery, and a small sandwich for lunch with a thermos of apple juice and apple cider vinegar (sounds gross until you try it, last time I drank it consistently I went from 230 down to 177 with no other changes). And dinner from my juicer with a salad. Saturday I still eat healthy but mix it up and sunday I usually visit my parents and we have pork chops or steak. I balanced out all of it in a spreadsheet and its basically about 1500 calories with 100% DV except sugar (which is about 60%).

Just want to say that 6'2" and 150lbs is a really skinny frame for a guy. For female too I would say. Also, not sure if you have small, medium, or large bone frame. If anything bigger than small I would say 150 is going to be really skinny!

I haven't weighed 150 since Freshman year of HS, and I've never been skinny since I was like 6 lol. So, for me, thats kind of the point. I want to push myself to get fit, and once I cross the lower bound of where I've weighed as an adult (175) I'll see how I feel about going further.

About the receding hairline I have read in some male forums for hair loss that for healthy males a dutasteride is an option in that even if they have healthy T levels stopping the DHT stops the hair loss and the recession, so this is something you could talk to your doctor about.

Finasteride vs dutasteride? Which do you think would be a better option to try for? I've been doing scalp massages and onion juice for a couple weeks now (and taking flaxseed and saw palmetto) and am starting to see some mild improvement, especially in the back where I was starting to get a bald spot, that feels more or less filled in now.

Thanks for the advice. My goals are to get myself physically to where I'm happier with my body, and the first step is to save my hair and lose weight. I don't think that will be enough for me, but transitioning is scary right now. I've repressed these feelings for so long I have a lot of catching up to do, but also don't want to rush things. I'm trying to be rational about all this but my mind won't turn off lol.

[BrookeW]

Forgot to add, I am 6'2", have a 30" inseam, so I am definitely top heavy. Supposedly the ideal female ratio of legs to height is 45%, well I'm basically at 40%. Or I have the legs of a 5'6" girl with an extra 8" in my back lol. This is very much a large part of my dysphoria. My pants size right now is 38x30, but when I was 177 it was 28x30. My shoulders are quite wide though. Since we're talking about all this lol, my hands are bigger than the average womans but smaller than the average guys and I wear size 11 shoes (or rather, I have to because my left foot is a flat 11 and my right is 10w with a bad arch). So being able to pass, for me, is going to be a big worry until I cross that threshold. One thing at a time though

[bobbisue]

      I have had great results with finasteride and minoxidil it takes time but it did work for me and I thought i was beyond hope

     bobbisue

[Asakawa]

Finasteride vs dutasteride? Which do you think would be a better option to try for? I've been doing scalp massages and onion juice for a couple weeks now (and taking flaxseed and saw palmetto) and am starting to see some mild improvement, especially in the back where I was starting to get a bald spot, that feels more or less filled in now.

Thanks for the advice. My goals are to get myself physically to where I'm happier with my body, and the first step is to save my hair and lose weight. I don't think that will be enough for me, but transitioning is scary right now. I've repressed these feelings for so long I have a lot of catching up to do, but also don't want to rush things. I'm trying to be rational about all this but my mind won't turn off lol.

According to wikipedia and it's sited articles

https://en.wikipedia.org/wiki/Dutasteride

"Dutasteride belongs to a class of drugs called 5α-reductase inhibitors, which block the action of the 5α-reductase enzymes that convert testosterone into DHT.[35] It is a competitive, mechanism-based (irreversible) inhibitor of all three isoforms of 5α-reductase, types I, II, and III (IC50 values are 3.9 µM for type I and 1.8 µM for type II).[1][12][36][37] This is in contrast to finasteride, which is similarly an irreversible inhibitor of 5α-reductase[37][38] but only inhibits the type II and III isoenzymes.[12]"

So it blocks all 3 forms of DHT while Finasteride only blocks 2 forms. I would say if you mention it to your doctor print the linked scientific article and other studies online and show them to your doctor so you can let him know why you'd prefer Dutas over finasteride.

