Helping estrogen pills work faster

[Arianna Valentine]

I am so happy that I posted this topic I as well as a bunch of other ladies I am sure have been wondering about this like DietLind and have gotten wonderful answers from all of you thank you my sister's for all of your wonderful advice as usual

If you can't accept yourself,  how can you expect others to accept you?

[Dena]

As I am on a half transition dosage, I wasn't seeing progress happen very fast. After over a year and discussing it with my provider, I started sticking in my cheek. For the first time ever in my life, my breast became sensitive and after all these years I grew at least another cup size. For me anyway, avoiding the stomach made the pills more effective. I don't expect much more development because years of hormones probably have resulted in most of the possible changes. Though I was surprised after all these years that there was some potential left.

[Gerri]

In Oz a number of us use pellets which are implanted in the buttock, and combine this with conjugated or compounded progesterone and Spiro. Seems to have worked better for me than E pills, whether taken sub lingually or not
Safe travels
Gerri


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[V M]

I go sublingual under the tongue, seems to have worked well for me 

[Kirsteneklund7]

So as the title of this topic says I'm wondering if anybody has come up with ways to increase the speed on which the estrogen pill patch or shot actually works I myself take the pill it is a lot slower than the patch and the shot but I would like to help it speed up preferably without self-medicating other than vitamins and creams

If you can't accept yourself,  how can you expect others to accept you?

I have tried pills & E gel. I would highly recommend gel. Contrary to popular belief gel is potent and puts me above the normal female range. I follow doctors recommendation

E gel is low risk for blood clots and bypasses the liver for better effect and less liver stress.

Only for your consideration though. Whatever works for you!

Kind regards, Kirsten.

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*No Dosages Please*

[Devlyn]

Puberty is a natural process that takes years. You're basically asking "How can I get older faster?" Trust me, if there was a way, you'd regret it sooner than you think. 

Hugs, Devlyn

[Arianna Valentine]

I have tried pills & E gel. I would highly recommend gel. Contrary to popular belief gel is potent and 4mg day puts me above the normal female range. I follow doctors recommendation at 3mg per day

E gel is low risk for blood clots and bypasses the liver for better effect and less liver stress.

Only for your consideration though. Whatever works for you!

Kind regards, Kirsten.

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Thank you very much Kirsten my doctor I don't believe offers that gel as far as I know she only offers the shots patches and pills but I have an appointment with her January so I will be sure to ask about that

If you can't accept yourself,  how can you expect others to accept you?

[Arianna Valentine]

Puberty is a natural process that takes years. You're basically asking "How can I get older faster?" Trust me, if there was a way, you'd regret it sooner than you think. 

Hugs, Devlyn

I'm not trying to get older faster I'm trying to get features faster LOL

If you can't accept yourself,  how can you expect others to accept you?

[Kirsteneklund7]

Thank you very much Kirsten my doctor I don't believe offers that gel as far as I know she only offers the shots patches and pills but I have an appointment with her January so I will be sure to ask about that

If you can't accept yourself,  how can you expect others to accept you?

To satisfy the question of the options open to you - make enquires at pharmacies to see what products they will supply under a prescription. Oestrogel or Sandrena should be readily available. Then ask your doctor for a prescription. It is low risk medication from a doctors perspective.

Drive the agenda yourself. Any regimen you prefer is out there.

Pills, injections,patches,gel, pellets.

Kind regards, Kirsten.

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[josie76]

For all taking bioidenticle estradiol tablets

If you swallow the pill, it will mostly be converted to estrone in the liver. This raises liver protein levels and estrone / estrone sulfate do increase the blood playlet clotting factor. Blood from the intestin s passes by the liver before going anywhere else.

Sublingual, under the tongue. Dissolved in the mouth, most of the estradiol is absorbed into the blood stream dodging the liver conversion. The estradiol can directly activate cells and a much smaller amount is initially converted to estrone. The sweetness of the pill will trigger a lot of saliva to be produced so you may end up swallowing more than you realize.

Buccal absorption is when you place it in the upper cheek. There is a bit of a ridge that your upper gum forms. You can put the pill there and it will dissolve much slower as this does not trigger production of much more saliva.

Ideally you want estradiol in your bloodstream not estrone. Large amounts of estrone don't do much good. Estrone is a storable form that can be converted back to estradiol as the body wants it but barely activates cell receptors.

[ChrissyRyan]

For all taking bioidenticle estradiol tablets

If you swallow the pill, it will mostly be converted to estrone in the liver. This raises liver protein levels and estrone / estrone sulfate do increase the blood playlet clotting factor. Blood from the intestin s passes by the liver before going anywhere else.

