Susan's Place Transgender Resources

Community Conversation => Transitioning => Hormone replacement therapy => Topic started by: androgynouspainter26 on June 16, 2014, 02:41:11 AM

Title: Just got my bloodwork back...not happy news.
Post by: androgynouspainter26 on June 16, 2014, 02:41:11 AM
I just got some unfortunate news from my physician about my levels :( )   My dosage wasn't always steady; I was on the patch for a while, but no matter where I put it, it wouldn't stay on for more than a few days-and then I missed about a month of pills.  But I've been on a pretty steady regimen for the better part of a year now-and my results haven't been stelar, but I'm not sure if that's just because I come from a family of tall, small breasted women in general.

I met with my physician; he's not an endocrinologist, but he practices at an LGBT clinic, and has plenty of experience.  He told me that my testosterone is way beyond acceptable levels-high in the 200s-which on it's own wouldn't be a huge issue, I've had this problem before.  But he also said that my prolactin is high-not at scary levels, but high enough that he's not entirely raising my dosage.  I told him that I hadn't been perfect about taking the pills, which is true-I'd miss a dose every few days, and he said we should wait a month or two, but no longer than that. 

I've been very diligent this past month not to miss any doses; my appetite is spiking (which is probably a good thing, I'm six feet tall, 130lbs, and my shoulders shot my modeling career in the back of the head months ago), and my breasts are tender for some reason.  Still, I'm completely panicking.  He's talking about taking me off the hormones, or "re-considering our options", and I'm so scared that my levels won't be correct by next month.  I don't know if I can live without hormones...the thought of watching my body become that which I've worked so hard to escape is to much for me to bear.  I have all of these stupid, drastic measures flitting about in my head, if things don't correct themselves-quitting school to raise money for an orchi, even doing it myself-or something worse.  Sorry to vent like this, but I've come this far and now it's all up in the air...anyways, if anyone has some advice for me, please please let me know.




Dosages removed - please don't post dosages
Cindy
Title: Re: Just got my bloodwork back...not happy news.
Post by: Cindy on June 16, 2014, 02:49:14 AM
You may suggest putting you on implants. They give a far better steady E level and are less toxic than other forms of E.

I was put on them for similar reasons that you mention.
Title: Re: Just got my bloodwork back...not happy news.
Post by: androgynouspainter26 on June 16, 2014, 03:18:48 AM
Why do you bother hiding dosages?  I understand the self-medicating issue, but (not to be a cynic) anyone with half a brain could get those numbers in five seconds with a quick google search; that's from first-hand experience.  As much much as we wish it could be, we can't prevent anything by redacting information...thanks though, I'll ask about the implants.
Title: Re: Just got my bloodwork back...not happy news.
Post by: Cindy on June 16, 2014, 03:22:40 AM
8. The discussion of hormone replacement therapy(HRT) and it's medications are permitted, with the following limitations:
A. You may not advocate for or against a specific medication or combinations of medication for personal gain. This is strictly prohibited.
B. You may not discuss the means to acquire HRT medications without a prescription. The discussion of self medication without a doctors supervision is prohibited.
C. The discussion of recommended or actual dosages is strongly discouraged to prevent information obtained on this site from being used to self medicate.
We can not in good conscience condone the self administering of these medications. Not only may self medication be illegal, but HRT medications can cause serious health problems, and many have the potential for life-threatening side effects that can only be detected and prevented with proper medical supervision.
Title: Re: Just got my bloodwork back...not happy news.
Post by: V M on June 16, 2014, 03:26:34 AM
Quote from: androgynouspainter26 on June 16, 2014, 03:18:48 AM
Why do you bother hiding dosages?  I understand the self-medicating issue, but (not to be a cynic) anyone with half a brain could get those numbers in five seconds with a quick google search; that's from first-hand experience.  As much much as we wish it could be, we can't prevent anything by redacting information...thanks though, I'll ask about the implants.

