I know that medication dosages cannot be discussed here but I was wondering what other members hormone levels (E and T) are and what method of delivery they are on and how long they have been on HRT? What levels does your doctor say is ideal?
Estrogen: 157 pmol/L according to me and common sense. 450 or 1100 according to my endo, both on the same dose. I made a topic on that. >_> 400-600 is more or less what he's aiming for, regardless of how horribly doubtful the results are.
Testosterone: 0.5 nmol/L. He's made no comment, so I assume that's fine. It's on the low side for women, so.
I've been on cyproterone acetate (Androcur), a medium dose.
I started with Estrace, a low dose, and then I switched over to Estrogel, a low dose as well, the same they give to menopaused women to reach the ~200 bare minimum to tame the worst symptoms. I wanted the more stable delivery. But as of today I'm going back to Estrace, because Estrogel fakes test results and the endo refuses to look at the valid results (24 hours since last dose), and on top, Estrogel is sort of expensive, and not covered.
My HRT time is, well, down here, in my signature.
My Estradiol level stays between 150-200 pg/ml... and my Total Testosterone level stays around 20-25 ng/dl. Generally most endos want to keep your E levels between 100-200 pg/ml and your Total T level below 40 ng/dl. I've been on HRT 3 years, sublingual E and oral T blocker.
For those members living in the rest of the world (Europe, UK, et al) with the metric system (ie SI units) to convert your Estradiol level to US units (conventional units) divide your level by 3.67, which will convert it to pg/ml. To convert your Testosterone level to US units (conventional units) divide by .0347 to convert nmol/L to ng/dl. For us here in the US to convert to SI units, simply multiply your levels by those same factors for E & T respectively. That way we can compare apples to apples. Not apples to oranges.
First blood test after my first implant 'E' was 2068 pmol/L, 'T' didn't read, hasn't for the last 5 tests. Second blood test (6 weeks later) 'E' dropped and stabilised at 1824 pmol/L, again no 'T'.
Heading off for my second implant this Friday and will have Progesterone implant as well. Should be interesting to see next result.
After coping with the patch 'checker board' over my stomach for the first 7 months of HRT, implants are just so easy and comfortable.
Huggs
Catherine
I have also considered the implant route. Does it not hurt and leave liitle scars Catherine?
Huggs
Megs
Quote from: Maegan on January 15, 2013, 09:00:35 AM
I have also considered the implant route. Does it not hurt and leave liitle scars Catherine?
Huggs
Megs
I had some discomfort once the the local anaesthetic wore off, but only for a day or so. I currently have a very short visible scar, but it's fading quite quickly..
Hi Maegan,
Good to see you round. Hope 2013 realises your every wish and desire in abundance.
No it doesn't hurt, nor leave a scar. It requires two stitches what need to be removed 3- 4 days later. The incision for a 3mm implant is about 1.5 - 2.0mm incision, depending on how clumsy your Endo is :laugh: (Fortunately mine isn't). The Progesterone is even smaller and my Endo is looking for a large hypo style injectable device. But for now I think I'm in for an even smaller incision.
Just to show how individual we all are; a girl I know interstate had an implant double my dosage and she went from 322 pmol/L to 435pmol/L. And I went from 483 to 2068 pmol/L. Go figure.
I know I'm skating on thin ice here with respects to ToS, but should you ever reach those lofty heights, it certainly takes you psychologically to an all new level of understanding.
Hope whichever way you go, you achieve the goals you desire.
Love
Catherine
Quote from: JennX on January 15, 2013, 08:25:07 AM
My Estradiol level stays between 150-200 pg/ml... and my Total Testosterone level stays around 20-25 ng/dl. Generally most endos want to keep your E levels between 100-200 pg/ml and your Total T level below 40 ng/dl. I've been on HRT 3 years, sublingual E and oral T blocker.
For those members living in the rest of the world (Europe, UK, et al) with the metric system (ie SI units) to convert your Estradiol level to US units (conventional units) divide your level by 3.67, which will convert it to pg/ml. To convert your Testosterone level to US units (conventional units) divide by .0347 to convert nmol/L to ng/dl. For us here in the US to convert to SI units, simply multiply your levels by those same factors for E & T respectively. That way we can compare apples to apples. Not apples to oranges.
Considering the standard for the world minus the US is the SI, I think it would've made more sense to convert your numbers to those, but anyway. xD
Quote from: Maegan on January 15, 2013, 09:00:35 AM
I have also considered the implant route. Does it not hurt and leave liitle scars Catherine?
