Susan's Place Transgender Resources

I'll summarize:
- I started Spiro  about a year ago
- I started Estradiol  3 months ago
- My doctor agrees I'm due to double my dose of estradiol
- My total testosterone levels before spiro were 249 and after a year they're 220 so they havent lowered much if at all
- My doctor doesnt seem to think this is a problem

Someone on ->-bleeped-<- said something like "my doctor doesn't even check for those levels because they don't mean anything because the spiro is blocking it from working" - I am heavily paraphrasing but they said something like that

Which brings me to my question:
I was under the impression and I am open to being wrong about this, but what I thought was that the goal for mtf HRT was to lower the T levels to cis female levels and bring the Estrogen up to cis female levels. Right?

Ok, so my worry is:
Would upping my estradiol dose  affect me negatively because then both my testosterone AND my estrogen would be high at the same time? Shouldn't one of them always be lower than the other?

What I am picturing is my body being affected negatively by this like overload, by both of them being high at the same time. But I might be imagining it more dramatically than it needs to be.

Any help is appreciated

TLDR; WILL I DIE IF I TAKE A HIGHER ESTRADIOL DOSE WHILE MY T LEVES ARE ALSO HIGH?

 Oooops you need to remove the dosage info for posts on this site. Or a moderateor will do it for you and give you a stern talking to.

Hugs for ya.
   Laurie

You are correct in that the goal should be to get both E and T within normal female levels. Having T high will severely limit the feminization effects.


~Brooke~

As it appears you haven't been welcome before, welcome to Susan's Place. You didn't include units so assuming they are ng/dl, they are still in the low masculine range. A higher estradiol level may lower testosterone as well as a higher Sprio dosage so your doctor may be working the two together in order to determine what your body requires. At your current levels, your dysphoria may be higher than it would be on a lower levels and feminizing might be slower but it it's not harmful. Before blocker were used in treatment, we transitioned using estrogen only. The modern mixes provide a far more realistic experiences of what a feminine chemical mix is like.

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Was on sprio and same thing happened to me to some degree.. So I had to take a whole new T-blocker!

Quote from: Dena on May 03, 2017, 10:20:55 PM
A higher estradiol level may lower testosterone as well as a higher Sprio dosage so your doctor may be working the two together in order to determine what your body requires.

I'm not sure about the efficacy of spiro alone in lowering testosterone levels. I can point to a case study of one, me. :)   Before starting HT, I took spiro in a low dosage for several years for CHF. At one point, I tripled my intake for three weeks prior to having a routine testosterone test. I didn't get copies of the results so I can't tell you the exact numbers, but the results were testosterone levels dropped from the upper 600's ng/dl to the lower 600's. Not really much of a change.

Roll forward about a year, I started HT which only doubled the spiro but added a moderate dosage of estradiol, my testosterone levels dropped to the 30's. That's a big change and was on a spiro dosage of 50% less that my ad hoc test. I might add that several years of low dosage spiro did result in significant gynecomastia, so I would assume there's some T blocking going on irrespective of the total T levels.

Just one person's experience.

All the best,
--AshleyP

Yes, Spironolactone ALSO blocks some testosterone so even if levels are somewhat high, this does not tell the whole story. This is why measuring levels isn't very relevant or useful in this context.

As estradiol increases in the body, testosterone naturally drops. Like a thermostat. The body senses an increase in one hormone, it reduces the other (i.e. hypothalamus, pituitary gland, luteinizing hormone). The only way for both to be high is you take both testosterone and estrogen from outside sources.

Thanks everyone for your answers and sorry I put my dose won't happen again!

Quote from: KayXo on May 04, 2017, 03:52:47 PM
Yes, Spironolactone ALSO blocks some testosterone so even if levels are somewhat high, this does not tell the whole story. This is why measuring levels isn't very relevant or useful in this context.

As estradiol increases in the body, testosterone naturally drops. Like a thermostat. The body senses an increase in one hormone, it reduces the other (i.e. hypothalamus, pituitary gland, luteinizing hormone). The only way for both to be high is you take both testosterone and estrogen from outside sources.

Thank you! I will move forward with the estradiol dose increase that I discussed with my doctor.

Quote from: KayXo on May 04, 2017, 03:52:47 PM
As estradiol increases in the body, testosterone naturally drops. Like a thermostat. The body senses an increase in one hormone, it reduces the other (i.e. hypothalamus, pituitary gland, luteinizing hormone). The only way for both to be high is you take both testosterone and estrogen from outside sources.

Kay - does that really mean that after some amount of time we can reduce the Spiro or eliminate it altogether and just do the E? That'd be great! Must ask my doc about that next month. Do you know of a reference I can check out regarding that.

The problem is that most often, the amount of E prescribed by doctors is not enough to suppress T to castrate levels so that is the reason they use an anti-androgen. Any doctor should know that E naturally suppresses T.

I personally think that higher doses of estradiol, when bio-identical, are safe enough in most cases and even perhaps safer and better for quality of life than taking an anti-androgen, especially if the E is taken by injection or by pellets. But, I'm not a doctor so you need to discuss this with them and find out what their position is.

Quote from: laurenb on May 05, 2017, 03:30:36 PM
Kay - does that really mean that after some amount of time we can reduce the Spiro or eliminate it altogether and just do the E? That'd be great! Must ask my doc about that next month. Do you know of a reference I can check out regarding that.

If it helps I'm on patches and them alone have kept my Testosterone in female ranges. I do have a friend that tried Estradiol alone and it didn't workout so it may vary from person to person.