Could have something to do with the Site Rules (https://www.susans.org/forums/index.php/topic,2.0.html), particularly rule 8

Quote8. The discussion of hormone replacement therapy(HRT) and it's medications are permitted, with the following limitations:
A. You may not advocate for or against a specific medication or combinations of medication for personal gain. This is strictly prohibited.
B. You may not discuss the means to acquire HRT medications without a prescription. The discussion of self medication without a doctors supervision is prohibited.
C. The discussion of recommended or actual dosages is strongly discouraged to prevent information obtained on this site from being used to self medicate.
We can not in good conscience condone the self administering of these medications. Not only may self medication be illegal, but HRT medications can cause serious health problems, and many have the potential for life-threatening side effects that can only be detected and prevented with proper medical supervision.

Is there a problem?
Title: Re: Just got my bloodwork back...not happy news.
Post by: luna nyan on June 16, 2014, 04:54:54 AM
Quote from: androgynouspainter26 on June 16, 2014, 03:18:48 AM
Why do you bother hiding dosages?  I understand the self-medicating issue, but (not to be a cynic) anyone with half a brain could get those numbers in five seconds with a quick google search; that's from first-hand experience.  As much much as we wish it could be, we can't prevent anything by redacting information...thanks though, I'll ask about the implants.
1.  Site rules
2.  If the site advocates medications in specific, then it is in danger of being liable for any damages that someone experiences, even if the TOS say otherwise.  Medico legal things tend to go the way of the plaintiff.
Title: Re: Just got my bloodwork back...not happy news.
Post by: androgynouspainter26 on June 16, 2014, 12:44:13 PM
Listen, I'm not saying the policy doesn't make perfect sense; just that it's going to take a lot more than that to prevent self medication, as much as I wish it could.  That's all.  That wasn't the point of this post anyways, so please, can we all go home and forget about this?
Title: Re: Just got my bloodwork back...not happy news.
Post by: teeg on June 16, 2014, 01:13:21 PM
Patches seem iffy for HRT. The surface loses contact, multiple patches on the body to equal the dose nessecary in HRT. Like Cindy mentioned there are better ways of going about it.

The point of HRT is to change your male hormonal make up to a female hormonal make up. Not sure which units they're being measured by but testosterone being in the 200 range sounds quite high.

6' 130 sounds anorexic. I'm 5'8" 139.

I'm not sure why orchiectomies are brought up so often here. With the right professional guidance there should be no need for one - anti-androgens when prescribed correctly should effectively block testosterone. If you're thinking about that in the context of self-mutilation you need help.

Also discussing dosages isn't allowed on this forum for good reason. Your dose that might be good for you may be harmful to me, and visa versa. Dosages for a 20 year old probably wouldn't work for a 40 year old and visa versa. Even individual to individual it will be different.
Title: Re: Just got my bloodwork back...not happy news.
Post by: KayXo on June 16, 2014, 06:22:40 PM
Quote from: androgynouspainter26 on June 16, 2014, 02:41:11 AM
I just got some unfortunate news from my physician about my levels :( )   My dosage wasn't always steady; I was on the patch for a while, but no matter where I put it, it wouldn't stay on for more than a few days-and then I missed about a month of pills.  But I've been on a pretty steady regimen for the better part of a year now-and my results haven't been stelar, but I'm not sure if that's just because I come from a family of tall, small breasted women in general.

I met with my physician; he's not an endocrinologist, but he practices at an LGBT clinic, and has plenty of experience.  He told me that my testosterone is way beyond acceptable levels-high in the 200s-which on it's own wouldn't be a huge issue, I've had this problem before.  But he also said that my progestin is high-not at scary levels, but high enough that he's not entirely raising my dosage.  I told him that I hadn't been perfect about taking the pills, which is true-I'd miss a dose every few days, and he said we should wait a month or two, but no longer than that. 

