Susan's Place Transgender Resources

So recently I discovered that I could take my estrogen pills sublingually and just let them dissolve under my tongue. I read that this is a safer and more efficient way to take them than simply swallowing as the don't have to go through my digestive system. On another note how does it compare to taking patches and injections in both efficiency and safety.

I'm very curious about that as well. I know it's better than swallowing the pills, but I never knew about this.

It is well-known that not only estradiol absorbed more efficiently via sublingual (it also absorbs thru the cheeks so don't worry if some escapes) but also other pills should be administered sublingual. I know xanax works faster if kept under the toungue, which is important because panic attacks suck so you want to get relief asap. My doctor told me to do this if I am having a really bad one but I havent had a single one since transition. It is also easier on the liver if taken under the toungue. (though 17-b E is pretty easy on the liver in general). As far as patches, they are used more for over 40 women and women with DVT issues. The injection v. pill debate will never be solved but I do hear circumstantial evidence injections cause better results.It could all be coincidence. Pills are fine.

Here is a study on just this (Dosages removed please PM if I miss one which I won't):

Abstract
OBJECTIVE:

To investigate the pharmacokinetic profiles of different doses of micronized 17 beta-estradiol administered by oral or sublingual routes.

METHODS:

Single doses of micronized 17 beta-estradiol were administered orally  or sublingually  to six postmenopausal women in a randomized clinical trial. We calculated pharmacokinetic parameters for estradiol (E2) and estrone (E1) of maximum serum concentration, time to maximum serum concentration, terminal half-life, area under the concentration curve, and oral clearance. Serum levels of E1 sulfate also were compared at 4, 12, and 24 hours after dosing.

RESULTS:

Sublingual administration resulted in rapid absorption with significantly higher E2 levels than did comparable oral dosing. Estrone levels did not vary with route of administration but correlated with the dosage administered. Estrone sulfate levels correlated with the dosage administered and also tended to be higher with sublingual administration. Sublingual administration resulted in a significantly lower E1 to E2 ratio during the 24 hours than did oral administration.

CONCLUSION:

Sublingual administration of micronized 17 beta-estradiol results in a rapid, burst-like absorption into the systemic circulation, yielding high E2 levels that fall rapidly over the first 6 hours.

I believe that keyword here is "micronized", no? Thus, Progynova could be administered sublingually, but Estrofem not? Please, correct me, if I am wrong.

That was an interesting read. So let me get this straight now, its more efficient and easier on the liver if taken sublinguallg, awesome. Going to co to UE it that way and would it be wiser to split my dose up?

I know 17ß-estradiol (brand name Estrace notably) can be taken sublingually. I don't know about estradiol hemihydrate (brand name Estrofem notably), but I THINK I remember my ex-girlfriend saying she took hers sublingually. I think.

But you can try it, regardless. Put it under your tongue, and if after an hour (should be less normally) there's pretty much nothing left, then you can take it sublingually. If not, you can't. Just swallow it.

Also, this probably means that taking the pills sublingually makes it advisable to split the dose in three instead of two times a day.

PS: Estradiol and estradiol hemihydrate are almost the same thing BTW, except that the latter is just a tiny bit slower to do its effect (which is probably a plus).

I've heard both good and bad things about this method.  I'm going to ask my doctor if I could go about it this way because I want all the effects to work their wonders asap :)

So I think tomorrow I'll start splitting up my E doses.on the positive the piles dissolve within 5-10 minutes so it definitely works.

5-10 minutes is pretty minimal. Sometimes it takes a good half an hour for me. Maybe my mouth is too dry. :p

learningtolive: What bad things?

Quote from: A on June 07, 2013, 04:42:07 PM
5-10 minutes is pretty minimal. Sometimes it takes a good half an hour for me. Maybe my mouth is too dry. :p

learningtolive: What bad things?

I've heard that some meds cannot be taken sublingually and you wouldn't be properly absorbing them.  I don't know if that applies here, but I want to make sure my body is fully absorbing everything.  It's probably fine, but I want to check with my doctor to make sure it will work.  I'm starting hrt in a few days, so I don't have the experience you guys have to assess whether one method works better or not.

Oh, uhm, yeah. Some medications cannot be taken sublingually. But then it's not "bad" if you do, it's just impossible. The pill will just turn into a sort of mud no matter how long you wait, and the only thing is that you'll have to swallow it.

