Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: Jaime320 on November 16, 2018, 11:55:26 AM Return to Full Version
Title: What should be sublingual for optimum results?
Post by: Jaime320 on November 16, 2018, 11:55:26 AM
Post by: Jaime320 on November 16, 2018, 11:55:26 AM
I know E should be sublingual. Should spiro or fin also be sublingual? I've just been swallowing the spiro and fin
Title: Re: Whwhat should be sublingual for optimum results?
Post by: Lacy on November 16, 2018, 12:11:06 PM
Post by: Lacy on November 16, 2018, 12:11:06 PM
Quote from: Jaime320 on November 16, 2018, 11:55:26 AMThe Spiro I'm on is pill form with a nasty mint coating on it. I was instructed to swallow it. I am not aware of Sublingual Spiro.
I know E should be sublingual. Should spiro or fin also be sublingual? I've just been swallowing the spiro and fin
Hugs,
Lacy
Title: Re: What should be sublingual for optimum results?
Post by: Jaime320 on November 16, 2018, 12:21:17 PM
Post by: Jaime320 on November 16, 2018, 12:21:17 PM
Yeah I'm no fan of the mint either. It was unexpected.
Title: Re: Whwhat should be sublingual for optimum results?
Post by: ChrissyRyan on November 16, 2018, 12:27:44 PM
Post by: ChrissyRyan on November 16, 2018, 12:27:44 PM
My Fin. is not a coated pill, if that means some kind of thick hard shell. I swallow my pill.
I am not in a position to advise for you that Fin. should be specifically taken sublingually or swallowed, please ask your physician. :)
Chrissy
I am not in a position to advise for you that Fin. should be specifically taken sublingually or swallowed, please ask your physician. :)
Chrissy
Title: Re: What should be sublingual for optimum results?
Post by: Jaime320 on November 16, 2018, 12:44:18 PM
Post by: Jaime320 on November 16, 2018, 12:44:18 PM
Aww come on. I will not hold anyone liable. I'm getting mixed info between pharmacy and doc. Just wanted to ask the audience. Doc said swallow btw.
Title: Re: What should be sublingual for optimum results?
Post by: ChrissyRyan on November 16, 2018, 12:52:40 PM
Post by: ChrissyRyan on November 16, 2018, 12:52:40 PM
Quote from: Jaime320 on November 16, 2018, 12:44:18 PM
Aww come on. I will not hold anyone liable. I'm getting mixed info between pharmacy and doc. Just wanted to ask the audience. Doc said swallow btw.
You could ask the pharmacist and your physician to consult each other.
Each person's case is personal and specific to him or her.
People here can tell you what they do but that may not be right for you.
Title: Re: What should be sublingual for optimum results?
Post by: Devlyn on November 16, 2018, 12:58:54 PM
Post by: Devlyn on November 16, 2018, 12:58:54 PM
I was on patches at first, then switched to oral estradiol, taken sublingually. When I mentioned to my doctor that I had drooled pn myself and spit blue on the sidewalk once or twice, she said "You can just swallow the damn pills, Devlyn, you're getting plenty of estrogen."
These things aren't critical, we make too much of them. It isn't a maximum overdose of E that gets the job done, it's long-term exposure to it. :)
These things aren't critical, we make too much of them. It isn't a maximum overdose of E that gets the job done, it's long-term exposure to it. :)
Title: Re: What should be sublingual for optimum results?
Post by: Jaime320 on November 16, 2018, 02:00:35 PM
Post by: Jaime320 on November 16, 2018, 02:00:35 PM
Thanks. I'll keep popping and stabbing as I've been doing.
Title: Re: What should be sublingual for optimum results?
Post by: Linde on November 24, 2018, 12:08:13 AM
Post by: Linde on November 24, 2018, 12:08:13 AM
Quote from: Jaime320 on November 16, 2018, 12:44:18 PMThe pharmacist knows best. Docs get their info from the pharmaceutical reps or the Merck register. Pharmacists are the ones who are creating those guidelines!