I've been very diligent this past month not to miss any doses; my appetite is spiking (which is probably a good thing, I'm six feet tall, 130lbs, and my shoulders shot my modeling career in the back of the head months ago), and my breasts are tender for some reason.  Still, I'm completely panicking.  He's talking about taking me off the hormones, or "re-considering our options", and I'm so scared that my levels won't be correct by next month.  I don't know if I can live without hormones...the thought of watching my body become that which I've worked so hard to escape is to much for me to bear.  I have all of these stupid, drastic measures flitting about in my head, if things don't correct themselves-quitting school to raise money for an orchi, even doing it myself-or something worse.  Sorry to vent like this, but I've come this far and now it's all up in the air...anyways, if anyone has some advice for me, please please let me know.


Why would he stop hormones? If you are using a progestin, it may have androgenic side-effects, by the way. :(

Not enough estrogen and too high T could account for why results haven't been good and the fact that you don't take hormones diligently. Hopefully, your doctor will find a solution soon. :)
Title: Re: Just got my bloodwork back...not happy news.
Post by: KayXo on June 16, 2014, 06:28:15 PM
Quote from: teeg on June 16, 2014, 01:13:21 PM6' 130 sounds anorexic. I'm 5'8" 139.

I'm 5'6 1/2 and 160 bs. I have breasts and curves. Perhaps a few pounds heavy but that's all.

Quote from: teegI'm not sure why orchiectomies are brought up so often here. With the right professional guidance there should be no need for one - anti-androgens when prescribed correctly should effectively block testosterone.

Orchiectomy sometimes to avoid side-effects associated with anti-androgens but estrogen alone can also inhibit effectively androgen especially by means of implants and injectables as higher levels can be obtained, usually without compromising health. As always, do as your doctor says. 


Title: Re: Just got my bloodwork back...not happy news.
Post by: androgynouspainter26 on June 16, 2014, 08:17:30 PM
Thanks for the replies!

First off, I sort of like being thin.  If I can't tell someone to lose pounds if they're overweight, don't tell me to gain any.  I wish I had curves, but that's not going to happen anyways, unless I can afford implants.  Ahhh, well.

Elevated progesten levels put you at a drasticly elevated risk for blood clots, thyroid tumors-a whole bunch of nasty things.  I'm not taking a progesten; my understanding is that nobody should be taking it because of the risks.  I'm talking about all of this so...drastically because I'm already on a fairly high dose of spiro, and the dosage of E I'm on is barely causing any change at all.  If my progesten levels moves any more, he's going to stop prescribing them "for my own safety", or sharply cut my E doses-which are already too low to cause any change-and that's where bottom surgery comes in.  Of course I'm listening to my doctor, but he's telling me that I may have to stop HRT, so you'll understand why my faith in him is shaken.  He's not an endo, for one thing.
Title: Re: Just got my bloodwork back...not happy news.
Post by: KayXo on June 16, 2014, 09:33:41 PM
Quote from: androgynouspainter26 on June 16, 2014, 08:17:30 PM
Elevated progesten levels put you at a drasticly elevated risk for blood clots, thyroid tumors-a whole bunch of nasty things.  I'm not taking a progesten; my understanding is that nobody should be taking it because of the risks.  I'm talking about all of this so...drastically because I'm already on a fairly high dose of spiro

* You stated earlier "he also said that my progestin is high-not at scary levels, but high enough that he's not entirely raising my dosage."

* Spiro is a progestin with anti-androgenic effects and stronger anti-mineralocorticoid properties than progesterone dose for dose.

* Progestogens are not all the same, as was thoroughly explained with supporting strong evidence in the thread about progesterone.  It is wrong to put all progestogens in the same category and claim that risks are high for all of them. Progesterone levels are, by the way, extremely high during pregnancy. Some women go through pregnancy several times during their lives.

Quote from: androgynouspainter26the dosage of E I'm on is barely causing any change at all.

Perhaps, it's too low. Something to discuss with your doctor.

