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So, I recently had my next set of blood work and my estrogen values were sitting at 86.9pg/ml. My doctor today said that she would be ok upping my dosage by half of what I'm currently taking after I questioned her about what I feel to be a bit low blood test results, but she strongly discouraged it saying there isn't any evidence that upping my hormone levels will help from what she's read. She seemed a bit cautious and she once again brought up the risks associated with these meds. I've been on hormones for about 7 months now. I've been reading that I should really be more in the 200pg/ml range. What do you guys think? Is there anything I might be able to bring up with her?

Thanks!

I'm sure my doc uses a totally different scale when telling me my levels... it all goes straight over my head and I never write them down anyway.

While I'd be inclined to say trust your doc, the question I'd ask is, how much experience does she have with prescribing HRT for M2F? If the answer is "not much" then it's probably best not to pressure her into more since she could potentially give you an inappropriate dosage - I'd suggest finding another endo for a second opinion. If the answer is "a lot" then I'd suggest trusting her on this but if you're still not happy then maybe ask for a different delivery method or find another endo for a second opinion.

She supposedly has worked with a lot of MTF, but it still seems -very- low. Generally I'm hearing that others have same measurements nearly double mine. If it helps, I'm 23 and generally in picture perfect health...

My understanding is that everyone has different levels. Person A on X dosage may have higher levels than person B on the same dosage. However, giving person B a 2X dosage (or 1.5X, or whatever) might actually be dangerous to their health and still make no difference to their levels. It's best not to compare your levels to others but chat with your doc about other delivery methods, or different HRT meds some can be more effective for some people than others. Regardless they do all come with risks as I'm sure you'd understand.

I like this chart (Wikipedia also has a chart from T)

https://en.wikipedia.org/wiki/File:Estradiol_during_menstrual_cycle.png

My endo replaces implants when the blood levels drop below 800pmol/L, which is around 210pg/mL. I'm usually higher than that of course, 1000+. Implants are very stable, so levels only change very slowly, and I assume you get a reasonably accurate measurement. I understand that other forms of HRT are all over the place depending on when you take them. I'm not sure if this makes any difference.

I've heard quite often that many other doctors prefer a much lower level. I was on around 50pg/mL (on purpose) for a long time and its dramatically better now.

I suspect most doctors don't have a clue what they are doing, but I don't know which ones are which.

Quote from: AnonyMs on December 28, 2015, 09:49:08 PM
...800pmol/L, which is around 210pg/mL...

ah, picomols per litre... that's why I could never figure out his system!! ;D

My pre-hrt labs had my estrogen at 201.7 pg/mL. I guess I feel pretty lucky after hearing from so many others who are trying to reach that. I have my first labs while on HRT on March 1 so I am pretty interested in seeing how low dose is working. I really do hope everything goes well for you on your journey!

Hi Grace
My Doctor dropped my dosage by 1/3 because my reading was 526 pg/ml way to high. But I'm Post-op

Hugs Lyndsey

My doctor tries to keep mine around 200 pg/ml. Hugs
Mariah

Quote from: Azurefrost on December 28, 2015, 09:13:37 PM
So, I recently had my next set of blood work and my estrogen values were sitting at 86.9pg/ml. My doctor today said that she would be ok upping my dosage by half of what I'm currently taking after I questioned her about what I feel to be a bit low blood test results, but she strongly discouraged it saying there isn't any evidence that upping my hormone levels will help from what she's read. She seemed a bit cautious and she once again brought up the risks associated with these meds. I've been on hormones for about 7 months now. I've been reading that I should really be more in the 200pg/ml range. What do you guys think? Is there anything I might be able to bring up with her?

Thanks!

What are the risks associated with higher estradiol levels? I have levels that range from 1,000-4,000 pg/ml, I'm post-op and so far, my blood test results have come back normal (liver panel, clotting factor, lipids, glucose/insulin, etc.). Pregnant women have levels that go as high as 75,000 and the risk of DVT remains very low. It's also been observed that the more pregnancies, the lower the risk of breast cancer. Finally, studies on men with prostate cancer found that levels between 400-700 had no adverse effects on health and actually protected against the onset of thrombosis. Your doctor may be confusing non bio-identical estrogen with bio-identical estrogen.

