I just started 2 months ago on HRT. I take Estrodiol and Bicalutamide. Unfortunately, I live in a small community where my doctor has no transgender experience. For the girls that have been on bica, what were your experience on the blood tests regarding testosterone levels? My first testosterone test will be next week. I have an ongoing dispute with him as to the level of testosterone when taking bica. I told him my level will actually be higher than normal, as it is a blocker, and will not lower the production of testosterone . I told him a T-test is really not needed, but he wants to prove his point of view. He thinks my T-level will be in the low range closer to 50 ng/dL. My guess since bica will increase my T-levels, I will be higher than normal. Of course I could be one of those people who get lucky and see T levels go down because of Estrodiol. If that is true, then taking bica was not needed. It is always possible that the combination of adding bica to the mix could lower my T level too. The mechanisms results are different for each girl. The only real test if you a taking the proper dosage of Bicalutamide, is whether or not your morning erections have been eliminated. After 6 weeks, mine did. So I told him my dosage if just right. It is blocking Testosterone from being used, comparable to someone that has taken some other type of pills to reduce the production levels down to 50 or so. A month ago, when I had what I thought was going to be a complete workup, he only did total estrogen. Boy was I disappointed. I should have made sure my doctor was going to get the first tests done correctly. When you are starting bica, it is imperative you have a liver test after 30 days. These pills have the potential to destroy your liver if you don't keep track. After just a few weeks, if your liver does not take to the bica very well at all, your test numbers can head south really fast. Once you make sure your liver functions are going to be ok, after the 3rd month, just monitoring every 6 months should do the trick. Although the odds are extremely very low with any kind of liver problems from taking this pill, (less than 1% I think) it is wise to make sure first, before you go blindly month after month.
My doctor and I also have a disagreement about monitoring the Estrogen to see if I need more or less Estrodiol. Out of frustrations with me, he as agreed my tests next week will also include E-2 and E-1, not the total Estrogen (which is mainly E-1, E-2 and E-3). He was concern that my total last month for Total Estrogen of 765 was way too high. My thumbnail calculation based on the time of the day I took my Estrodiol pill vs the test, I probably had a 180 E-2 with the bulk of the remainder at E-1. I did for the first two weeks of starting HRT take my Estrodiol pill sublingually. Since he has never treated anyone like me, I tried to explain that when taking Estrodiol, you must take a E-1 AND a E-2 to get a useful number. If your doctor only gives you a E-2, (Estrodiol) test, that number could be very deceiving too. If your E-1 (Estrone) happens to be a lot higher than E-2, the effectiveness of Estrodiol is so much lower. That is why there are so many girls that go on for a long time and see no expected results if they are near 200 Estrodiol. In reality because of high Estrone numbers, feminization is not working as strongly as anticipated. I now take my Estrodoil buccal to try and cut down the Estrone. If my results next week are closer to where I think is ok, I will keep on taking my Estrodiol pills buccal. My goal would have a 200-300 Estrodiol level, with no more than 400-500 Estrone. (Very best is to have the same E-1 and E-2 number). I have no desire at all to take the injections to cut down on the Estrone problem, (hate the needles!) so I hope I can get the numbers in line. If not, I will have to figure out something different. I cannot take spironolactone. Extra potassium in my body would build up with the spiro and it would cause me to have temporary paralysis issues.