Aww come on. I will not hold anyone liable. I'm getting mixed info between pharmacy and doc. Just wanted to ask the audience. Doc said swallow btw.
Title: Re: What should be sublingual for optimum results?
Post by: Dani on November 24, 2018, 05:10:16 AM
Post by: Dani on November 24, 2018, 05:10:16 AM
Retired Pharmacist here.
Finasteride and Spironolactone should be swallowed. There is no need for sublingual for these two medications, especially for the Finasteride. Finasteride causes birth defects in a fetus whose mother was exposed to Finasteride. For this reason all Finasteride in the US is coated to prevent dust from the tablet getting to where is may cause a problem. The coating makes Finasteride impossible to use sublingual effectively.
Spironolactone is such a large tablet, I would think that taking it sublingual would be difficult to do. Spironolactone works just fine with swallowing the tablet. Sublingual adds nothing.
The only reason to take your Estradiol sublingual is to avoid the first pass through the liver. Yes, with sublingual you get much higher blood levels initially, but they soon drop to a more normal level. Injections and patches also avoid the first pass effect, but they do not provide the high blood level spike. They were designed for provide steady state blood levels.
As others have posted, blood levels are not that important for transition purposes. You just need to be in the normal female range and with long term exposure, you will reach your goal as well as any other female in your family.
Finasteride and Spironolactone should be swallowed. There is no need for sublingual for these two medications, especially for the Finasteride. Finasteride causes birth defects in a fetus whose mother was exposed to Finasteride. For this reason all Finasteride in the US is coated to prevent dust from the tablet getting to where is may cause a problem. The coating makes Finasteride impossible to use sublingual effectively.
Spironolactone is such a large tablet, I would think that taking it sublingual would be difficult to do. Spironolactone works just fine with swallowing the tablet. Sublingual adds nothing.
The only reason to take your Estradiol sublingual is to avoid the first pass through the liver. Yes, with sublingual you get much higher blood levels initially, but they soon drop to a more normal level. Injections and patches also avoid the first pass effect, but they do not provide the high blood level spike. They were designed for provide steady state blood levels.
As others have posted, blood levels are not that important for transition purposes. You just need to be in the normal female range and with long term exposure, you will reach your goal as well as any other female in your family.
Title: Re: What should be sublingual for optimum results?
Post by: TonyaW on November 24, 2018, 07:14:07 AM
Post by: TonyaW on November 24, 2018, 07:14:07 AM
Quote from: Devlyn on November 16, 2018, 12:58:54 PM
I was on patches at first, then switched to oral estradiol, taken sublingually. When I mentioned to my doctor that I had drooled pn myself and spit blue on the sidewalk once or twice, she said "You can just swallow the damn pills, Devlyn, you're getting plenty of estrogen."
Why I don't spit for a good hour after I take a pill. I'm sure I'm swallowing at least half of my dose since I'm not super diligent about waiting 30 minutes etc to eat or drink anything.
Quote from: Dietlind on November 24, 2018, 12:08:13 AM
The pharmacist knows best.
That's what I keep trying to tell everyone [emoji4]
Quote from: Dani on November 24, 2018, 05:10:16 AM
Retired Pharmacist here.
Spironolactone is such a large tablet, I would think that taking it sublingual would be difficult to do. Spironolactone works just fine with swallowing the tablet. Sublingual adds nothing.
Would just add that if you were successful in raising the blood levels of spironolactone, that could be a bad thing due to potentially unsafe drops in blood pressure.
Sent from my SM-G930T using Tapatalk
Title: Re: What should be sublingual for optimum results?
Post by: KatieP on November 24, 2018, 03:21:54 PM
Post by: KatieP on November 24, 2018, 03:21:54 PM
Um.... If you are silly enough to try spiro sublingually one time, I promise it will be your last.
;D
Even when they get stuck in the mouth for too long, it is enough to adversely affect my taste for a while...
Kate
;D
Even when they get stuck in the mouth for too long, it is enough to adversely affect my taste for a while...