Quote from: Ms Grace on December 28, 2015, 09:55:57 PM
ah, picomols per litre... that's why I could never figure out his system!! ;D

Lol

I'm usually somewhere between 300-600 these days - obviously higher immediately after implant refresh.  Next to no T to speak of and that's with no progesterone in the mix.

Quote from: luna nyan on December 29, 2015, 08:41:56 PM
Lol

I'm usually somewhere between 300-600 these days - obviously higher immediately after implant refresh.  Next to no T to speak of and that's with no progesterone in the mix.

I know the feeling Mine is around 537 now and I'm post-op from October 2015

Hug's

Quote from: KayXo on December 29, 2015, 10:42:11 AM
What are the risks associated with higher estradiol levels? I have levels that range from 1,000-4,000 pg/ml, I'm post-op and so far, my blood test results have come back normal (liver panel, clotting factor, lipids, glucose/insulin, etc.). Pregnant women have levels that go as high as 75,000 and the risk of DVT remains very low. It's also been observed that the more pregnancies, the lower the risk of breast cancer. Finally, studies on men with prostate cancer found that levels between 400-700 had no adverse effects on health and actually protected against the onset of thrombosis. Your doctor may be confusing non bio-identical estrogen with bio-identical estrogen.

Kay,

Those numbers can't be right, if they are pg/mL.   Peak estradiol levels for women who are ovulating are usually less than 400 pg/mL (see chart cited by AnonyMs).  Here are typical numbers:

Male   < 60 pg /mL       

Females ovulating   Early follicular   Late follicular    Luteal phase
pg /mL                   30 - 100           100 - 400           60 - 150

Pregnant   First Trimester   Second Trimester   Third Trimester
pg /mL     190 - 2460        1280 - 7190            6150 - 3460

Postmenopausal   < 18 pg /mL

I doubt Azure's doctor is confused about estradiol. You would have to be completely clueless as an MD. Serum E2 levels are determined by enzyme immunoassay. The assay does not measure equine estrogens or semi-synthetics like ethinyl estradiol. 

~Terri

My levels range from 1,000-4,000 pg/ml. These numbers ARE CORRECT. These levels have been verified several times by two different labs.

I have several sources showing that levels during pregnancy can range from 1,000-40,000, up to 75,000 before giving birth. Levels are in pg/ml. I can send them to you privately if you want.

Hi Kay,

I am hesitant to get into any debate about hormone levels, since that it is a clinical decision made by your endocrinologist, and I am chemist, not a medical doctor.  I read the scientific literature, and I have a casual interest in what other transgender women have observed. Your results are not typical if we are talking about free estradiol levels, and not including SHBG- and albumin-bound E2.  About 98% of E2 in the blood is protein-bound, so if your numbers include total estradiol, that could account for the large difference in your blood levels and everybody else's.

My free serum estradiol levels are now about 36 pg/mL.  They started at 27 pg/mL before going on the patch four months ago. I have experienced breast  growth, skin changes, including decreased body hair growth, less sebaceous gland activity, and changes in body odor.  And of course, mental changes.

My liver enzymes are normal, but I am experiencing an increase in my triglyceride levels and blood glucose levels (but not A1C), as well as some elevated creatinine levels, and it is something I am concerned about.

I guess all I wanted to add for anyone reading this thread is that the best levels are those that will achieve the desired degree of feminization with the least health risk, and that is an individual matter.

With kindness,

Terri

Quote from: Maybebaby56 on December 31, 2015, 11:53:23 AM
Your results are not typical if we are talking about free estradiol levels, and not including SHBG- and albumin-bound E2.

Estradiol that is almost always measured in people in general is TOTAL estradiol, VERY rarely free estradiol. So, yes I meant total estradiol, not free.

