So I was wondering if my E/T levels are where they generally tend be after 6 months on HRT. I've heard from other trans women that their estrogen levels were quite a bit higher at around the 6 month mark, which concerns me a little.
My estrogen levels have been consistently around 55 pg/ml for about 3-4 months (which is on the very low end of adult female range), and my T levels have been consistently dropping and are now around 25 ng/dl (which seems fine).
It seems like changes have been stagnant (of course, I know my mileage may vary), but I was wondering if I should maybe be concerned enough based on those levels to talk to my doctor about if my dose is appropriate.
I think any concern is worth bringing up to your doctor. They may not agree but you will have their opinion then and not be guessing or relying on a forum for magic answers. Not that it isn't worth asking here.
Quote from: LordKAT on June 08, 2014, 01:19:30 PM
I think any concern is worth bringing up to your doctor. They may not agree but you will have their opinion then and not be guessing or relying on a forum for magic answers. Not that it isn't worth asking here.
Yup, not looking for magical answers from a forum, so much as just some general info based on others' experiences, which has some (although limited) value.
Ask your doctor what the levels of E ant T should be after 6 months. If they give you a number, that's a good start. If they talk about female normal, well, that is better. But if they hem and haw and don't think you should worry about the levels, it's all about how you feel, try a new doctor.
Hugs,
Jen
Quote from: JLT1 on June 08, 2014, 09:32:42 PM
Ask your doctor what the levels of E ant T should be after 6 months. If they give you a number, that's a good start. If they talk about female normal, well, that is better. But if they hem and haw and don't think you should worry about the levels, it's all about how you feel, try a new doctor.
Hugs,
Jen
Yes, I got the latter. He has some experience with trans care and HRT, but he's by no means a specialist. He's been my doctor for a while now (for long before I even came out), and the number of trans care specializing doctors in my area (and state) is very limited.
My levels for e were "normal female range" but my t was like 3 after 2 months. Idk what it is now. I change my dosage in another month and get tested again after that.
My endo doesn't believe in testing E levels, and thinks the results are too variable and difficult to interpret to be useful, and instead goes by T levels and whether the patient is happy with the changes and rate of change. (So in your case she'd be willing to up the dose; I was content, so she didn't.)
My T levels dropped into the cis female range by 3 months on HRT and stayed there, although they went a little lower (from upper-middle of the range to lower-middle) post-op.
Quote from: Thylacin on June 08, 2014, 12:11:14 PM
So I was wondering if my E/T levels are where they generally tend be after 6 months on HRT. I've heard from other trans women that their estrogen levels were quite a bit higher at around the 6 month mark, which concerns me a little.
Don't compare yourself to anyone. Every individual is different, responds differently due to various sensitivities so in some, more is needed, in others, less. With your doctor, dosage should be titrated according to results and well-being.
Quote from: Thylacin on June 08, 2014, 12:11:14 PMMy estrogen levels have been consistently around 55 pg/ml for about 3-4 months (which is on the very low end of adult female range)
This is indeed quite low and I wouldn't expect much feminization in anyone at that level if that level is constant from hour to hour. But, if results are good which they do not seem to be as you state further that changes have been stagnant, then yes, you should discuss this with your doctor.
Quote from: JLT1 on June 08, 2014, 09:32:42 PM
Ask your doctor what the levels of E ant T should be after 6 months. If they give you a number, that's a good start. If they talk about female normal, well, that is better. But if they hem and haw and don't think you should worry about the levels, it's all about how you feel, try a new doctor.
I actually disagree with you as I believe that we all differ in how sensitive we are so that there is no right level for everyone. It varies, depends. Results, how you feel is the best gauge to determining if dosage you are taking is effective for you. Even in ciswomen, levels vary constantly, from less than 100 to up to 650 pg/ml within the same month. There is right level for ciswomen, neither is there for us. But, there is a right dosage.
Quote from: TiffanyT on June 08, 2014, 10:32:24 PM
My levels for e were "normal female range"
Range is quite wide. From less than 100 to 650, up to 75,000 during pregnancy. Any number you get will end up in that range! lol.
All depends when u get tested, at the 6 month mark I was around 5k, next week I did testing for 7 month and was lower. Last month I was about 55pg, this month I was around 1k. Variance happens.
What matters is how you feel and changes, 6months is early. Also, e is higher then T, thats good.
And I can also tell you are on oral at that number, (at least willing to bet on it)- lower range e orally, with higher range anti androgen.
Quote from: PrincessDayna on June 09, 2014, 07:25:33 PM
All depends when u get tested, at the 6 month mark I was around 5k, next week I did testing for 7 month and was lower. Last month I was about 55pg, this month I was around 1k. Variance happens.
What matters is how you feel and changes, 6months is early. Also, e is higher then T, thats good.
And I can also tell you are on oral at that number, (at least willing to bet on it)- lower range e orally, with higher range anti androgen.
Oral taken subligually.
Then there is your answer, if taken sublingually/oral, serum levels may not be showing high, but you body is definately, or should be, putting that estrogen to use. 6 months is way early in a transition. If you feel fine, and are getting results, dont worry.
If e levels are higher then T, on an oral sublingually administered dose, things *should* be moving along.
How are your emotional peaks at? You feel E drop or no?
Also, if sublingual I assume that you take more then one dose daily split up to limit peaks/troughs?
Either way, and as aleays, if you have concerns bring them up with your medical professional.
Serum orally and sublingual tends to be a bit lower then intra muscular, or dermal applications. As long as it is doing the job, do not fret too much over numbers. Some bodies do pretty well low spectrum, some higher. Everyone is different.
Quote from: KayXo on June 09, 2014, 11:03:17 AM
Range is quite wide. From less than 100 to 650, up to 75,000 during pregnancy. Any number you get will end up in that range! lol.
Yes, which is why I put it in quotes. ::)
Quote from: Thylacin on June 09, 2014, 08:21:31 PM
Oral taken subligually.
Sublingually, levels vary ENORMOUSLY. There really is no point in measuring them. You won't get an accurate picture unless you test levels out every hour or so for 24 hours and even then...who really cares? Do you care more about numbers or feminization and well-being?
Quote from: KayXo on June 10, 2014, 12:32:53 PM
Sublingually, levels vary ENORMOUSLY. There really is no point in measuring them. You won't get an accurate picture unless you test levels out every hour or so for 24 hours and even then...who really cares? Do you care more about numbers or feminization and well-being?
Does that enormous variation mean that feminization might be negatively impacted? AFAIK, sublingual means more estrogen is usable in my system than if I swallow the pills. Taking them orally would mean more stable levels though, right?
It's unfortunate that there isn't much data on what is optimal for feminization, it just seems like anecdotes, personal experience, and opinions :(
Yes, orally, levels are more stable. Some girls noticed improvement in feminization after switching to sublingual, others didn't. In the end, you and the doctor have to find a dose that works best for you while minimizing risks. Each case is different. Trial and error.
Sublingually, more estradiol is available to your system relative to estrone because there is less overall metabolization of estradiol.