Huggs
Megs
Btw Maegan that injection implant is over R3000 every 3 months here in South Africa(This is just the T blocker one though I remember we only get E pills here)
T= < 20.2 ng/dl
E= 177.2 pg/ml
I coverted my units to the american units because most members here seem to use those.
I use pills
paigeme: Probably there's a recent medication change and she wants it to stabilise. 3 months is what's generally said for hormones to really stabilise.
LilDevilOfPrada: Don't spread the evil! D: Kidding, kidding.
QuoteBtw Maegan that injection implant is over R3000 every 3 months here in South Africa(This is just the T blocker one though I remember we only get E pills here)
Wow, that is expensive! I remember someone telling me that the implant is no longer available here in South Africa.
@ Catherine: It is nice to be back although I never really went away. I just got snowed under by work.
I am sure that 2013 is going to be a fantastic year for ALL of us!
Huggs
Megs
At 3 months I was 88 pg/ml E and 11 ng/dl T and after a dose adjustment (more estrogen, slightly less spiro), at 5.5 months I was 128 pg/ml E and 14 ng/dl T. I go back next month at the 9 month mark and will have them read again. I see some people report their doctors shoot for much higher levels. Some of it may be due to the European units but some are reporting in the units I am using. I do see the Endocrine Society recomends E of less then 200 pg/ml and T less than 55 ng/dl.
Quote from: Tammy M on January 15, 2013, 06:27:31 PM
At 3 months I was 88 pg/ml E and 11 ng/dl T and after a dose adjustment (more estrogen, slightly less spiro), at 5.5 months I was 128 pg/ml E and 14 ng/dl T. I go back next month at the 9 month mark and will have them read again. I see some people report their doctors shoot for much higher levels. Some of it may be due to the European units but some are reporting in the units I am using. I do see the Endocrine Society recomends E of less then 200 pg/ml and T less than 55 ng/dl.
I think it comes down simply to that all docs are different. Some swear by oral pills, other prefer injections. Some prescribe Tylenol for pain, others swear by Advil. There is a general consensus +/- among all the E & T level posted here overall. Some docs might like to be a bit more daring, others more conservative. It's all about the destination for me. I could care less how I get there.
:)
girl you look fierce, sounds like you're not responding well to spiro. A pity you're in the US and you can't try cyproterone.
Tammy M, 88 pg/mL should be about 320 pmol/L, which is an acceptable value, although on the low side. If you're having good results, it should be okay. It all comes down to what the doctors are aiming for. The average levels for women, the average levels for teenagers, the lowest normal levels for women... I think yours is shooting for the lowest normal female values or so. "The smallest dose for the desired results" philosophy that many doctors have, forgetting that in a trans person's case, the "desired results" are the maximum results. But it's also one of the safest approaches. Until trans HRT is more of an exact science, which will take a long time, I think it'll be hard to say who's right and who's wrong. Especially when you're not an endo. By the way, don't call them european units; they're international units. It's only you in the US who are still using units from another age, along with feet, degrees Farenheit and ounces. :p
(It would be nice if a dedicated mod edited posts so they all have both units.)
Nope, you can't. US authorities consider it too dangerous or something. I'm not really sure of the reasons. Perhaps it's because some countries use it as chemical castration of sexual criminals and they find it inhuman, even though they actually kill some of their criminals.
The best I can do is give you this link. :c http://en.wikipedia.org/wiki/Antiandrogen (http://en.wikipedia.org/wiki/Antiandrogen)
They do. And in the mean time, there's orchiectomy you can have.
Quote from: girl you look fierce on January 15, 2013, 09:36:27 PM
My E is like 66 pg/ml and my T is like 700 ng/dl :(
I take medium-high dose of spiro and low dose of oral estradiol.
Been on hrt for like 8 months and FT for most of that so wtf right? Oh well. Trying to get it sorted out :-/
Have you tried a different form of estradiol other than tablets? Tablets never worked for me because my body wasn't processing them properly. I won't go into the whole thing, but pre-HRT my T was at ~325 ng/dl, the uneven processing of estradiol tablets drove my LH & FSH off the charts which drove my T levels to over 1200 ng/dl, and in 6 weeks (3 shots) on injections I was down to 7 ng/dl and stable there. My development took off after that. I was taking the same spiro dosage the entire time, but it didn't do anything because my endocrine system was confused by the irregular fluctuation in my E level - the LH & FSH shooting up were my body trying to balance my endocrine system out.