QuoteAbout 98% of E2 in the blood is protein-bound, so if your numbers include total estradiol, that could account for the large difference in your blood levels and everybody else's. My free serum estradiol levels are now about 36 pg/mL.  They started at 27 pg/mL before going on the patch four months ago.

I think you may be mistaken. Your estradiol and that of others reported, including mine, are total estradiol. The numbers you provided earlier are also total estradiol.

Free estradiol levels are MUCH MUCH lower. Range in ciswomen (probably higher during pregnancy) is 0.6 - 7.1 pg/ml according to this source. For males, 0.2-1.5.

http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/91215

Also they indicate that between about 1.5 and 3.5 % in women is free estradiol, meaning 98.5 to 96.5 % is bound to SHBG and albumin and that number (percent of free estradiol) is slightly higher for males, 94.6 is bound.

36 pg/ml is a low number BUT the important thing is feminization and health, also well-being.

QuoteMy liver enzymes are normal, but I am experiencing an increase in my triglyceride levels and blood glucose levels (but not A1C), as well as some elevated creatinine levels, and it is something I am concerned about.

My triglyceride levels are normal, so is glucose, insulin, HbA1C (measured last year) and creatinine. I don't take anti-androgens though. My levels of estradiol are high while my progesterone levels range from 13-20 ng/dl. I am careful with my diet, so restrict carbs as these tend to significantly raise triglycerides. I was under the normal range once when I restricted all carbs! And my HDL was wayyyyyyy high! Glucose, HbA1C, and insulin are also adversely affected by too many carbs, more so in some than others.

I know that, in a few, creatinine is adversely affected by spironolactone.

QuoteI guess all I wanted to add for anyone reading this thread is that the best levels are those that will achieve the desired degree of feminization with the least health risk, and that is an individual matter.

I agree. :)

Happy new year to you and everyone. Health, peace of mind and lots of fun. Do as your heart desires. :)

Well a rule of thumb for decent feminization for many people is 200pg/ml estrogen and 50 testosterone.
Of course individual reactions vary and its also a matter of form of application.
With internal applications like implants and injections there are very few studies showing adverse effects with higher doses.
Some endos even use higher doses of estrogen which can drive down teststerone into the female range. So no anti androgens are needed. Anti androgens also have side effects.
As said its only considered safe with implants and injections.

And any endos ask how people feel . Its not only blood levels. (Treat the patient not the lab ).

Additionally bioidentical progesterone could be helpful.
Its also present in natal females and can help with breast development, possibly with mood and some side effects of estrogen.


hugs

Quote from: Laura_7 on December 31, 2015, 05:03:50 PMWell a rule of thumb for decent feminization for many people is 200pg/ml estrogen and 50 testosterone.

I disagree. Where are the studies proving this? Levels also don't stay put, they move up and down.

QuoteWith internal applications like implants and injections there are very few studies showing adverse effects with higher doses.

There are NO studies as of yet showing adverse effects. If there are, please let me know.

QuoteAs said its only considered safe with implants and injections.

I'm not convinced of this either as I think bio-identical estradiol in general, even when taken orally, is quite safe. This is just my opinion based on everything I read. I'm not a doctor.

Quote from: KayXo on January 01, 2016, 10:06:48 AM
I disagree. Where are the studies proving this? Levels also don't stay put, they move up and down.

As said its a rule of thumb.
Its from people asking other endos and watching peoples progress.
Of course people are individual.
And some endos do not give much to levels because it shows free substances and not absorbed ones.
They rather ask how people feel and watch overall health.

Quote
I'm not convinced of this either as I think bio-identical estradiol in general, even when taken orally, is quite safe. This is just my opinion based on everything I read. I'm not a doctor.

With oral, not sublingual intake, there is a certain strain on the liver because it immediately breaks down part of the estrogen. Also not really wanted estrogens like estrone are produced. And clotting factors may rise. The liver seems to suppose an internal leak.

So risk seems higher with oral intake, still present yet lower with sublingual intake for really higher doses.


