HRT without an Endocrinologist?

[Kay]

Hi,
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I'm looking for your opinions/advice:
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I spoke with my doctor this week about starting HRT in December.  I've been on Finasteride for about a year now (I'm 35 if that matters), and was referred to this doctor by my counselor/psych.
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She has handled trans patients before, but I was surprised to hear that my doctor doesn't refer patients to an endocrinologist, as seems to be the regular way of things...at least as I read about them on these forums.
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She told me that she generally prescribes Estrace, Provera, and either Spironolactone or Finasteride (which I'm already taking) (all in pill form) for a beginning regimen.  Removing the Provera from the regimen after 2 years time.
(I didn't inquire about dosages, but I couldn't post that info here anyway)
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She has so far given me a typical blood test (cholesterol, etc) this year and last, and that would continue.  But there are no plans for additional testing related to the HRT.
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While she apparently hasn't had any issues handling things this way,
I'm wondering if there are any complications or issues that I should be concerned about?  I think she probably does it this way to 'fly below the radar' so-to-speak...leaving any of the obvious trans expenses off the books.
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Getting back to the question at hand...in short...what does your Endocrinologist do for you, and how has it effected your treatment?   Have you found an Endo to indispensable...or unneeded?
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Thank you.

[Hannah]

Hi kay 
If I'm reading it right, this doctors regimen might be a little inadequate. You'll want to consider both antiandrogens, not either or. On the bright side spiro doesn't cost near what finasteride does! For things to sort themselves properly and to avoid huge doses of Estrogens, you need your testosterone dropped to a level which I don't believe finasteride can achieve alone. My doctor isn't insisting on an endocronologist either, as long as your bloodwork comes back ok there aren't a whole ton of factors to worry about that a gp can't handle.

[Mister]

I've never seen an endocrinologist- I look like a man and I'm pretty sure I'm not dead

[NicholeW.]

I've never seen an endocrinologist- I look like a man and I'm pretty sure I'm not dead

Actually, you look like an elephant sitting under a waterfall and squirting water from his trunk. Well, to me you do.

Kay, rather than the provera you might wanna do some research on bio-identical progesterone (comes in pills and injectibles) and discuss that with your doc, make sure you bring the research with you. I'd also suggest that you check into a compounding pharmacy to order your E and progesterone through. They make their own, every bit as effectively and perhaps even more purely than the chain pharmacies get theirs from the pharmaceutical companies and they are MUCH, much cheaper even with postage charges. (The costs of the meds like finasteride or dustasteride will not be cheaper through the compounders though as they are exclusively produced and marketed as yet by the pharma-giants.) 

I agree with Becca about the finasteride by itself not being enough of an a-a dosage to lower the T sufficiently. If the finasteride is being used to treat incipient male-pattern baldness at all then I'd suggest dutasteride (Avodart.) That's much more expensive than the finasteride, but (and much of this is according to male-pattern baldness sites as well as discussions of transitioning I've been at in the past) it does a couple of things apparently more effectively for most that finasteride does.

Otherwise I agree, a GP and perhaps even a psychiatrist (not sure which doc you were writing about) can effectively do your prescribing for you.

Best of fortune as you begin. 



 

[Mister]

Actually, you look like an elephant sitting under a waterfall and squirting water from his trunk. Well, to me you do.

A male elephant... amirite? 

p.s. it is so damn hard to type without fingers.  i have to hold a stick in my trunk.  those other elephants think they're soooo coool b/c they can paint.  HA!

[fae_reborn]

p.s. it is so damn hard to type without fingers.  i have to hold a stick in my trunk.  those other elephants think they're soooo coool b/c they can paint.  HA!

Kay, just to share with you, I was referred to a local endocrinologist by my GP, because he could not prescribe hormones.  I started on Spiro and Estradiol, going off the Spiro after my Orchi.  I have been seeing my endo every 3-6 months for the past 2 years, and getting bloodwork done roughly around the same schedule (3-5 months).  Thankfully, nothing has come up.  She has been very knowledgeable about trans- issues because she has been seeing patients for a long time (10+ years), and I trust her because of her experience.  In my opinion, a GP can't replace an endo, who is experienced in these issues.

But best of luck to you all the same.

[Janet_Girl]

My doctor also did not recommend an Endocrinologist.  Just blood work to monitor the liver and other possible side effects.

I take Estradiol, Spiro and Proscar.  The Proscar is for my hair loss.

My doctor goes by my development, only. 

Janet

[Naturally Blonde]

The two or three endo's I saw were very limited in knowledge and I have found it easier to work on my own.