Dutasteride also has a longer half life of 4-5 weeks while dutas is around 5 or 6 hours. So it should provide better protection.

Oh, I should also mention that Progesterone can inhibit DHT and has a positive effect on hair follicles in that it makes them last longer before shedding. I believe it lengthens the hair cycle and can make your hair grow longer and faster. I've also herd it can make your nails stronger, but this I don't know.  DHT thins your hairs by closing the follicle opening over time.

[Randi]

Ten years ago, I was diagnosed as hypogonadic with a T level of 150 on a  300-1100 scale. I started T-Cyp injections.

It increased my energy level, endurance and strength, which at age 58 was most welcome.  As the months passed my gender dysphoria increased.  Six month in, due to conversion of T to E via the enzyme aromatase, my nipples were erect all the time and I started developing breasts.

I later learned that, in some people, testosterone actually increases dysphoria.  Anne Vitale wrote about this:  http://www.avitale.com/TNote15Testosterone.htm 

A few years ago I stopped the T shots for a few months and my natural T level was close to zero. 

At one point I was convinced I was transexual and started taking E.   Of course the dysphoria then virtually disappeared.  I took that as an indication that I was really female and replacing T with E was the proper thing to do.

Now ten years from the start, at age 68, I find myself weak and lethargic and have resumed the T injections.
Like the first time, the aromatase kicks in.  There is no way I could become more masculine, even if I wanted that.  I'm not sure what I want, but I do know that both our minds and bodies are malleable and dependent on what type of hormones are circulating in our bodies.

I have a large feminine butt, and my breasts are the size of half cantaloupes.  I have had no surgery or electrolysis. 

I don't know how to summarize this, but you have both thyroid and hypogonadic problems, there may be no totally satisfactory treatment.  I would prefer to be either male or female, but I'm stuck in the middle and here I will remain.

Randi 

[Asakawa]

Ten years ago, I was diagnosed as hypogonadic with a T level of 150 on a  300-1100 scale. I started T-Cyp injections.

It increased my energy level, endurance and strength, which at age 58 was most welcome.  As the months passed my gender dysphoria increased.  Six month in, due to conversion of T to E via the enzyme aromatase, my nipples were erect all the time and I started developing breasts.

I later learned that, in some people, testosterone actually increases dysphoria.  Anne Vitale wrote about this:  http://www.avitale.com/TNote15Testosterone.htm 

A few years ago I stopped the T shots for a few months and my natural T level was close to zero. 

At one point I was convinced I was transexual and started taking E.   Of course the dysphoria then virtually disappeared.  I took that as an indication that I was really female and replacing T with E was the proper thing to do.

Now ten years from the start, at age 68, I find myself weak and lethargic and have resumed the T injections.
Like the first time, the aromatase kicks in.  There is no way I could become more masculine, even if I wanted that.  I'm not sure what I want, but I do know that both our minds and bodies are malleable and dependent on what type of hormones are circulating in our bodies.

I have a large feminine butt, and my breasts are the size of half cantaloupes.  I have had no surgery or electrolysis. 

I don't know how to summarize this, but you have both thyroid and hypogonadic problems, there may be no totally satisfactory treatment.  I would prefer to be either male or female, but I'm stuck in the middle and here I will remain.

Randi

Randi there is nothing wrong with being stuck in the middle. Like you said our bodies are malleable and this is by design. If it was not supposed to be it would not be, but alas the human body is a vessel for both genders and it is able to switch back and forth as we can see. It is not so much about one or the other but about being. As they say just be yourself.

From your article:

"However, along with the increase in libido, the testosterone caused a re-masculinization of her body. To complicate matters, the girlfriend not only enjoyed her partner's increased libido, she also enjoyed the masculinization and encouraged S. to take increasingly massive doses of testosterone. In time S. had in effect retransitioned back to looking and presenting as a male."