*hugs*

I'm 9 mos. into cross sex hormone therapy.  I've been on the patch.  Initially one, then two, then three.  Total E levels only moved from 31 at 90 days (one patch)  42 at 120 days (2 patches) 76 at 180 days (3 patches). Little feminization.
Some breast tenderness, mental changes, body odor. T is very low.  My endo is taking me off the patches in favor of injections.  His target was around 200.  We'll see if this change is effective.  Have to stop all hormones next week in prep. for GCS.  Who knows what will work after my surgery.

Bring it on!  I'm down for this!

Quote from: Joi on January 01, 2016, 01:11:27 PM
I'm 9 mos. into cross sex hormone therapy.  I've been on the patch.  Initially one, then two, then three.  Total E levels only moved from 31 at 90 days (one patch)  42 at 120 days (2 patches) 76 at 180 days (3 patches). Little feminization.
Some breast tenderness, mental changes, body odor. T is very low.  My endo is taking me off the patches in favor of injections.  His target was around 200.  We'll see if this change is effective.  Have to stop all hormones next week in prep. for GCS.  Who knows what will work after my surgery.

Bring it on!  I'm down for this!

Hi Joi

After surgery a lot will change. You will be cut way back on your meds and no more spiro as you will not need it at all. My estrogen meds have dropped in half and they are still high when last checked 523 WOW it a wonder thing have been crazy with me. They are still trying to get me adjusted and will for sure in January 2016. I feel so good now and Love my choice to have SRS but for the ones who don't that is ok too as you are no less a women if you decide not to.


Hug's
Lyndsey

Quote from: Laura_7 on January 01, 2016, 10:45:50 AMWith oral, not sublingual intake, there is a certain strain on the liver because it immediately breaks down part of the estrogen.

I don't believe that this puts a significant strain on the liver. Drugs like acetominophen, alcohol, excess sugar do however put on a strain. The effect is so small and insignificant with bio-identical estradiol that I would hesitate to put liver damage as one of the potential side-effects. Studies have also NOT shown this with bio-identical estradiol.

QuoteAnd clotting factors may rise

Yes but when one considers that birth control pills given to tens of thousands of women over the world have such little affect on risk of clotting, that these contain a type of estrogen that affects clotting to a much greater degree than bio estradiol (500 times, as much as 2500 times), I consider the effect with bio-identical small, especially considering doses prescribed are usually quite conservative.

My 2 cents. ;)

Quote from: Lyndsey on January 02, 2016, 09:47:07 AM
After surgery a lot will change. You will be cut way back on your meds and no more spiro as you will not need it at all. My estrogen meds have dropped in half

Pre-surgery, T is suppressed to post-surgery/castrate levels. So before and after surgery, T remains low. Nothing changes hormonally. Why lower E then if T remains the same before and after surgery?

The rationale for lowering E post-surgery comes from way back when E was used ALONE and higher doses were prescribed to help suppress T sufficiently and since post-surgery, T is low, E can be reduced as it need not suppress T now. Times have changed. It's important to question why we do what we do.

Quote from: KayXo on January 02, 2016, 01:08:15 PM
I don't believe that this puts a significant strain on the liver. Drugs like acetominophen, alcohol, excess sugar do however put on a strain. The effect is so small and insignificant with bio-identical estradiol that I would hesitate to put liver damage as one of the potential side-effects. Studies have also NOT shown this with bio-identical estradiol.

Yes but when one considers that birth control pills given to tens of thousands of women over the world have such little affect on risk of clotting, that these contain a type of estrogen that affects clotting to a much greater degree than bio estradiol (500 times, as much as 2500 times), I consider the effect with bio-identical small, especially considering doses prescribed are usually quite conservative.

My 2 cents. ;)

Pre-surgery, T is suppressed to post-surgery/castrate levels. So before and after surgery, T remains low. Nothing changes hormonally. Why lower E then if T remains the same before and after surgery?

The rationale for lowering E post-surgery comes from way back when E was used ALONE and higher doses were prescribed to help suppress T sufficiently and since post-surgery, T is low, E can be reduced as it need not suppress T now. Times have changed. It's important to question why we do what we do.

