My family history sucks. strokes and clotting disorders abound. the clotting disorders being mthfr, both variants. c677t and a1298c.
This is probably the main reason I haven't chosen a female name yet, I don't want to be crushed if I get turned down for risk factors. my factors might not be active though due to my age (20), so I may get lucky and be able to take the HRT until I can get castrated and reduce my dose to a very low risk level.
has anybody else had any experience with this?
Not quite like your situation, but just as depressing. I am 66, and a newly realized TG and TS. Trust me. long boring story. Been on HRT for 4 months, good emotional stability finally, and even some minor physical changes, unexpected but appreciated. Liver functions last week not good, being retested this week. Dr. thinks at my age it would be best to go off HRT. Not sure how I can handle the change back. It really sucked last year.
I wish you the best and hope your Dr will work with you for options.
Barbara
I am also a high risk for clotting but for a different reason. I am confined to a wheelchair and being unable to move around puts me at risk. But my doctor felt confidant enough to start me on a low dose. I have no idea how I would have handled being denied hrt. I wish you the best
Hugs
Bethany
@tomthom,
I really think your age of 20 is working for you being successful for hrt. At that age you are healthy & your liver is probably in excellent shape. You don't mention if you have seen a Doctor about transition yet. That is your first step and either get blood work done by the Doctor or if they refer you to an Endocrinologist for the blood sample tests.
I am just in the early stages at the age of 71 of having the testing done with a gender friendly Doctor & assistant then assess the effects & risks of hrt.
Think positive.
Jamiep
yeah, I'm meeting with them soon. just getting all the appointments in order (I'm very very busy for my age.)
hopefully it works out and I'm one of the lucky few that has the mutations but they are completely inert. or inert long enough to develop the changes and get me back to safe levels.
thanks for the reassurance guys. it's just something my family can't bring. (doubters and naysayers with good intentions but horrid execution)
Even with liver tests slightly out of the norm or any other test, if its that or death if you are persistent enough, you'll be able to start. Many doctors believe it is unethical to deny this care to people, especially if you cry and say this is your last resort. I know people say hormones are nothing to be trifled with, and they aren't, but it is unfair to deny them to people. HIV+ people ahve bee able to transition so you should as well.
Hey Tomthom, I'm not at risk of blood clots but before I started HRT my blood pressure pretty damn high, I was absolutely petrified I would not be able to start hormones.
Many red eye nights behind the computer researching and making myself even more petrified..
But in the end it was no problem and actually helped because of the Spiro.
In any case, don't run yourself into the ground because you never know, that and your young too so that counts lots :)
I think everyone should know about hormone implants
http://www.collegepharmacy.com/images/download/BHRTPelletFAQ.pdf (http://www.collegepharmacy.com/images/download/BHRTPelletFAQ.pdf)
"... Pellet implants bypass the liver and don't negatively impact clotting factors, blood pressure, lipid levels,
glucose, or liver function."
Worth checking out!
I go to Dr. John Odea in Marina del Rey here in California. He swears by pellet implants, and now I can swear by them too :D
tomthom,
Youch. Looking that up brought back bad memories of biochem. The long and the short of it boils down to having sufficient testing done to find out exactly how high a risk you have of developing blood clots. In my twisted way of thinking, dying of a blood clot by stroke/infarct wouldn't be too bad, but surviving one and being left debilitated afterwards would seriously suck.
The chances are that they'll probably put you on something to mitigate the risks, and that could vary from anything like low dose aspirin to warfarin (or some of the more recent blood thinners). Depending on what happens, it may still be possible to cautiously start HRT. Just be patient, sometimes these things will take time to sort out.
Quote from: tomthom on February 27, 2013, 11:18:22 PM
This is probably the main reason I haven't chosen a female name yet, I don't want to be crushed if I get turned down for risk factors.
Though just because you don't take HRT doesn't mean you can't live your life as your true gender. HRT's not actually a requirement to change your name or live a a woman. I know a couple of women who've never taken hormones but live their lives completely female (and are very attractive).
Almost all of us have had to deal with some physical issues that are not optimal (I've lost almost all the hair on the top of my head, for example). No HRT sucks and is so unfair, but it doesn't spell the end of your transition.
.
I'll have to further research the different delivery methods and all of their effects. it's just so hard to find real solid data, especially with my blood conditions as a factor.