Sublingual, under the tongue. Dissolved in the mouth, most of the estradiol is absorbed into the blood stream dodging the liver conversion. The estradiol can directly activate cells and a much smaller amount is initially converted to estrone. The sweetness of the pill will trigger a lot of saliva to be produced so you may end up swallowing more than you realize.

Buccal absorption is when you place it in the upper cheek. There is a bit of a ridge that your upper gum forms. You can put the pill there and it will dissolve much slower as this does not trigger production of much more saliva.

Ideally you want estradiol in your bloodstream not estrone. Large amounts of estrone don't do much good. Estrone is a storable form that can be converted back to estradiol as the body wants it but barely activates cell receptors.

Hi everyone!

I am curious.  If there are some apparent benefits of dissolving in the mouth the non-coated estrogen pills as compared to swallowing the estrogen pills, unless there is a medical reason for a patient to swallow as noted by the doctor, why do not most physicians simply instruct on the prescription for the estrogen pills to be taken sublingually?

Maybe because the physician realizes that the effective dose might be lower if swallowed and she or he wants you to start mtf HRT on a lower estrogen dose and later have you go sublingual for a higher effective dose?

Maybe the doctor does not understand the different estrogen blood level impacts, if any exist?

If sublingual administration is going to give you a higher average blood estrogen level, that may impact your next prescription dosage, up, down, or constant.

So ask if sublingual is okay instead of taken by mouth (swallowed) and keep your physician informed.

Note that you can often leave a message with a physician or her or his nurse, then you should get a reply.  You should not necessarily have to setup another appointment simply to ask if sublingual is okay for you.

Chrissy

[Linde]

I have tried pills & E gel. I would highly recommend gel. Contrary to popular belief gel is potent and puts me above the normal female range. I follow doctors recommendation

E gel is low risk for blood clots and bypasses the liver for better effect and less liver stress.

Only for your consideration though. Whatever works for you!

Kind regards, Kirsten.

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*No Dosages Please*

It is very often a question of insurance.  My insurance pays for patches (with a very high copay), and pills with a rather low copay.  They do not pay for gels or injections!

Any transdermal delivery (and gel is transdermal) or injection would have similar effects on the liver.  Having the pills dissolve under the tongue, would be trans mucous membrane, which would promise to be even faster introduction into the bloodstream caused by the structure of the membrane, than transdermal would do.

[Linde]

Hi everyone!

I am curious.  If there are some apparent benefits of dissolving in the mouth the non-coated estrogen pills as compared to swallowing the estrogen pills, unless there is a medical reason for a patient to swallow as noted by the doctor, why do not most physicians simply instruct on the prescription for the estrogen pills to be taken sublingually?

Maybe because the physician realizes that the effective dose might be lower if swallowed and she or he wants you to start mtf HRT on a lower estrogen dose and later have you go sublingual for a higher effective dose?

Maybe the doctor does not understand the different estrogen blood level impacts, if any exist?

If sublingual administration is going to give you a higher average blood estrogen level, that may impact your next prescription dosage, up, down, or constant.

So ask if sublingual is okay instead of taken by mouth (swallowed) and keep your physician informed.

Note that you can often leave a message with a physician or her or his nurse, then you should get a reply.  You should not necessarily have to setup another appointment simply to ask if sublingual is okay for you.

Chrissy

I almost have the feeling that most physicians don't even think about the delivery form, or don't know the difference (never thought about it).
The new endocrinologist I am seeing admitted that he does not know anything about trans people, and just prescribed what my psycho recommended.  He wants me to see a specialist endo for transgender issues, who he  cooperates with ,to make detailed adjustments.

In reality, I did not know about the dissolving of oral pills, even though I am pretty familiar with transdermal delivery.  The better decission makers concerning delivery of medications are pharmacists because they the ones who are way better educated about stuff like this than physicians are.

[Arianna Valentine]

I sent a private message to my doctor and she okayed me to stick it under my tongue it take it that way she said the pill is absorbed by your body either way so I want to do it that way she has no problem with it they will just want to check my blood levels when I come in which they're going to do anyway so I got the go-ahead and it's a good thing cuz I did it last night anyways LOL

If you can't accept yourself,  how can you expect others to accept you?

[Jessica]

@Gerri

In Oz a number of us use pellets which are implanted in the buttock, and combine this with conjugated or compounded progesterone and Spiro. Seems to have worked better for me than E pills, whether taken sub lingually or not
Safe travels
Gerri


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[Dani]

Just a few more comments about sublingual administration of Estradiol:

In the US all drugs that are for sale here are reviewed by the Food and Drug Administration (FDA). They require the drug manufacturers to provide safety and effectiveness data which includes recommended administration. There are also many  studies to examine other uses that the FDA has not put in the official recommendation. These are called Off Label Indications. Sublingual administration of Estradiol is one of these Off Label Indications. For reports of these studies, I just Google "sublingual estradiol". I only trust reports that have been published in well known medical journals.