Hi All

I think that it is very important that we question what we take and the amount that we put in our bodies. My Doctor and I talk all the time and If he is trying to get something right I may have blood tests once a month.
Lyndsey

This is something I've been thinking about since I got my latest blood work back last week.

I've had 2 years of estradiol injections, but the last few months I've been too busy to make some of the two-weekly appointments and I've been using patches to keep my levels up for as much as 10 days after the time an injection was due.

The latest levels came back as 37.9pg/ml for oestrogen, and 17.3pg/ml for testosterone. Both of these are actually within male ranges for my age, when my last tests I think were in female ranges.

Having said that the blood was drawn 2 weeks after the previous injection. Breast growth has been more than satisfactory, fat distribution to my hips has happened a bit, and my face has rounded out.

I wonder if after some time the body begins to reassert itself some and a certain amount of 'oestrogen intolerance' takes place. I think I read that somewhere, but I may be wrong.

Should I ask about upping the dosage?

Quote from: Joan on January 02, 2016, 04:22:39 PM
This is something I've been thinking about since I got my latest blood work back last week.

I've had 2 years of estradiol injections, but the last few months I've been too busy to make some of the two-weekly appointments and I've been using patches to keep my levels up for as much as 10 days after the time an injection was due.

The latest levels came back as 37.9pg/ml for oestrogen, and 17.3pg/ml for testosterone. Both of these are actually within male ranges for my age, when my last tests I think were in female ranges.

Having said that the blood was drawn 2 weeks after the previous injection. Breast growth has been more than satisfactory, fat distribution to my hips has happened a bit, and my face has rounded out.

I wonder if after some time the body begins to reassert itself some and a certain amount of 'oestrogen intolerance' takes place. I think I read that somewhere, but I may be wrong.

Should I ask about upping the dosage?

Hu Joan

Why doesn't your Doctor let you give yourself the shots mine does. I do them once a week it keeps it more even. Every two weeks is like a roller coaster ride. Way up than way down. The hell with that. I would ask him. I would be welling to bet he lets you do that. :angel:

Hug's Lyndsey

Quote from: Lyndsey on January 02, 2016, 04:30:44 PM
Hu Joan

Why doesn't your Doctor let you give yourself the shots mine does. I do them once a week it keeps it more even. Every two weeks is like a roller coaster ride. Way up than way down. The hell with that. I would ask him. I would be welling to bet he lets you do that. :angel:

Hug's Lyndsey

Hi Lyndsey, and thanks for that :)

I've been thinking about how to get around this, as it's an hour's drive to the clinic. I hadn't thought about self-injecting, but I may ask. I might also ask about an implant, though I'm not sure implants are available in Japan.

I can feel myself begin to slide a bit when I get to the end of the two weeks.

Quote from: Joan on January 02, 2016, 04:39:34 PM
Hi Lyndsey, and thanks for that :)

I've been thinking about how to get around this, as it's an hour's drive to the clinic. I hadn't thought about self-injecting, but I may ask. I might also ask about an implant, though I'm not sure implants are available in Japan.

I can feel myself begin to slide a bit when I get to the end of the two weeks.

Hi Joan

The implants are out my doctor told me that they have had a few issues with them. Self injecting is the way to go.I'm sure your Dr. will let you if you are not scared to do it yourself

Hug's
Lyndsey

Quote from: Joan on January 02, 2016, 04:39:34 PM
Hi Lyndsey, and thanks for that :)

I've been thinking about how to get around this, as it's an hour's drive to the clinic. I hadn't thought about self-injecting, but I may ask. I might also ask about an implant, though I'm not sure implants are available in Japan.

I can feel myself begin to slide a bit when I get to the end of the two weeks.

Yes, two week cycles can be a big problem.
In the beginning there is a very high amount, and at the end a low phase, which might also effect mood.

