Susan's Place Transgender Resources

So I got good and bad news.
The bad news is that T can indeed cause blood clots. Not directly, though. Polycythemia (increased blood count) and conversion to estrogen can lead to DVTs.

The good news is that I can get T on a low dose to avoid the estrogen conversion, DVTs and may or may not have to start taking light Aspirin to prevent clotting.

At first, I thought he was gonna say no and I wanted to show him my resources. But he was so certain about T causing DVTs that he said he did not need to see them. I wasn't gonna argue with the doctor, so I wanted to hear him out. And when he told me the good news, I was speechless.

He said he would send off his recommendations today to my endo's office so by the time my next appointment with my endo rolls around on the 6th of next month, I just might get my first dose of Testosterone. I am so, so, so stoked right now!!! Thank you guys so much for getting me this far. Thank you all!^^

Congratulations  :)


Well done  :)


*hugs*

Congrats, man -- that's great!

 :icon_joy: :icon_joy: :icon_joy: :icon_joy: :icon_joy: :icon_joy: :icon_joy: :icon_joy: :icon_joy:

Oh hell yeah!  Congrats, man!  I'm so happy for you.  :)

Great news!!! Congrats!

Sent from my SM-G870W using Tapatalk

Quote from: King Phoenix on May 09, 2016, 05:12:02 PM
The bad news is that T can indeed cause blood clots. Not directly, though. Polycythemia (increased blood count) and conversion to estrogen can lead to DVTs.

E alone doesn't increase risk of clots, if anything you will have less E on TRT than before. This claim doesn't hold up in the face of this fact. High levels of E in men aged 49-91 showed no relation to an increase in risk in clots, up to 700 pg/ml which are MUCH higher than levels you will have on T. Pregnant women with levels up to 75,000 pg/ml have a clot risk of less than 0.2%. My levels are in the range of 1,000-4,000, clotting times remain normal.

E becomes problematic when it is not BIO-IDENTICAL and when taken orally, none of these apply to you. Such an explanation coming from scientists and doctors who should know this information surprises me, to be honest with you.

As far as increased blood count increasing risk of clots, I have no clue. But, then, aren't all men in their teens, 20's, 30's at risk of getting clots and do we deny them T for this reason if we find they are genetically predisposed or castrate them?

QuoteThe good news is that I can get T on a low dose to avoid the estrogen conversion, DVTs and may or may not have to start taking light Aspirin to prevent clotting.

Transmen take high doses of T and their E levels remain VERY low. Same holds true for genetic men who have very high levels of T early in their lives and yet E remains at around 10-40 pg/ml, at most 90-100 pg/ml. 7 times that amount in men have shown no risks, 750 times that amount equals to risk of clotting of less than 0.2%.

Whether aspirin is indeed useful for prevention of clotting is still debatable (affects arterial clotting more than vein, platelets) and if not needed, can irritate intestines and cause ulcer, long-term.

As always, I'm not a doctor but I thought it be important for you to have this information at hand so as not to be in the dark and have a constructive discussion with those treating you.

Quotehe was so certain about T causing DVTs that he said he did not need to see them.

In my opinion, not a good sign. Openness to diverging info is a quality that is required of any doctor and strengthens their knowledge base. Anyone who is too sure of themselves and refuses to see other evidence cannot evolve and become better. I would have personally asked for a second opinion. Doctors can be wrong (they are human) and even amongst doctors, there is disagreement about many issues.

Happy you got your T but still...

Fertil Steril. 2010 Mar 1;93(4):1267-72.

"VTE during cross-sex hormone therapy is rare. General screening for thrombophilic defects in transsexual patients is not recommended. Cross-sex hormone therapy is feasible in MtF as well as in FtM patients with aPC resistance."

J Clin Endocrinol Metab. 2003 Dec;88(12):5723-9.

"Testosterone administration to female-to-male transsexuals had an antithrombotic effect."

Endocr Pract. 2013 Jul-Aug;19(4):644-50.

None of the 50 transmen in this study developed blood clots.

Congradulations dude! You earned it! ;D

Quote from: KayXo on May 11, 2016, 06:52:00 PM
E alone doesn't increase risk of clots, if anything you will have less E on TRT than before. This claim doesn't hold up in the face of this fact. High levels of E in men aged 49-91 showed no relation to an increase in risk in clots, up to 700 pg/ml which are MUCH higher than levels you will have on T. Pregnant women with levels up to 75,000 pg/ml have a clot risk of less than 0.2%. My levels are in the range of 1,000-4,000, clotting times remain normal.

E becomes problematic when it is not BIO-IDENTICAL and when taken orally, none of these apply to you. Such an explanation coming from scientists and doctors who should know this information surprises me, to be honest with you.

As far as increased blood count increasing risk of clots, I have no clue. But, then, aren't all men in their teens, 20's, 30's at risk of getting clots and do we deny them T for this reason if we find they are genetically predisposed or castrate them?

Transmen take high doses of T and their E levels remain VERY low. Same holds true for genetic men who have very high levels of T early in their lives and yet E remains at around 10-40 pg/ml, at most 90-100 pg/ml. 7 times that amount in men have shown no risks, 750 times that amount equals to risk of clotting of less than 0.2%.