I hope you find something that works for you...good luck!
I'm also on hormone implants, but with a progesterone injection. I didn't know there were progesterone implants as well? That is nice!
Can't wait to get my levels checked at the beginning of feb when the next progesterone shot is scheduled. Very curious!
Tomorrow is my week 6 anniversary, and things are happening... fast ;)
Hi Jennygirl,
Just had a Progesterone and Oestrogen implant. My Endo has just imported them from, of all places, Colorado USA So go figure. As he said, implants give the most effective and constant delivery rate for any medication. I'm happy about that. Hope you are as well.
Huggs
Catherine
That is wonderful- thank you for the info, Catherine :) Might you PM me your endo's name? I would like to have mine get in contact with them about the progesterone implant if you'd be comfortable with that.
Currently I am on a schedule to go in every 2 months for a progesterone shot. My endo told me progesterone wouldn't work subcutaneously... I think he mentioned something about the size of the molecule they have been able to synthesize... But perhaps they have discovered a new way to synthesize it which would be fantastic. I'd love to know my progesterone levels are just as steady as estradiol and skip the shots!
Thanks again, woop! :D
And yes, I am very happy with the steady delivery rate! It's one of the main reasons I went for implants as well.
Also I just found this PDF online that details subcutaneous HRT implants... A good read for anyone who is curious about them.
http://www.collegepharmacy.com/images/download/BHRTPelletFAQ.pdf (http://www.collegepharmacy.com/images/download/BHRTPelletFAQ.pdf)
I wonder if it's the same place they order them from- the publisher is from Colorado USA
Even though I'm not too fond of being cut, implants sound nice. I don't think we can get those in Canada, though. It would be awesome if it could be an "intelligent" implant though. One that would monitor your blood levels, and pick proteins from the blood, make estradiol out of them, and release them to keep levels at the desired range. And of course, since it would produce, not release, hormones, it would be a permanent, one-time procedure. :p Pretty awesome indeed.
Quote from: A on January 18, 2013, 05:46:40 PM
Even though I'm not too fond of being cut, implants sound nice. I don't think we can get those in Canada, though. It would be awesome if it could be an "intelligent" implant though. One that would monitor your blood levels, and pick proteins from the blood, make estradiol out of them, and release them to keep levels at the desired range. And of course, since it would produce, not release, hormones, it would be a permanent, one-time procedure. :p Pretty awesome indeed.
I believe it's coming out in the next software release, A. :laugh:
My Endo checked his site from the last one and siad there was no sign of scarring. With a local anaesthetic shot you feel nothing.It's only a 3mm incision I've felt more pain during electrolysis. This guy was like a mosquito bite. ;D
But yes; the set and forget for 6 months is nice. Nearly goofed this morning reaching for my progesterone pill. Plus knowing this is the most efficient form of delivery. My Endo imports his supply from, of all places, Colorado, US.
Give them a go. You won't look back.
Huggs
Catherine
Quote from: girl you look fierce on January 17, 2013, 08:28:07 PM
Wow, that's weird. I kinda wondered if my E wasn't a bit low? I mean it's in the female range but my endo just said it's fine and I was thinking most trans women have 2x as much it seems like (but she just adjusted the spiro the first time). But she also suggested maybe patches before bloodwork was done.
The LH/FSH thing confuses me cause mine were varied, My LH was 6.4 which is in the middle of the reference range, FSH was around 1 I think, which is low? (Sorry I don't remember the units, just the standard ones)
Unfortunately I don't recall what my E levels or LH & FSH levels were specifically, but the endo said my estrogen was jumping between too low and too high over the time we were trying to get things sorted out. What I remember was the endo's attempt at humor asking me if I was taking fertility drugs to try to get pregnant while also using steroids to bulk up - evidently that's what my levels looked like to him.
Quote from: girl you look fierce on January 17, 2013, 07:57:03 AM
Wait.. like androcur? You can't get that in the US? D:
Ughh I was gonna suggest that to endo if the spiro increase did nothing :(
I was prescribed bicalututimide (brand name Casodex) because of a drug interaction between spirolactone and lisinopril, one of my heart medications.
I was on Androcur for about a year. (It is available here in South Africa) I got a shot every second week. I can tell you one thing, Androcur is chemical castration!