You might ask for ten day or preferably weekly cycles.


hugs

Ask for weekly cycles it has no low

lyndsey

Quote from: Lyndsey on January 02, 2016, 04:45:17 PM
Hi Joan

The implants are out my doctor told me that they have had a few issues with them. Self injecting is the way to go.I'm sure your Dr. will let you if you are not scared to do it yourself

Hug's
Lyndsey

It's an individual response and may also depend on how the implant was compounded.

My first one left me with a nice little lump for a while.   Consequent ones which were compounded differently have been great.

Quote from: luna nyan on January 02, 2016, 09:27:08 PM
It's an individual response and may also depend on how the implant was compounded.

My first one left me with a nice little lump for a while.   Consequent ones which were compounded differently have been great.

That's interesting. I thought implants were the safest (low strain on liver) and most hassle-free (fewer visits than for IM) means of delivery. I didn't realise there were specific and unique problems.

Quote from: Joan on January 02, 2016, 04:22:39 PM
This is something I've been thinking about since I got my latest blood work back last week.

I've had 2 years of estradiol injections, but the last few months I've been too busy to make some of the two-weekly appointments and I've been using patches to keep my levels up for as much as 10 days after the time an injection was due.

The latest levels came back as 37.9pg/ml for oestrogen, and 17.3pg/ml for testosterone. Both of these are actually within male ranges for my age, when my last tests I think were in female ranges.

Having said that the blood was drawn 2 weeks after the previous injection. Breast growth has been more than satisfactory, fat distribution to my hips has happened a bit, and my face has rounded out.

I wonder if after some time the body begins to reassert itself some and a certain amount of 'oestrogen intolerance' takes place. I think I read that somewhere, but I may be wrong.

Should I ask about upping the dosage?

I'm not surprised your estradiol levels dropped as you skipped some of the injections, the blood was drawn 2 weeks after the injections and patches typically don't give much. I think it's important NOT to miss your injections when they are due.

If you measure levels 2-3 days after the injection, you will surely get a VERY different result. So levels don't really say much. You seem to be doing good so that's what's most important, I think. :)

Testosterone, I think, is in ng/dl, no?

Quote from: KayXo on January 03, 2016, 09:59:37 AM
I'm not surprised your estradiol levels dropped as you skipped some of the injections, the blood was drawn 2 weeks after the injections and patches typically don't give much. I think it's important NOT to miss your injections when they are due.

If you measure levels 2-3 days after the injection, you will surely get a VERY different result. So levels don't really say much. You seem to be doing good so that's what's most important, I think. :)

Testosterone, I think, is in ng/dl, no?

Hi Kay, and thanks for that.

The testosterone level is definitely pg/ml. I guess something down there is putting up a fight :D

I try not to miss injections, but between my schedule and the clinic opening times sometimes I just can't find the time.

Hey All

It's rather funny. Before SRS I took spiro to knock out the T and my dose of estrogen now I take less than half the estrogen and they are giving me T cream so as to bring it back up and WOW increase libido. Go figure! Crazy.


Lyndsey

Quote from: Joi on January 01, 2016, 01:11:27 PM
I'm 9 mos. into cross sex hormone therapy.  I've been on the patch.  Initially one, then two, then three.  Total E levels only moved from 31 at 90 days (one patch)  42 at 120 days (2 patches) 76 at 180 days (3 patches). Little feminization.
Some breast tenderness, mental changes, body odor. T is very low.  My endo is taking me off the patches in favor of injections.  His target was around 200.

8 months 15 days in. 

Dr has had me on patches since day one.  2 at a time changed twice a week.. My E went from <20 to 80 to 252.  I see hardly anything when it comes to physical changes.  Some breasts.  Face appears softer, but that's about it. 

Will be seeing a new Dr next month.  I'm curious to see what they'll have to say.

Quote from: DanaDane on January 04, 2016, 10:54:11 AM
8 months 15 days in. 

Dr has had me on patches since day one.  2 at a time changed twice a week.. My E went from <20 to 80 to 252.  I see hardly anything when it comes to physical changes.  Some breasts.  Face appears softer, but that's about it. 

Will be seeing a new Dr next month.  I'm curious to see what they'll have to say.