Whether aspirin is indeed useful for prevention of clotting is still debatable (affects arterial clotting more than vein, platelets) and if not needed, can irritate intestines and cause ulcer, long-term.

As always, I'm not a doctor but I thought it be important for you to have this information at hand so as not to be in the dark and have a constructive discussion with those treating you.

In my opinion, not a good sign. Openness to diverging info is a quality that is required of any doctor and strengthens their knowledge base. Anyone who is too sure of themselves and refuses to see other evidence cannot evolve and become better. I would have personally asked for a second opinion. Doctors can be wrong (they are human) and even amongst doctors, there is disagreement about many issues.

Happy you got your T but still...

Fertil Steril. 2010 Mar 1;93(4):1267-72.

"VTE during cross-sex hormone therapy is rare. General screening for thrombophilic defects in transsexual patients is not recommended. Cross-sex hormone therapy is feasible in MtF as well as in FtM patients with aPC resistance."

J Clin Endocrinol Metab. 2003 Dec;88(12):5723-9.

"Testosterone administration to female-to-male transsexuals had an antithrombotic effect."

Endocr Pract. 2013 Jul-Aug;19(4):644-50.

None of the 50 transmen in this study developed blood clots.

But I tried to get the man to look at my resources and he said, no. It's not like I could put a gun up to his head and demand that he either looks at my resources or he will be looking six feet under. In other words, he just outright refused to look at them. I was devastated and your post makes me feel very inadequate, as if what I have accomplished is not enough and that there is always a but in my life just waiting around every corner to nip me. I'm not sure whether I should feel good or bad now.

I feel like I am settling for less than what I really need because that is all I am allowed. Again, I had a history of clots and I think that is their fear. If I weren't predisposed, maybe I would be on a higher dose like the other lucky transmen who are able to find endocrinologists that don't seem like they want to work against them. Hell, he hasn't even responded to the recommendations yet. Like he really doesn't want to treat me. From who else may I obtain an opinion? My hematologist was the second opinion.:-\

Very cool  ;D ;D ;D ;D

Liz K

I'm not sure I'd worry too much about the risks of taking T. There are risks in taking estrogen, but I know what's going to happen if I don't and that's far worse.

Perhaps you can find some way to reduce whatever extra risks there may be. I spoke to my endo about low dose aspirin (when taking estrogen) and he said the risks of taking asprin outweighed the risks of not taking it. I'm reasonably confident my endo knows what he's doing (not something I'd say about most doctors).

I found I got a lot healthier just though a reduction in stress when I increased my estrogen levels. It showed up in my blood tests getting heaps better.

At the end of the day men don't live as long as women and perhaps you'd get some of that, but it doesn't really matter does it? Its not like there's much choice in this for us.

Quote from: King Phoenix on May 11, 2016, 10:05:52 PMFrom who else may I obtain an opinion? My hematologist was the second opinion.:-\

Then get a third and a fourth opinion. Etc. I'm sure there are other hematologists better versed in this matter and who could help you more. You need to work harder to find them, make calls, talk to people around you, etc but will be worthwhile in the end. Doctors who are set in their ways and unwilling to learn and listen can do more harm than good. I think if perhaps, you had raised some of the things I did, he would have also responded differently like the fact that your E levels will BE LESS on T so if E raised the risk, how would E from conversion of T pose a problem, if anything risks would be less because you have less E now...see how what he said makes no sense? You need to critically assess what he says and not be afraid to argue and question.

Quote from: AnonyMs on May 12, 2016, 06:31:35 AM
There are risks in taking estrogen, but I know what's going to happen if I don't and that's far worse.

When the estrogen is bio-identical, risks seem to be negligible and benefits to the body and psyche unequivocal. Half the world population is flooded with it for most their lifetimes. We only started to perceive estrogen in a negative way when other forms, not bio-identical, were taken by women, often with progestogens which were also not bio-identical. Should we be surprised of the negative results?!

Quote from: KayXo on May 13, 2016, 12:18:35 PM
Then get a third and a fourth opinion. Etc. I'm sure there are other hematologists better versed in this matter and who could help you more. You need to work harder to find them, make calls, talk to people around you, etc but will be worthwhile in the end. Doctors who are set in their ways and unwilling to learn and listen can do more harm than good. I think if perhaps, you had raised some of the things I did, he would have also responded differently like the fact that your E levels will BE LESS on T so if E raised the risk, how would E from conversion of T pose a problem, if anything risks would be less because you have less E now...see how what he said makes no sense? You need to critically assess what he says and not be afraid to argue and question.

I agree with you, actually, especially about doctors being very sure of themselves. He seemed that way and did not even look at my lab work from my endocrinologist office. I couldn't even debate her uncertainty with my hematologist's decision to ok me being on T because he never even seen the lab work. Like he is just that sure that low T is the answer.

But I saw what alot of other members on here who started hormones said about that. They also began on a low dose and within 6 months, that is when they increased their dose. It depends on how well each individual responds. Not everyone is designed the same way, so not everyone will respond well to a high dose. That doesn't mean that they won't mature as well as other trans people on hormones. It may take longer, but I say it's better to be safe than sorry.