Kate
Title: Re: What should be sublingual for optimum results?
Post by: Jaime320 on November 24, 2018, 08:44:58 PM
Post by: Jaime320 on November 24, 2018, 08:44:58 PM
Thanks everyone. I gave up on express route. Besides I spilt my water and held spiro today longer than I wished. Yuck. Also Normal methods have been express enough. I've just been taking spiro and fin normally, and IM injecting the EV. 3 weeks in things work only if really asked, & you can definitely tell spiro is 100% in effect. 3 month labs should be interesting.
Title: Re: What should be sublingual for optimum results?
Post by: Coffeedrew on November 24, 2018, 10:30:39 PM
Post by: Coffeedrew on November 24, 2018, 10:30:39 PM
Any one ever get swollen under tongue after taking E that way? I was told to switch sides has anyone else experienced ??? that swelling goes down after I use mouth wash and it returns to normal.
Title: Re: What should be sublingual for optimum results?
Post by: GordonG on November 25, 2018, 06:24:49 PM
Post by: GordonG on November 25, 2018, 06:24:49 PM
I've been on E sublingual now for 6 weeks and have not experienced that.
Title: Re: What should be sublingual for optimum results?
Post by: Dani on November 25, 2018, 07:22:43 PM
Post by: Dani on November 25, 2018, 07:22:43 PM
Quote from: Coffeedrew on November 24, 2018, 10:30:39 PM
Any one ever get swollen under tongue after taking E that way? I was told to switch sides has anyone else experienced ??? that swelling goes down after I use mouth wash and it returns to normal.
I have been on sublingual Estradiol for 4 years now and I never had any swelling of any kind from my Estradiol.
Title: Re: What should be sublingual for optimum results?
Post by: Linde on November 25, 2018, 08:46:08 PM
Post by: Linde on November 25, 2018, 08:46:08 PM
Quote from: Dani on November 25, 2018, 07:22:43 PMI could think of some type of allergic reaction! I don't know what the coating on those pills is, but if it is some type of enteric coating, it is on the basic side. Mouthwash contains alcohol, and that is acidic. Could be that the alcohol in the mouthwash neutralizes the reactions to the basic enteric coating?
I have been on sublingual Estradiol for 4 years now and I never had any swelling of any kind from my Estradiol.
Title: Re: What should be sublingual for optimum results?
Post by: Coffeedrew on November 25, 2018, 11:23:35 PM
Post by: Coffeedrew on November 25, 2018, 11:23:35 PM
I believe it's called the submandibular gland.Anyway I asked my doctor, he just said switch sides you take pill on.I was just curious if anyone else experienced that.It is not causing me pain it's just IDK why my body does weird things lol.
Title: Re: What should be sublingual for optimum results?
Post by: LilithWild on November 25, 2018, 11:38:58 PM
Post by: LilithWild on November 25, 2018, 11:38:58 PM
Taking E sublingually caused bleeding sores on the inside of my lips, so I switched to swallowing. I will ask my doctor about it during my next visit. Anyone else had this reaction?
Title: Re: What should be sublingual for optimum results?
Post by: Coffeedrew on November 25, 2018, 11:41:01 PM
Post by: Coffeedrew on November 25, 2018, 11:41:01 PM
Not me.Mine tatstes all sugary and then I'm left with a bunch of chalk in my mouth.
Title: Re: What should be sublingual for optimum results?
Post by: Linde on November 25, 2018, 11:47:02 PM
Post by: Linde on November 25, 2018, 11:47:02 PM
Quote from: LilithWild on November 25, 2018, 11:38:58 PMAll kinds of unusual reactions here. I don't take this stuff orally (I have patches), what says it on the packaging slip how the medication is to be taken? Do you know what kind of coating the pill has. Who told you to take it sublingual?
Taking E sublingually caused bleeding sores on the inside of my lips, so I switched to swallowing. I will ask my doctor about it during my next visit. Anyone else had this reaction?
Physicians are neither biochemists nor are the pharmacists, and your doctor may not have an answer why this occurred!