Quote from: androgynouspainter26If my progesten levels moves any more, he's going to stop prescribing them "for my own safety"

But, you now just said that you weren't taking any?? Your progesterone levels are high? I'm confused! They would only be higher if you took bio-identical progesterone or if somehow Spiro increased progesterone levels in the body which I never heard of, ever before.  ???

Quote from: androgynouspainter26or sharply cut my E doses-which are already too low to cause any change

What does E have to do with progestogen or progesterone? This is very confusing. LOL.

Title: Re: Just got my bloodwork back...not happy news.
Post by: Hideyoshi on June 16, 2014, 09:43:10 PM
Quote from: androgynouspainter26 on June 16, 2014, 08:17:30 PM
I'm not taking a progesten; my understanding is that nobody should be taking it because of the risks.

I'm assuming you mean progestin? I've been on medroxyP for 6 months and my blood clotting is fine. My endo told me that medroxyprogesterone is "safe and efficacious," (incoming bioidentical post from kayxo) and he prescribes it to his other MTF patients, and sees unopposed estradiol as what's dangerous. You can't get two endos to agree on much, reading everybody's experience here with endos.

How are your progestin levels elevated when you aren't on progestin?

I'd get a second opinion if I were you. Are you taking oral E?
Title: Re: Just got my bloodwork back...not happy news.
Post by: androgynouspainter26 on June 16, 2014, 10:17:44 PM
I don't know-I'm quoting what my physician said: my progestin levels are high.  I'm not taking any; I'm taking estrodiol and spironolactone orally, and that is causing those levels to rise.  Listen, I'm simply quoting my physician; they feel the risk is too high to continue taking hormones at my current relatively ineffective dose if those levels don't stabilize. 

As for those levels before-I don't know, it's not information they have access to because I started with one doctor, then started seeing my current one, and my records vanished.  My old physician was absolutely fine with everything on my chart; my new doctor handed me a list of supplements and told me I had to take every single one of them if I was going to continue HRT...no two doctors can ever agree, it seems.
Title: Re: Just got my bloodwork back...not happy news.
Post by: teeg on June 17, 2014, 12:18:33 AM
Quote from: androgynouspainter26 on June 16, 2014, 08:17:30 PMFirst off, I sort of like being thin.  If I can't tell someone to lose pounds if they're overweight, don't tell me to gain any.  I wish I had curves, but that's not going to happen anyways, unless I can afford implants.
It's just as dangerous to be underweight as it is overweight.

Medical records don't "vanish". In fact I wouldn't doubt it if it's illegal to discard of medical records for the potential liabilities. Have you ever bothered to call your old physician and ask they send a copy of your records over to your new one? Why didn't your new physician request your previous records from your old physician? This is standard practice.

If your "physician" is saying testosterone levels of 200 are normal and that you have high levels of something you're not supplementing I'd say it's time to find a new physician.

Like Hideyoshi mentioned with her clotting risks being fine, when HRT is prescribed and taken properly (missing doses won't help you) I don't think there's many risks to worry about.
Title: Re: Just got my bloodwork back...not happy news.
Post by: androgynouspainter26 on June 17, 2014, 12:53:53 AM
I feel the need to say something about this: If is not ok to shame someone because they are fat, then it is also very, very rude to chastise me because I am thin.  I have no health issues related to my weight, and it close enough to normal that I am not at risk for any health issues relating to my weight.  I eat normally, have a nominally active lifestyle, and make no effort to lose weight-this is the weight that my body happens to be, and I would appreciate if you would all stop lecturing me on the subject.  Believe it or not, I know more about my body than you do. 

With that in mind, thank you all for your lovely responses!  I made an error before (mixed up words-it can happen to anyone), it's my PROLACTIN that came back high.  It's never been an issue before now, and that's what is eliciting the concern.

You are right, medical records do not normally disappear, however, my test results were waiting to be uploaded to the computer in the clinic's basement, which flooded during Hurricane Sandy.  I have called, numerous times.  I've even contacted LabCorp in an attempt to recover them.  And no, my physician is not saying that two hundred is a normal level of T.  He is saying that he is not comfortable doing anything to fix it. 