The body is always able to become more masculine! It just needs the right signaling to do so. Yes! The aromatase will change some of your T to E. In body building when they go on a Testosterone 'cycle' they use an aromatase inhibitor and also estrogen blockers to prevent their male bodies from being altered somewhat by Testosterone to Estrogen Conversion via aromatase, and the E blockers just prevent anything getting through or circulating from binding to the cells.

There is a condition where aromatase activity is super heightened and converts a very large amount of T into E.

https://en.wikipedia.org/wiki/Aromatase_excess_syndrome

Not many people have that and the ones that do naturally have decent sized breasts and very female appearances. The normal level of aromatase is far below that of the mentioned syndrome, so if you take T the aromatase will convert some of that T to E, and you will have some feminization , but your body will still be mainly male in appearance. Even at advanced age with the proper regime (Aromatase INhibitor, Estrogen Blocks, Testosterone Inj, DHT inj,) Your body will be masculinized. Obviously the younger the better the changes, but even at advanced age the hormones will signal the process.

Your response reminds me a lot of the thread I recently started here:

https://www.susans.org/forums/index.php/topic,232845.msg2072980.html#msg2072980

I did not mention testosterone, but I presented it in a way that places a male prior to HRT who cross Dresses and is sexually active and uses that as a 'fuel' to transition... but is then met by a 'crash' because as HRT begins the dysphoria to be a woman diminishes and so....

Anyway, I really liked the article you linked. I truly believe that all of this is real and there is nothing wrong with that. I think it might just be that the wiring in the brain is different in this type of male and high levels of T  (Basically off or no HRT with E) causes a high level of dysphoria to want to be female to the point that one thinks she is female and in fact I believe this male is female just the wiring responds to the wrong hormone.

Obviously the girl mentioned in the article did not have a 'crash' and was instead encouraged back into a male gender role by her lover, but I believe there are those that do go into HRT and have a sort of crash that leads them back to being male only to eventually return to female until there is a balance. Maybe not very common, but that was my thought on it. In the end I feel that these individuals are trans, are women, and it is just the inert wiring from birth that is the issue in that taking T causes the dysphoria to increase greatly. Not their fault really.

"Case Study 2.: In a similar vein, I recently received an email message from a genetic male who had transitioned, complete with SRS, to living in the female gender role in the early 1980s. Over the last several years the individual, expressing regret for having transitioned, reported that he had been very active over the internet as an anti-transition advocate. Having read my previous report on what role I believe testosterone plays in exciting feelings of femineity in some males, he contacted me telling me that in an attempt to remasculinize, he made three attempts at taking testosterone, all with the same result. Puzzled by it all, he writes:

"That's the third time I've taken testosterone and every time I've had overwhelming desires to present myself as a female.""

As you said with out T some individuals just get really lethargic and foggy. I have known I think one or two trans women who have been prescribed T just to be able to be more physically activite and have more energy. So Testosterone can be beneficial as an added part of HRT if your T is very low. Genetic females can have up to 100ng/dl in testosterone, but most tend to dwell around 80ng/dl.

Either way when it comes down to testosterone for the trans women it is generally not welcomed because of the masculization effect it can have. Yet, it isn't so much as Testosterone that heavily masculinazes the body (Well depending also on how much is present), but actually conversion from T to DHT

https://en.wikipedia.org/wiki/Dihydrotestosterone

DHT is many more times potent than T and from what I have briefly looked in FTM forums (Very briefly) I have read that it is used to create the more male development in appearance such as stronger beard, more body hair, and hair line recession.

There is also another condition called 5α-Reductase deficiency

"In the condition, circulating testosterone levels are within or slightly above the normal male range, but DHT levels are low (around 30% of normal),and the ratio of circulating testosterone to DHT is greatly elevated (at about 3.5 to 5 times higher than normal)"

So in the DHT deficient Male T levels are either normal or above normal, but DHT is greatly reduced.