Hi All

From My experience My Doctor has put me on 1 time a week injections and it has remained very stable. I seam to have no ups and downs. But when the estrogen went threw the roof a month after surgery I have to say that I was and emotional basket case. I could cry if someone even looked at me wrong. After he got me down to 280 I have been feeling great. Wow what a ride. LOL!  :angel:

Hug's Lyndsey

Quote from: DanaDane on January 04, 2016, 10:54:11 AM
8 months 15 days in. 

Dr has had me on patches since day one.  2 at a time changed twice a week.. My E went from <20 to 80 to 252.  I see hardly anything when it comes to physical changes.  Some breasts.  Face appears softer, but that's about it. 

Will be seeing a new Dr next month.  I'm curious to see what they'll have to say.

If e is pg/ml levels should be good.
But its not all levels, internal applicaion ike injections works better for some people.
How are t levels ? They might stand in the way of some feminization...


hugs

Quote from: Joan on January 03, 2016, 04:11:47 PMThe testosterone level is definitely pg/ml.

Is this free testosterone, bio-available testosterone or total testosterone?

Quote from: Lyndsey on January 03, 2016, 08:09:06 PM
It's rather funny. Before SRS I took spiro to knock out the T and my dose of estrogen now I take less than half the estrogen and they are giving me T cream so as to bring it back up and WOW increase libido. Go figure! Crazy.

Other than an increase in libido, what other effects (positive and/or negative) have you noticed? How long have you been on the cream? Post-op, the only testosterone that we produce comes from adrenal glands, in other words, very low.

Quote from: KayXo on January 04, 2016, 12:38:02 PM
Is this free testosterone, bio-available testosterone or total testosterone?

Other than an increase in libido, what other effects (positive and/or negative) have you noticed? How long have you been on the cream? Post-op, the only testosterone that we produce comes from adrenal glands, in other words, very low.

Hi Girls

My levels of testosterone were only .04  now they are 4.0  My Estrogen is now 323 down from 523

I feel great and my boy friend like it too as I have been getting very frisky. LOL!  >:-)

Hug's
Lyndsey

Quote from: KayXo on January 04, 2016, 12:38:02 PM
Is this free testosterone, bio-available testosterone or total testosterone?

Hi Kay

That's free testosterone.

Quote from: KayXo on January 04, 2016, 12:38:02 PM
Is this free testosterone, bio-available testosterone or total testosterone?

Other than an increase in libido, what other effects (positive and/or negative) have you noticed? How long have you been on the cream? Post-op, the only testosterone that we produce comes from adrenal glands, in other words, very low.

Hi Kay

I have not been on the testosterone  cream long enough to know what effects it has on me all I know is i'm very frisky now and My junk has not grown back. My Boy friend sure like it. Time will tell and I will let everyone know. By the way Dr. Bowers is the one who scribed it for me.
Hug's
Lyndsey

Quote from: Lyndsey on January 04, 2016, 12:54:56 PM
My levels of testosterone were only .04  now they are 4.0

In what units? pg/ml? and is this free testosterone? please be more specific when stating levels.

Quote from: KayXo on January 05, 2016, 09:38:49 AM
In what units? pg/ml? and is this free testosterone? please be more specific when stating levels.

pg/ml

Lyndsey

You didn't say if it was FREE testosterone or not, but judging by the numbers provided in pg/ml, it most probably is.

Ranges for free testosterone are 1.0–8.5 pg/mL for females, 50-210 for males.
http://www.emedicinehealth.com/script/main/art.asp?articlekey=129553

So, you are well in female range while Joan's 17.3 is above female but under male.

Quote from: KayXo on January 05, 2016, 06:59:06 PM
Joan's 17.3 is above female but under male.

Thanks Kay. I'm seeing the endo on Saturday for my next injection so I'll have a chat wth her and see what she says. She seemed happy with the levels last time but it might be good to ask again.

She seemed happy with levels BUT more importantly, what about how you feel and your feminization? Aren't these what matter at the end of the day, more than levels?