Quote from: muuu on February 28, 2013, 10:46:46 AM
Isn't most of it because of AA in combination of E? I think there's something about higher risk for deep vein thrombosis if you take your AA and E as pills.
Dunno, but I don't need to take AA's with the pellet implants. So if she found an endo that offers it that way it wouldn't be an issue.
E is a lot better for the body, or at least easier on it, and progesterone is usually enough to keep the T at bay.
I haven't taken any AA's and the results I've had from less than 3 months with the implants have astounded me. They are considerably more $$ though, so that is a definite drawback.
My endo told me my life expectancy would go up by 5-10 years with this method if HRT. That alone tells me it is worth the extra cost
Quote
My endo told me my life expectancy would go up by 5-10 years with this method if HRT. That alone tells me it is worth the extra cost
10 years? That's really something to consider...
Quote from: agfrommd on February 28, 2013, 07:00:46 AM
Though just because you don't take HRT doesn't mean you can't live your life as your true gender. HRT's not actually a requirement to change your name or live a a woman. I know a couple of women who've never taken hormones but live their lives completely female (and are very attractive).
Almost all of us have had to deal with some physical issues that are not optimal (I've lost almost all the hair on the top of my head, for example). No HRT sucks and is so unfair, but it doesn't spell the end of your transition.
Very good advice. I'm still waiting for HRT approval and that's not stopping me from doing life in my true gender. It could be really hard at first, but it's worth it.
Even dressing unisex with no makeup at all and looking boyish you can still live as the woman you are with your friends.
Quote from: Jennygirl on February 28, 2013, 07:26:33 PM
Dunno, but I don't need to take AA's with the pellet implants. So if she found an endo that offers it that way it wouldn't be an issue.
E is a lot better for the body, or at least easier on it, and progesterone is usually enough to keep the T at bay.
I haven't taken any AA's and the results I've had from less than 3 months with the implants have astounded me. They are considerably more $$ though, so that is a definite drawback.
My endo told me my life expectancy would go up by 5-10 years with this method if HRT. That alone tells me it is worth the extra cost
can they be partially covered by insurance?
I'm pretty sure I remember the assistant at the office telling me that insurance was not covered, but since I don't have insurance the thought didn't change my consideration at all and I can't remember clearly what exactly was said.
My guess is probably not? Maybe though, depending on the endo...
Either way, it's not like you CAN'T take hrt because of clotting risks. There are also other options that bypass the liver and don't affect clotting factors like creams and shots. What makes pellets the best, though, is the even & steady level of estrogen.. plus the convenience of not having to keep up with a daily hormone routine. The cons are high cost & needing to have an office visit to implant them every 4-6 months. With creams, you can just order online and have it shipped directly to you.
Also perhaps the creams / shots would be more easily covered by insurance?
are you sure those methods don't affect clotting risks? I have no problem sticking myself in the bum. I'm just really frantic and keep finding mixed results online.
Quote from: tomthom on February 27, 2013, 11:18:22 PM
This is probably the main reason I haven't chosen a female name yet, I don't want to be crushed if I get turned down for risk factors.
Not being able to start HRT doesn't mean you cannot have a female identity - why do you have to refrain from choosing a female name?
Quote from: Jennygirl on February 28, 2013, 05:09:19 AM
I think everyone should know about hormone implants
http://www.collegepharmacy.com/images/download/BHRTPelletFAQ.pdf (http://www.collegepharmacy.com/images/download/BHRTPelletFAQ.pdf)
"... Pellet implants bypass the liver and don't negatively impact clotting factors, blood pressure, lipid levels,
glucose, or liver function."
Worth checking out!
I go to Dr. John Odea in Marina del Rey here in California. He swears by pellet implants, and now I can swear by them too :D
^^^^^^^^
This +1
yeah, but I have a lot of genetic markers that may harm my clotting factor. but as stated before, I may be able to bypass that risk completely, or at least reduce it to a manageable and comparable level to a cis female.
Quote from: girl you look fierce on March 12, 2013, 09:47:24 AM
Umm, afaik clotting risks are just related to E levels. So a low dose would not put you at any more risk than a cis girl... and would still give you changes long-term.