Not that it bothered me at all. I went over to Spiro a couple of months ago and I am getting better results. Okay, I do pee like a racehorse on steroids, but have learnt to live with it.
Spiro is also a lot cheaper here than Androcur.
Both work well though.
Huggs
Megs
Catherine Sarah: It's not a matter of choice. If some higher-up in the health system doesn't decide you can use a medication, you can't, period. Higher-ups who are usually quite cautious with health risks, as well as costs.
Maegan: Yes, it is. They use it on some criminals. I find it a much more sensible approach to the trans issue (at least once everyone is sure of the problem), because instead of just fiddling with testosterone and eventually getting levels down, its main purpose is to, well, destroy, not to mention it's a progestin, so whatever unproven advantages there could be with progesterone, you might as well get them too. Switching to spiro after a while makes sense, too, I guess, since once the organs aren't producing so much anymore, fiddling with what is left might be the most effective course of action.
My T has stayed suppressed since the first test I took. But I had 1 less T test than E because the doctor considered it suppressed enough not to test for it all the time.
Test 1 (2 months) - 25 ng/ml
Test 2 (5 months) - 9 ng/ml
Test 3 (10 months) - 7 ng/ml
Test 4 (12 months) - 18 ng/ml
Test 5 (16 months) - <3 ng/ml (ie undetectable)
My E has bounced all over the place.
Test 1 (2 months) - 175 pg/ml
Test 2 (5 months) - 722 pg/ml
Test 3 (8 months) - 88 pg/ml
Test 4 (10 months) - 112 pg/ml
Test 5 (12 months) - 230 pg/ml
Test 6 (16 months) - 135 pg/ml
Progesterone was in the 12.5 range every time it was taken.
My CMP, TBC, Liver Panel tests always showed normal on everything.
I've had pretty good results with HRT. I'm a B cup (bordering a C), my muscles thinned out to the point where they look cis, cheek fat is coming in nicely, skin tone is feminine, I pass now when I never could've before HRT.
I just got my hormone levels tested again at the 9 month HRT mark and they are: Estrogen 183.6, Testosterone less than 10. My sodium is a little low so the doctor wants a 25% reduction in Spiro, which should be ok because my T is so low anyway. Also I am going to increase my estrogen dose by 25%.
Hi Girls;
I must admit I am about confused about all these levels as my Doctor/GP in Melbourne says that testing E levels is very unreliable but for me its all about getting the T Levels as low as possible.
Currently I am only on Oestrogen 2 tablets daily (No dosage). My Doctor says that Progesterone is not worth it for me as my T levels are so low ll it would probably do is cause a rise in my T levels and give me depression and other stuff without really doing anything on the breast development.
I am now coming up to 4 months on HRT
When I started my T Levels were 8 ng/ml
After 1 month my T levels were 7.9 ng/ml
After 3 months they had dropped to 5.8 ng/ml
This is when my Doctor increased my doasge of Oestrogen
His aim for me is to get my T under 2.0 ng/ml but he said anything now under 4 ng/ml will start to get some more dramatic results. Already down below has stopped working completely which is just wonderful.
I am not sure why though that he says E levels are not worth testing for me.
Hugs
Judith Lynn
PS Sarah, can you email me the name of your Sydney Endo as I would love to get a second opinion about possible implants.
.
.
Quote from: Venus-Castina on March 07, 2013, 09:12:40 AM
My estrogen level is 128 pmol/L. While my endocrinologist says it is perfect I am not so sure because that brings me in the normal range of men and post-menopausal women.
I am very worried that with such a low level I will never get an optimal feminization. Does anyone of you have advice or some knowledge about this?
I am pretty much in the same situation. Very similar blood levels, too. I have not had any feminization at all, or very little of it.
My endo aims for 400-600 pmol/L (more or less; forgot what he said exactly), and the only reason I'm being kept as such low levels (which are indeed the "bare minimum" that's being aimed for in menopause) is that I've had a streak of "falsified" results because of Estrogel that had been applied to the sampling area not long before the test. Two successive tests appeared at 1100 and 450 pmol/L, both unrealistic numbers (and once is twice as much as the other).
Unless they're saying it's okay "for a start" and they want to start slow (which is perfectly fine), your endo is treating you like a post-menopausal woman. Which won't do. Have a serious talk with them and/or find someone else. It would even be surprising to have any visible feminization at all with such levels. At over one year with such levels, the most I've had is sore nipples.