"Genetic males (46,XY) with 5α-reductase type II deficiency are born with undervirilization including pseudohermaphroditism (ambiguous genitalia), pseudovaginal perineoscrotal hypospadias, and usually undescended testes.[12] Their external genitalia are female-like, with micropenis (a small, clitoris-like phallus), a partially unfused, labia-like scrotum, and a blind-ending, shallow vaginal pouch.[12] Due to their lack of conspicuous male genitalia, genetic males with the condition are typically raised as girls.[18] At the time of puberty however, they develop striking phenotypically masculine secondary sexual characteristics including partial virilization of the genitals (enlargement of the phallus into a near-functional penis and descent of the testes), voice deepening, typical male musculoskeletal development,[11] and no menstruation, breast development, or other signs of feminization that occur during female puberty.[12][18][1] In addition, normal libido and spontaneous erections develop,[20] they usually show a sexual preference for females, and almost all develop a male gender identity.[12][21]

Nonetheless, males with 5α-reductase type II deficiency exhibit signs of continued undervirilization in a number of domains.[12] Facial hair was absent or sparse in a relatively large group of Dominican males with the condition.[12] However, more facial hair has been observed in patients with the disorder from other parts of the world, although facial hair was still reduced relative to that of other men in the same communities.[12] The divergent findings may reflect racial differences in androgen-dependent hair growth.[12] A female pattern of androgenic hair growth, with terminal hair largely restricted to the axillae and lower pubic triangle, is observed in males with the condition.[12] No temporal recession of the hairline or androgenic alopecia (pattern hair loss or baldness) has been observed in any of the cases of 5α-reductase type II deficiency that have been reported,[12] whereas this is normally seen to some degree in almost all Caucasian males.[12] Individuals with 5α-reductase type II deficiency were initially reported to have no incidence of acne,[7][1] but subsequent research indicated normal sebum secretion and acne incidence.[11]

In genetic males with 5α-reductase type II deficiency, the prostate gland is rudimentary or absent, and if present, remains small, underdeveloped, and unpalpable throughout life.[7][3] In addition, neither BPH nor prostate cancer have been reported in these individuals.[13] Genetic males with the condition generally show oligozoospermia due to undescended testes, but spermatogenesis is reported to be normal in those with testes that have descended, and there are case instances of men with the condition successfully fathering children.[20][22]

Unlike males, genetic females with 5α-reductase type II deficiency are phenotypically normal.[23][20] However, similarly to genetic males with the condition, they show reduced body hair growth, including an absence of hair on the arms and legs, slightly decreased axillary hair, and moderately decreased pubic hair.[23][20] On the other hand, sebum production is normal.[23][24] This is in accordance with the fact that sebum secretion appears to be entirely under the control of 5α-reductase type I.[24]"

[Gertrude]

That sounds like what happened to me (except the hornier part, but its been a very emotional last few months, I think that part of it is all mental while I re-find myself). Could you tell me more about this diet you're on? Sounds interesting. Right now my M-F Diet consists of an orange at 800 (my first break, get up for work at 330), carrots, celery, and a small sandwich for lunch with a thermos of apple juice and apple cider vinegar (sounds gross until you try it, last time I drank it consistently I went from 230 down to 177 with no other changes). And dinner from my juicer with a salad. Saturday I still eat healthy but mix it up and sunday I usually visit my parents and we have pork chops or steak. I balanced out all of it in a spreadsheet and its basically about 1500 calories with 100% DV except sugar (which is about 60%).

I haven't weighed 150 since Freshman year of HS, and I've never been skinny since I was like 6 lol. So, for me, thats kind of the point. I want to push myself to get fit, and once I cross the lower bound of where I've weighed as an adult (175) I'll see how I feel about going further.

Finasteride vs dutasteride? Which do you think would be a better option to try for? I've been doing scalp massages and onion juice for a couple weeks now (and taking flaxseed and saw palmetto) and am starting to see some mild improvement, especially in the back where I was starting to get a bald spot, that feels more or less filled in now.

