Doctor said it was like I hadn't even been taking my pills

[sui]

So I have a few questions prompted by what has happened recently.

So I identify as trans-nonbinary, and when I started hrt (around a year and a half ago) I was trying to ease in and try for a more androgynous transition. So with my doctor I decided to forego Tblockers initially and see how only E felt. Which was nice, the doctor said my T levels were very minorly suppressed and my E was hightened, and tho I saw middling results I pretty much just stuck with that until recently where it seems the extent of the E was pretty much exhausted, though I wasn't where I wanted to be (no real redistribution of fat, very minor changes elsewhere).

So about three weeks ago I got blood work and we decided to start me on blockers. Now about a week after starting. I became nearly non functional. I was so tired after being awake for only 3-4 hours I would have to go back to bed, I was extremely irritable, and attain almost no sexual pleasure or satisfaction at all. So I went down to taking it once a day to try to midigate the effects seeing as I couldn't get any work done at all.

Then today, I got a call from the doctor saying that the blood work that had been done when I was in last(pre blockers) had extremely low E and very high T (I have had bloodwork done multiple times over the last year and a half and it was good throughout until this instance). As if I had just stopped taking anything altogether. Which I assume is why I felt so awful on blockers. Because it had left me without any sex hormones at all. So now I'm waiting on a call back from my doctor and I'm freaking out a bit.

Has anyone ever had something like this happen? Like a sudden shift or tolerance build up?

What did you do, and was it permanent?

Is there a course of action to take now to midigate any reversion until the doctor calls? (I'm thinking of just going back to two a day on the blockers as I'm pretty terrified of T levels like that being anywhere near me)

Would love any wisdom or input. Thanks!

[Mikaela]

I'm no expert, but I've heard (and experienced) that sudden reductions in antiandrogens will cause temporary, sometimes severe peaks in testosterone. It's a good idea to reduce from AAs gradually.


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[sui]

I'm no expert, but I've heard (and experienced) that sudden reductions in antiandrogens will cause temporary, sometimes severe peaks in testosterone. It's a good idea to reduce from AAs gradually.

Well this was before any antiandrogens we're introduced. This was the blood work before I even started or cutdown on T blockers

[Mikaela]

Well this was before any antiandrogens we're introduced. This was the blood work before I even started or cutdown on T blockers

Ok, I misread your original post. Apologies - my response doesn't help you at all.



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[Nikkimn]

How are you delivering your estrodial? I had that happen to me on the patch and that was because my body was becoming allergic to the adhesive and was blocking absorption. I switched to injections and it's going much much better.


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[jill610]

It might be temporary. Maybe ask them to redraw in a week or two. My E skyrocketed and my T took a nosedive suddenly earlier this year with no real explanation and I get tested monthly since then. Maybe a path until you stabilize?

I have also heard that if you change suddenly the body rebounds and overcorrects. Might be when you changed your E cycle, your body overcorrected momentarily?

[PurplePelican]

So I have a few questions prompted by what has happened recently.

So I identify as trans-nonbinary, and when I started hrt (around a year and a half ago) I was trying to ease in and try for a more androgynous transition. So with my doctor I decided to forego Tblockers initially and see how only E felt. Which was nice, the doctor said my T levels were very minorly suppressed and my E was hightened, and tho I saw middling results I pretty much just stuck with that until recently where it seems the extent of the E was pretty much exhausted, though I wasn't where I wanted to be (no real redistribution of fat, very minor changes elsewhere).

"Minorly depressed", I wonder what that actually means?  But what you describe actually sounds like hormone starvation. That's when both E and T get low.

So about three weeks ago I got blood work and we decided to start me on blockers. Now about a week after starting. I became nearly non functional. I was so tired after being awake for only 3-4 hours I would have to go back to bed, I was extremely irritable, and attain almost no sexual pleasure or satisfaction at all. So I went down to taking it once a day to try to midigate the effects seeing as I couldn't get any work done at all.

That IS hormone starvation.. Blockers are pointless and really only deliver side effects. Rather than adding a blocker like your doc did, the better option would have been to change your E delivery method and/or increase dose slightly. If your E level is sufficient, then your T level will be suppressed to female levels - or very close to.