It's also related to how the E is initially metabolized, such as orally or straight into the bloodstream. Orally, ALL of it passes through the liver, where it is converted into Estrone (the form of estrogen that is BAD bad bad). Going straight into the bloodstream (transdermal patches, subdermal implants, or injections) only a bit of it passes through the liver once it is already in circulation, reducing the conversion to estrone to a negligible level.
What you need in order to feminize is Estradiol. When the liver converts Estradiol to Estrone, feminization is not nearly as effective- and it comes with the heavy price of unhealthy side effects- the same as birth control pills.
While describing this to me, my endocrinologist was literally getting red in the face with anger because so many Dr's use oral methods to administer E. As far as he is concerned, oral E is just bad for the body because of the Estrone coversion. On the other hand, when administered straight into the blood, Estradiol prevails and is extremely good for you AND the feminization process. You need much less of it in order to be effective. Besides increasing the risk of breast cancer, it reduces blood pressure, makes the heart healthier, greatly reduces risk of prostate disease, promotes life longevity, and there were more reasons but I forget all of them.
I have my next implant scheduled for April 1st, I will try to ask him if he has any good literature on the differences in the biological effects of oral vs trans/subdermal. The article I posted earlier I found myself and describes it vaguely, but I am definitely interested to know the details.
thanks for all of your help Jenny. I enjoy the fact you've been supportive and helping with actual research since day one with this question of mine.
I'll definitely ask my endocrinologist about it when I go in next (April 1st or 2nd or something). I've been wondering too about the exact biological mechanism because I don't want to be spewing any kind of inaccurate information with such a serious scientific topic that I only have a surface level understanding of. He gave me kind of a layman's description of the process, and even then it was a bit overwhelming. I'll be seeking some literature I can easily share with you all.
But literally, he was red in the face if that is any indication. Hope I don't get him all RILED again! j/k
And tomthom you are so welcome, I really hope that this information can help you on your journey (as well as others', too). I'll get the details or proof or what have you and share them in this thread asap :D
Well I just said heck with it and sent him an email ;) maybe he will get back to me before our appointment.
Both of my parents have had clots and I had my first at 48 and eas in hospital for a week. I expressed my concern about being able to go on E. My internist said it probably would not prevent HRT but I would need close monitoring and maybe need an anticoagulant.
well, reviewing all of this information, I should be fine. I'd still love to see those tests and compile the research in a way that's easier for when others come by or if I need to reference it, but seeing as my age is 20 and all my current levels and risks are pretty much at perfectly acceptable levels, all I can do is go to the endo and see what we can do.
Quote from: Jennygirl on February 28, 2013, 05:09:19 AM
I go to Dr. John Odea in Marina del Rey here in California. He swears by pellet implants, and now I can swear by them too :D
Jennygirl, are you happy with Dr. O'Dea so far? Any other girls using him who want to comment?
Quote from: newgrrrl on March 23, 2013, 12:21:41 PM
Jennygirl, are you happy with Dr. O'Dea so far? Any other girls using him who want to comment?
I am extremely pleased with Dr. O'Dea. He has a quirky personality that I have come to adore and more importantly he really knows his stuff. From the beginning I got the feeling truly wants to help us girls feminize as fast or slow as we want and be healthy at the same time- both mentally and physically.
A huge plus with him is: the pellets are so safe, he lets you choose your own pace for feminization- and of course he operates on informed consent. He lets you pick anything in between slow and steady to fast tracking the feminization process. I have my second implantation on Wednesday, and I've decided to go up on the dose because things have been working out so well. I started on a medium dose but I am confident that going up will only make things better :)
He's a little pricey and I'm pretty sure he's not covered by insurance, that would be the only downfall I could see for someone wanting to use him and expecting insurance to cover it... But it's worth it. My results from a mid-range dose so far have been great to say the least.
So, yes.. I am very happy with him. He's a great endocrinologist :)
Most estrogen pills, like estrofem, are meant to be taken sublingually and thus are similar to injections, except for the nominal amount that is lost to the stomach. But, if you wait five minutes and don't swallow, the vast majority are absorbed by the mucuos membranes in the mouth. Correct me if I'm wrong, but very little of it gets to the liver first-pass. Ultimately, everything enters the liver. But with injections, patches, and sublingual administration, the pills enter the blood as estradiol. Doctors should not even prescribe pills that are not sublingual. Soon, all pills will be sublingual in the form of films that dissolve within seconds.
films do make more sense. But I always enjoyed needles, so hey, win win. ;D