Thanks for the advice. My goals are to get myself physically to where I'm happier with my body, and the first step is to save my hair and lose weight. I don't think that will be enough for me, but transitioning is scary right now. I've repressed these feelings for so long I have a lot of catching up to do, but also don't want to rush things. I'm trying to be rational about all this but my mind won't turn off lol.

I used the calculator at www.ruled.me for macros. It's gone down since I started. 2263cal a day, 165g fat, 30g carbs and 164g protein. That's a 20% calorie deficit in order to lose weight. I don't eat bread, rice, pizza, sugared pop, potatoes, or any candy. Lots of meat and poultry though. Cheese too. My carbs are mostly from green veggies, usually higher in fiber. I don't eat much fruit and I take a multivitamin and extra c and d with calcium.  So, in December of 2016 I was 397, 382 when I started keto in June, 289 now. I want to get to 240 and reevaluate. At that point I'll be 20% body fat. 230 would put me at 15% which is about perfect. I'm 6'5 though, LBM is 200. 7 years ago it was 210. I lost 10 to low t.


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[BrookeW]

Success!

So the last few days have been very stressful. The CEO came by our plant yesterday for the first time and it felt very much like Office Space with the Bobs for a while (though it actually went very well) and then today I had an appointment with my Doc for my thyroid checkup, and I had called last week to schedule a time to talk to him about my clomiphene. So all day today I couldn't settle down and was a twitchy nervous wreck.

But when I got there I went in and told him more or less what I said in my first post. After sharing that his reaction was, "Wow, I don't know how you can stand that, let's do something about it." I asked if he knew about Dutasteride and he said that he prescribes both Finasteride and Dutasteride. I showed him a printout I had found on the differences between the two and his reaction was "ok, lets see which one is more effective, letmesee letmesee letmesee, ok 2.5mg (scribbles really fast) here you go." I shared with him also the article referenced in this thread and when I told him about it his response was "ok, so hearing that it all makes perfect sense now, I'm glad you came in today."

Now I wait a couple days to see if my insurance will cover it (if not it will be $50 a month after a 93% off coupon).

Thus begins the long journey, to where? I don't know, but the journey is always more exciting than the destination. Just happy for now

[Asakawa]

Hi Brooke,

Congratulations! I am glad you were able to talk to your doctor about it and it sounded like he was okay with the change. Just be sure to keep an eye on all possible side effects from any new medicine you take, and if anything changes in your mood or well being speak with your doctor as soon as possible! Also, keep us updated on your progress .

[BrookeW]

Absolutely. He is also going to order my estrogen and DHT levels with the blood draw (I don't remember if I stated it, but I stayed on the clomithene until the appointment to get accurate blood work). I took my measurements today, and am surprised that I actually lost an inch of height. I guess I shouldn't be surprised given that of course its going to happen as the years go by (I think I last measured my height about 5 years ago). On the plus side I have now lost 15 lbs in 15 days, but I still have a ways to go, because my measurements are 38-38-41. I know numbers aren't everything, but they mean something to me lol.

[Asakawa]

Hi Brooke,

I'm not sure if the reduced height is welcomed for you, but I did hear that exercise can help with height through strengthening the mucles in the body and making posture over all better and joints more supportive . So glad you are doing this through your doctor I hope you get some great results! I too noticed about an inch or so loss in height some time after HRT. Though at the time I was pretty inactive Maybe it was bad posture too I should recheck someday....

[rmaddy]

Dutasteride also has a longer half life of 4-5 weeks while dutas is around 5 or 6 hours. So it should provide better protection.

Thinking that one can infer clinical superiority by comparing drug properties is incorrect, and the exact sort of approach that drug companies use to try to influence prescribing behavior.  Don't join them in that.

[Asakawa]

Sorry you are right I should look more into clinical trials to see if there is anything that can actually apply to us trans women. I don't really think I can find anything on dutas vs fina for trans, but if I ever come up on one I'll be sure to read it and see if there is any actual benefit for us . I just basically shared what I found on wikipedia. I  am hoping people looking into this will talk to their doctor before doing anything.