Then today, I got a call from the doctor saying that the blood work that had been done when I was in last(pre blockers) had extremely low E and very high T (I have had bloodwork done multiple times over the last year and a half and it was good throughout until this instance). As if I had just stopped taking anything altogether. Which I assume is why I felt so awful on blockers. Because it had left me without any sex hormones at all. So now I'm waiting on a call back from my doctor and I'm freaking out a bit.

Without some indication of your actual levels and delivery method, I'd be guessing here.. But I suspect that the low/moderate dose of E your were prescribed was not enough to suppress T on it's own and adding a blocker caused T to rebound - which can happen with some drugs. Again, the better option here would likely have been to modify your dose of E and/or it's delivery method.

Has anyone ever had something like this happen? Like a sudden shift or tolerance build up?

What did you do, and was it permanent?

I haven't had it happen to me, but I have read of similar cases. Generally it boils down to a bad HRT protocol and can be rectified with a proper HRT protocol.

Is there a course of action to take now to midigate any reversion until the doctor calls? (I'm thinking of just going back to two a day on the blockers as I'm pretty terrified of T levels like that being anywhere near me)

Would love any wisdom or input. Thanks!

Don't play with your meds, even if it seems like your doc doesn't really know what they are doing.

And don't be terrified of T, you do need some - aiming for a zero T level is not and should never be the goal, unless you have cancer..

[Angelic]

Blockers are pointless and really only deliver side effects. Rather than adding a blocker like your doc did, the better option would have been to change your E delivery method and/or increase dose slightly. If your E level is sufficient, then your T level will be suppressed to female levels - or very close to.

Citations please.

[Kendra]

I'll share my experience in case this helps.  I've never taken a t-blocker, my levels are all from an Estradiol prescription plus whatever my body produces. 

Started one year ago with E patches.  Follow-up measurements for E and T looked appropriate - E quickly going up, T coming down slowly.  Six months ago had GCS and of course T levels plummeted with those two little factories gone.  E levels jumped with less interference but... a couple months later E dropped sharply at the same time patches started leaving deep red welts on my skin.  This was with no change to brand of patch, timing or where I was placing them (switched sides each week as instructed).  At that point I was asked if I'd be ok stabbing myself every week with a needle.  I switched to self-injection and my E levels immediately recovered, T is low but within cis-gender female range.

Based on what I've experienced patches were a nice way to start this all but won't work for the long haul with my body.  I don't know if you are still on pills or patches, but injections are very reliable.

I am not saying everyone should get an injection prescription - this was just my particular experience.  I used to HATE needles, but after seeing the benefits (along with several hundred hours electrolysis, and many surgeries) I am slowly sort of getting used to stabbing E into my thigh every week. 

Kendra

[PurplePelican]

Citations please.

Try looking up "Androgen Deprivation Therapy" for a start. See also Kendra's post about her not taking a blocker, she's far from alone in that kind of protocol. And Oncologists have been all over it for a while..

Also, have a look through the HRT section of the forums, there is plenty of info there.

NOTE: I don't give direct links, I've been accused of cherry picking, so now I prefer people to do their own research..

[Angelic]

I guess my question is then, how do I convince my friend?

They are convinced that stopping T-blockers will "turn them into a man" (They have been on the blockers for over 2 years...)

Perhaps if I could convince them that removing T-blockers will feminize them?

[PurplePelican]

I guess my question is then, how do I convince my friend?

They are convinced that stopping T-blockers will "turn them into a man" (They have been on the blockers for over 2 years...)

Perhaps if I could convince them that removing T-blockers will feminize them?

Short version: In most trans women, a sufficient E level will cause the testicles to shut down, leaving the only source of T being the adrenal glands - and you want this T. In a small number of cases, a blocker might be needed.

It's a basic bio-feedback loop in the body.. A high sex hormone level (E or T, doesn't matter) will trigger the gonads to shut down. It's kind of highjacking the process by which the body naturally regulates hormones.

[Mikaela]

Short version: In most trans women, a sufficient E level will cause the testicles to shut down, leaving the only source of T being the adrenal glands - and you want this T. In a small number of cases, a blocker might be needed.

It's a basic bio-feedback loop in the body.. A high sex hormone level (E or T, doesn't matter) will trigger the gonads to shut down. It's kind of highjacking the process by which the body naturally regulates hormones.