Quote from: Joan on January 06, 2016, 02:20:53 AM
Thanks Kay. I'm seeing the endo on Saturday for my next injection so I'll have a chat with her and see what she says. She seemed happy with the levels last time but it might be good to ask again.

I would kind of echo what Kay said.

They might be happy but you have to watch out for your own best interest.
That is why imo its important to get educated, have information and be ready to have your points looked after, if necessary by another professional.

Some people are prudent, others not very well versed with transgender people. So having a discussion and getting a feel for it might help.

hugs

Quote from: KayXo on December 31, 2015, 04:45:22 PMMy levels of estradiol are high while my progesterone levels range from 13-20 ng/dl. I am careful with my diet, so restrict carbs as these tend to significantly raise triglycerides. I was under the normal range once when I restricted all carbs! And my HDL was wayyyyyyy high! Glucose, HbA1C, and insulin are also adversely affected by too many carbs, more so in some than others. I know that, in a few, creatinine is adversely affected by spironolactone.

You are so right about how things improve when you minimize carbs. My skin and especially my hair texture always improve. Any ideas for why this happens?? If only I could keep it up. But I've been pummeled over and over by so much life-changing bad news this year that I can't regain my discipline. I've got to capitalize on the prep for the colonoscopy that I'm undergoing early next month. Meanwhile, I hope some here can provide a more in-depth explanation than my endo did for why my progesterone level tested so high.

This month was the first time that I had asked to have it tested. The testes produce most of the progesterone in cis men. But I'm 10 years post-op and have been on estradiol valerate injections twice monthly long before and ever since. So I was shocked when the blood levels showed it at 13 ng. My endo said that the adrenals are evidently producing enough progesterone to balance my exogenous estrogen levels. "Balance"? Then why did the Lab Corp statement say 'high" 13 ng? Too bad I have no record of any pre-op progesterone level test. Would the level likely be this high?

This month T serum <3 ng. Bound T is <.2. E is 909 ng. B12 level is "high" at 1474 pg. HDL and LDL have long been high at 252 and 137. Iron is 339 bind/serum 339/125 ug. Creatinine serum LOW 0.62 mg; BUN/Creatinine ratio 13.

But regardless of progesterone levels, might I still be at risk for "estrogen dominance"? Even if not, could my progesterone levels put me at risk for other deleterious effects?

My main concerns are scalp hair and libido, in that order. But to take the latter first, as strange it may sound to some here, I wouldn't at all miss libido if it went away.  My main concerns are scalp hair and libido, in that order. But to take the latter first, as strange it may sound to some here, I wouldn't at all miss libido if it went away. I will never forget the very first two years after I began therapy (estradiol valerate, spiro and a little Premarin), long ago. I grew back so much hair that I looked like a different person!! I was truly stunning. And almost as heavenly was the totally unexpected loss of libido. Poof! It just vaporized; or as if some big weight had fallen off my shoulders.

Without 10% minoxidil + 0.1% progesterone and Dutasteride that my derm and endo had prescribed my hair would surely be worse than it is. But why did the hair loss AND libido slowly come back at all? Especially after orchiectomy??

And if the adrenals were trying to "normalize" my estrogen levels then why are they secreting high levels of progesterone, rather than just normal levels? Surely, the 0.1% progesterone in the topical that I press into my scalp twice daily is way too small to even penetrate the skin into the bloodstream, much less effect systemic levels.

Besides, by being a competitive inhibitor of 5-alpha reductase, progesterone is a natural antagonist of hair killing DHT. https://en.wikipedia.org/wiki/Progesterone_(medication)#Pharmacodynamics

Might it be that I've been using too much E for a typical post-op person, and/or because the vials of estradiol valerate are almost certainly synthetic rather than bioidentical?

I can get natural estradiol valerate made by a local compounding pharmacy. But what signs should a post-op person look for to determine the right estrogen dosing?

Bottom line: How likely is my high progesterone contributing to libido and hair loss years after surgery? If yes, would it likely decrease if my endo lowers the dose of the 40mg/mL estradiol valerate I take every 14 days?