The biggest disadvantage for sublingual administration is the blood levels go extremely high for about an hour or two right after putting the tablet under the tongue. There is no reported problems with this except for the need to get accurate blood levels. For this reason, it is recommended to get your blood levels drawn right before your daily dose of Estradiol. This is called the trough (lowest point) of the blood level during the daily highs and lows. If your doctor wants to see the peak blood level, he or she can order another blood level about one hour after you put a tablet under your tongue. If you take your Estradiol at your usual time and then get your blood drawn several hours later, your measured blood level will be somewhere between the peak and trough. The exact blood level reported will mostly depend on how many hours between administration and blood draw and can be quite variable, yielding useless data.

If all this sounds too complicated, you can get more steady blood levels with patches, gels or injection.

[Linde]

Just a few more comments about sublingual administration of Estradiol:

In the US all drugs that are for sale here are reviewed by the Food and Drug Administration (FDA). They require the drug manufacturers to provide safety and effectiveness data which includes recommended administration. There are also many  studies to examine other uses that the FDA has not put in the official recommendation. These are called Off Label Indications. Sublingual administration of Estradiol is one of these Off Label Indications. For reports of these studies, I just Google "sublingual estradiol". I only trust reports that have been published in well known medical journals.

The biggest disadvantage for sublingual administration is the blood levels go extremely high for about an hour or two right after putting the tablet under the tongue. There is no reported problems with this except for the need to get accurate blood levels. For this reason, it is recommended to get your blood levels drawn right before your daily dose of Estradiol. This is called the trough (lowest point) of the blood level during the daily highs and lows. If your doctor wants to see the peak blood level, he or she can order another blood level about one hour after you put a tablet under your tongue. If you take your Estradiol at your usual time and then get your blood drawn several hours later, your measured blood level will be somewhere between the peak and trough. The exact blood level reported will mostly depend on how many hours between administration and blood draw and can be quite variable, yielding useless data.

If all this sounds too complicated, you can get more steady blood levels with patches, gels or injection.

I think the sublingual administration comes closest to injections.  The entrance of the medication into the blood stream is much faster than through transdermal patches.  We know from transfer rates of bacteria that mucous membrane is not a real barrier to them (if we would not have our saliva wich is pretty good as a bactericidal agent, we would be sick quite a bit).  I belief that estrogen can pass through the mucous membrane as well as bacteria, and thus can enter the bloodstream immediately.

[Phlox1]

I'll add my 2 cents worth.  I've tried pills, patches and injections.  Injections are my preferred delivery method.

After being on pills for a while, I decided to let them dissolve under my tongue.  When I went back for my followup lab work, as I recall I either skipped my morning pill, or just took half of it.  My blood was drawn just an hour or two before I was due for my next pill.  The lab results showed the E level in my blood to be very high (can't remember how high, but higher than most women see, I think) and my doctor was going to cut my dosage by 2/3.  I explained how I was taking them under my tongue and promised not to do that again.  Soon after that I was given the option for injections, and that is what I still do. 

While I know everyone is a bit different, for me, it appears that taking the E pills under my tongue elevated my E level to perhaps an unhealthy level.  Something to be aware of.  Please be safe and take care of yourself.

[Arianna Valentine]

I'll add my 2 cents worth.  I've tried pills, patches and injections.  Injections are my preferred delivery method.

After being on pills for a while, I decided to let them dissolve under my tongue.  When I went back for my followup lab work, as I recall I either skipped my morning pill, or just took half of it.  My blood was drawn just an hour or two before I was due for my next pill.  The lab results showed the E level in my blood to be very high (can't remember how high, but higher than most women see, I think) and my doctor was going to cut my dosage by 2/3.  I explained how I was taking them under my tongue and promised not to do that again.  Soon after that I was given the option for injections, and that is what I still do. 

While I know everyone is a bit different, for me, it appears that taking the E pills under my tongue elevated my E level to perhaps an unhealthy level.  Something to be aware of.  Please be safe and take care of yourself.

I don't think I will have that issue because I take my medicine before bed

If you can't accept yourself,  how can you expect others to accept you?

[Colleen_definitely]

Any method with the exception of possibly patches is going to make your estradiol level spike right after taking it. So having a really high blood level right after taking a pill is completely normal.

I like injections because it's a once a week thing instead of daily.