My experience, too. My T is perfectly suppressed, on the low side of female norms, with Estrogen and Progesterone alone.


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[sui]

Ok it appears there is some common confusion. My T levels spiked BEFORE. I introduced antiandrogens. The E alone was supressing the T to an extent but not enough to get the results I wanted, and I believe i am on a moderate to high dose. I assume the exhaustion was from having no sex hormones at all. Because my E plumetted and T rose before the blockers. And then the T got supressed leaving and making me entirely deficient. My worry is about the fact that the E (tablets) appeared to stop working all together, before the blockers were even on the scene. I'm worried about what that implies.

I got the blood test in question done the day the blockers were perscribed as a routine check. And heard about the results today (doc had been on vacay) and I'm not scared of T in general, like I said am going for something more androgynous, but I'm afraid of the changes I have seen reverting.

EDIT: also I'm only on a half dose of T blockers. Because of the fact that I wanted some T to stick around

[PurplePelican]

Ok it appears there is some common confusion. My T levels spiked BEFORE. I introduced antiandrogens. The E alone was supressing the T to an extent but not enough to get the results I wanted, and I believe i am on a moderate to high dose. I assume the exhaustion was from having no sex hormones at all. Because my E plumetted and T rose before the blockers. And then the T got supressed leaving and making me entirely deficient. My worry is about the fact that the E (tablets) appeared to stop working all together, before the blockers were even on the scene. I'm worried about what that implies.

I got the blood test in question done the day the blockers were perscribed as a routine check. And heard about the results today (doc had been on vacay) and I'm not scared of T in general, like I said am going for something more androgynous, but I'm afraid of the changes I have seen reverting.

EDIT: also I'm only on a half dose of T blockers. Because of the fact that I wanted some T to stick around

Oral is the worst way to take estradiol. Micronized estradiol can be taken sublingually (under the tongue) and is far more effective than just swallowing it.

Oral admin is so crappy I sometimes have to wonder how much of a placebo effect is involved. It also results in higher estrone levels than are useful.

[pamelatransuk]

It might be temporary. Maybe ask them to redraw in a week or two. My E skyrocketed and my T took a nosedive suddenly earlier this year with no real explanation and I get tested monthly since then. Maybe a path until you stabilize?

Hello Jill

Strangely enough my E has recently skyrocketed to 1662 (Intl) 453 (US) and sadly my T has also increased to 2.4 (Intl) 69 (US) as you may have seen on my "Comparison of E & T Blood Test Results after 6/7 Months" thread here on HRT Board. Hence my Endo has advised and I agree another Blood Test next week for E and a change of AA from Finasteride to Decapeptyl(Triptorelin) by injection. I shall update my "Comparison" thread with my revised E result next week.

Hello Sui

I have read the whole thread and I believe that like me you should reiterate to your doctor that you are concerned (but not amend your medication dosage yourself) and insist you need another Blood Test urgently. It is permitted to list readings of E & T BT results or other BT results if you wish but not any medication dosages of course.

I hope you are successful in solving your problem which I appreciate presumably after revised BTs.

Hugs to you both

Pamela

[jill610]

Hello Jill

Strangely enough my E has recently skyrocketed to 1662 (Intl) 453 (US) and sadly my T has also increased to 2.4 (Intl) 69 (US) as you may have seen on my "Comparison of E & T Blood Test Results after 6/7 Months" thread here on HRT Board. Hence my Endo has advised and I agree another Blood Test next week for E and a change of AA from Finasteride to Decapeptyl(Triptorelin) by injection. I shall update my "Comparison" thread with my revised E result next week.

Hello Sui

I have read the whole thread and I believe that like me you should reiterate to your doctor that you are concerned (but not amend your medication dosage yourself) and insist you need another Blood Test urgently. It is permitted to list readings of E & T BT results or other BT results if you wish but not any medication dosages of course.

I hope you are successful in solving your problem which I appreciate presumably after revised BTs.

Hugs to you both

Pamela

Hi Pamela, my Spiro does was increased by 25% as my T has been <3 for 9 months and then suddenly comeback kid.

I am having grs in January so not sure how much it matters to me at this point but definitely interested in your next result. I am on delestrogen IM weekly.