Hormone therapy problems - can anyone help??

[KJS MOM]

Hello,
My MtF 19 year old is pre-surgery, but has been on estradiol and a testosterone blocker for about 4 months now.  He is happy with the results...starting to develop breasts and feminine features. Our doctor, Harold Reed, orders blood tests to check hormone levels.  The first test was okay but a little high, so he cut the dosage.  The last test showed estrogen level of 694, which he says is so high it could cause a stroke! (I guess most pre-menopausal women are about 100 -200).  He refuses to prescribe more until we see an endocronologist.  Well, that is easier said than done as no one will treat TG's (and I have called about 20 of them).  In any case, I will find one eventually, but my child is in tears because he is afraid he will start to regress without the estradiaol, and says he'll get it on-line!  Has this happened to anyone else and can you tell me what caused it?  My son (sorry, daughter) is also anorexic, so I think maybe that has screwed up her metabolism!  Any comments would be appreciated.....

Scared Mom
           

[Sarah Louise]

I don't blame you for being concerned about your daughter.  Have you asked Dr. Reed for a referal?  I am sure he can help you with that.

While it is frustrating for your daughter to have to stop hrt for a short while, it is for her health.  You should not allow her to self prescribe what she takes, this would be extremely dangerous.

I hope she addresses her eating problem also.

Sarah L.

[Rebecca Liz]

I agree that self-prescribing is very dangerous. Please make sure she avoids this!

Does Dr. Reed have experience with HRT for MTFs? Now, I'm not a doctor, and don't pretend to know too much about this, but it's my understanding (and it makes perfect sense) that in order to get the transformation moving properly, puberty levels of hormones should be administered. This will certainly result in levels much higher than pre-menopausal women. I had a friend that was well over 800 - the doctor just kept a close eye on things, and she was just fine.

Do ask for a referral - that may be the easiest way to find an endocrinologist with an open mind.

Becca

[NicholeW.]

Dr. Harold Reed is an SRS surgeon in Miami.

He should certainly at least know of endos. So the suggestion to request for a referral would be a good one I should think.

Nichole

[Mnemosyne]

Did the doctor do a base line on her before prescribing the meds?

Ask for a referral and leave that doctor far behind. If there are any local LGBT community centers, you can check with them.

[Keira]

The chance of having a stroke using just estradiol (or estradiol valerate),
is very very low unless you've got a very rare risk factor
(Leiden factor V, if it were the case, your daughter would also be taking a
a medication to control those risks, which doesn't seem to be the case).

I'm guessing she's not using ethinilestradiol, a conjugated estrogen or
premarin, since its impossible to measure estrogen
levels with them. Ethinilestradiol, can cause problems,
even in young adults, but its not usually a stroke, but rather a DVT (
a clot in the leg, which very rarely can go elsewhere).

I think your doctor is out to lunch if you ask me.

Pregnant women have levels way way way higher than that and how many get a stoke.
especially at that age? I'm guessing less than 0.001%...

Most doctors are total neophytes on this subject,
ask for a second opinion on dosages.

Low dosages cause problems too. Nobody wants to be menopausal at 19.

[Annwyn]

I find it highly unlikely that a 19 year old will start developing strokes because of having hormones in her system.

Many endos are paranoid.  And I think this one is too.

[KJS MOM]

Dr. Harold Reed is an SRS surgeon in Miami.

He should certainly at least know of endos. So the suggestion to request for a referral would be a good one I should think.

Nichole

Believe it or not, Dr. Reed knew of NO endocronologists, of course I asked him that first! -- he suggested the Univ of Miami would not turn her away!  I am losing faith in him now.  He is a surgeon, so maybe he doesn't know that young people metabaloize estrogen differently.  Like Rebecca Liz posted, her friend had levels over 800.  Thanks, everyone, for your help!