Everyone's system is different-some of us accumulate certain compounds more redly than others-and hormone replacement therapy does carry some inherent risk, even when the hormones are administered properly.  You seem like a relatively informed person; any hormonal supplement (including HRT) has some risk inherent to it. 
Title: Re: Just got my bloodwork back...not happy news.
Post by: Cindy on June 17, 2014, 03:03:26 AM
 :police:

Please people let us be nice and understanding.  Androgynouspainter is having a hard time, she is worried and concerned. There is absolutely no reason to be negative.

Let us all remember the days when we are frightened, don't know who to turn to and want help from our sisters.

Maybe we all should walk a mile in each others shoes?

Lets have a big mutual hug and help each other (legally!)

Cindy
Title: Re: Just got my bloodwork back...not happy news.
Post by: luna nyan on June 17, 2014, 05:05:21 AM
Now that makes more sense to me!

If your prolactin levels are spiking, then it makes sense to stop meds.  They need to sort out why it's happening through elimination.  If they are still high even off HRT, then there are bigger health issues to be concerned about as high prolactin can be a marker for more serious conditions.

Hopefully it'll be a short time off the meds, the prolactin levels drop, and then it's a case of finding a HRT regimen that doesn't cause it to spike again.
Title: Re: Just got my bloodwork back...not happy news.
Post by: Hideyoshi on June 17, 2014, 06:26:59 AM
Quote from: androgynouspainter26 on June 17, 2014, 12:53:53 AM
With that in mind, thank you all for your lovely responses!  I made an error before (mixed up words-it can happen to anyone), it's my PROLACTIN that came back high.  It's never been an issue before now, and that's what is eliciting the concern.

Are you lactating now?
Title: Re: Just got my bloodwork back...not happy news.
Post by: KayXo on June 17, 2014, 06:31:31 AM
Quote from: Hideyoshi on June 16, 2014, 09:43:10 PM
I've been on medroxyP for 6 months and my blood clotting is fine. My endo told me that medroxyprogesterone is "safe and efficacious," (incoming bioidentical post from kayxo) and he prescribes it to his other MTF patients, and sees unopposed estradiol as what's dangerous.

LOL...had to say something. Firstly, I'm glad that your clotting is fine. :) Second, the WHI study clearly showed that unopposed estrogen (Premarin) actually reduced breast cancer risk and barely affected cardiovascular risk while the addition of medroxyP increased breast cancer risk, further increased clotting and increased cardiovascular risk significantly. These are the data from the very large WHI study. I can give you the actual numbers, if you want. The same was observed in another large study in Denmark done over 6 yrs and another 10 yrs after the study was discontinued, that unopposed estrogen decreased breast cancer risk in women.

Unopposed estrogen only seems to pose a risk if a woman has a uterus.

In various studies, estrogen taken orally has shown to have a positive effect on cholesterol markers like HDL and LDL while the addition of medroxyP countered these effects unfavorably. MedroxyP, unlike bio-identical P also seems to have a negative effect on vascular function, according to studies and negate the favorable effect (vasodilation) that estradiol tends to have on arteries.

Quote from: HideyoshiHow are your progestin levels elevated when you aren't on progestin?

Firstly, let's be clear about something and I'm to blame as well for this. The only thing that is usually measured is progesterone levels and no progestin increases progesterone levels. Bio-identical progesterone is the only thing that could do that. Doctors never ever measure the levels of a progestin in the blood, this is only usually done for study purposes. 
Title: Re: Just got my bloodwork back...not happy news.
Post by: KayXo on June 17, 2014, 06:36:05 AM
Quote from: androgynouspainter26 on June 17, 2014, 12:53:53 AM
I made an error before (mixed up words-it can happen to anyone), it's my PROLACTIN that came back high.  It's never been an issue before now, and that's what is eliciting the concern.

Ah! There you go! What estrogen are you taking? Ethinyl estradiol, Premarin? Birth controls?