Quote from: A on June 08, 2013, 08:58:12 AM
Oh, uhm, yeah. Some medications cannot be taken sublingually. But then it's not "bad" if you do, it's just impossible. The pill will just turn into a sort of mud no matter how long you wait, and the only thing is that you'll have to swallow it.

I beg to disagree.  If I can't absorb my hormones, then it's very bad :)

You'll still absorb them when you swallow the yucky mud, just as if you had swallowed the pill. o.o As long as you don't spit it out or, like, brush your teeth really soon after taking it, you'll absorb the hormones anyway.

That's why I say there's no risk. Put it under your tongue. If it absorbs, great. If not, you'll notice it's still there after an hour. Just swallow the stuff and resume swallowing your pills afterwards. You just cannot go wrong, and you're not losing anything.

The little blue pill is gone in 20 seconds under my tongue. I do not swallow for a few minute.

I have been taking Estrofem sublingually for almost 5 weeks, and I have noticed, the time for it to dissolve varies greatly, strangely. sometimes the whole thing is gone into 20 some minutes, others it takes over a half hour or even an hour, and others it seems to never dissolve and I have to end up swallowing it. Does anyone know why this may be?

Anyway, I tend to be very much like you learningtolive. I am paranoid that while I am doibg this they will be getting stuck in my teeth or something and I will end up not absorbing the meds. But I hear the stomach acids are an obstacle to absorption as well so I am very reluctant to switch over to swallowing.

it doesn't help that I am crappy at taking it under my tongue, either. I always talk or open my mouth to check on it XD If I could be sure swallowing wouldnt damage the pill or slow my results I would just do that...

Quote from: A on June 08, 2013, 12:00:10 PM
You'll still absorb them when you swallow the yucky mud, just as if you had swallowed the pill. o.o As long as you don't spit it out or, like, brush your teeth really soon after taking it, you'll absorb the hormones anyway.

That's why I say there's no risk. Put it under your tongue. If it absorbs, great. If not, you'll notice it's still there after an hour. Just swallow the stuff and resume swallowing your pills afterwards. You just cannot go wrong, and you're not losing anything.

That's good to know. I'll probably do it this way then.  Still, I'll check with my doctor.  I wish I had a time machine to make Thursday come here faster. 

Quote from: Stefani2 on June 08, 2013, 05:33:57 PM
I have been taking Estrofem sublingually for almost 5 weeks, and I have noticed, the time for it to dissolve varies greatly, strangely. sometimes the whole thing is gone into 20 some minutes, others it takes over a half hour or even an hour, and others it seems to never dissolve and I have to end up swallowing it. Does anyone know why this may be?

Anyway, I tend to be very much like you learningtolive. I am paranoid that while I am doibg this they will be getting stuck in my teeth or something and I will end up not absorbing the meds. But I hear the stomach acids are an obstacle to absorption as well so I am very reluctant to switch over to swallowing.

it doesn't help that I am crappy at taking it under my tongue, either. I always talk or open my mouth to check on it XD If I could be sure swallowing wouldnt damage the pill or slow my results I would just do that...

It depends a lot on how much saliva there is down there, and how much physical movement it's subject to. If you're talking, for example, assuming it stays down there, it'll absorb a lot faster than if you put it in your dry mouth and stop moving. It's a solid, so it needs to be dissolved in saliva before being absorbed. And it's a pressed solid, so it needs some help to "undo" itself so that it can dissolve properly. (this doesn't mean you should chew it either - just make sure your mouth acts, ya know, alive.

Yes! I have noticed that it absorbs a lot faster when I talk (which I do a lot when I'm taking it cuz someones always babbling at me, lolz). I thought you were not supposed to talk and I was  actually worried because I always do XD

And, yeah. Today I was all alone, kept quiet and still and forgot to get a drink before taking it (so, dry mouth) and I ended up swallowing almost an entire pill after letting that sucker sit for an hour.

Tip: Slightly bite your cheeks and do some succion. Some saliva should appear. Let it go under your tongue, and there you go. You can also take a tiny sip of water. Also talking with your pill under your tongue is no issue, as long as it stays there. And even if it doesn't, honestly, it's not the end of the world to take half your pill subingually then swallow the rest, either  because you swallowed some saliva with E dissolved in it, either because you swallowed the rest of the pill. It's still better than just swallowing all of it with a glass of water, isn't it?