Hi everyone!
Okay, so I think I might be having a problem with my HRT and I don't know what to do. I wont mention any of the doses.
I've been on spiractin and oral estrogens for about a year now and had a weird encounter with my endo at my last appointment. I wasn't getting very noticable results and so asked him whether I should dissolve the tablets under my tongue (I've read a few places that this is better) and he said he'd never heard of that before and told me not to. Then I asked if I could be put on some other medications aswell (I think it was finasteride and a progestin, I'd read about those too) and he just waved his hand and said no. He said I wont experience any body changes because I'm thin (So I'm trying to put on maybe ten kilos now).
THEN he said he'd be cutting my estrogen dosage in half "because the testosterone is under control". The head of the gender clinic said he does this with all patients.
I guess my question is does this sound right? I thought I had to stay on a high dose of estrogen for longer than a year. Maybe I'm just over-reacting or something, but I just don't feel right about lowering the dose after only a year. Is that common practice with everyone?
I think that's everything. Thanks everyone! :D
-Birdie
From all the reports I've heard from other people, endocrinologists tend to be completely arbitrary in the regimens they prescribe.
Still, they are probably more sane than some of the regimens that some people have prescribed themselves.
I'm sure he has your best interest at heart.
Ultimately, when you get your blood checked next time you can argue for or against the lower dose and if its still beneficial.
Hmmmm. I would get a second opinion, or at least do a bit of research about sublingual oestrogen and controlling DHT with DHT-inhibitors like finasteride or dutasteride. Keep in mind that you want your T levels to be pushed down to, at most, mid female range, while you want oestrogen levels maintained around mid-cycle. He might well be cutting the E because high dosages can lead to thyroid problems, but GG's have those same high levels for a week out of every month, so that should also be taken into account.
A doctor's first priority is to do no harm, which occasionally causes them to be overly careful. I'm not saying that's the case here, but educate yourself so you can have a conversation with him. Ask questions, make suggestions and bring up research he might not be aware of, but don't just accept that he's always right. Remember, it's your body, your transition, and the doctor does not have authority over you.
Mina.
Yay! Messages! Thanks for the replies everyone!
Renate: That's true about the self medication thing. There is no way I'd want to do any of this without a doctor to watch out for me. And he's bound to know more about it than I do, which is why I kind of feel silly about doubting him, but it just feels like the wrong step to take, you know?
Ms Delgado: Oh I'm sure he's trying to do the right and best thing. He's a very nice man (though we're all always left waiting for hours in the waiting room!)
All of my blood tests and check ups have always been spot on perfecto though, so I don't think the blood tests had anything to do with it (unless there's something he hasn't told me, but that's probably way unlikely).
Mina: I wish I could get a second opinion, but down here every aspect of transition is fairly tightly controlled by the one clinic and there's only one endo they refer to. I can't break their rules, if I do I'm worried I'll get kicked out of the program, and there's nowhere else to go for treatment around here. So they do kind of have complete control to dictate the ins and outs of my treatment. They very, VERY rarely allow discussion of alternatives and tend to be pretty dismissive of everything I have to say. I try to research as much as I can about the medications but a lot of it goes over my head. At my last appointment I tried to talk to him about what I'd read but he just shot me down with lots of medibabble that confused me. I know my T levels were at my last test below the female norm, but I don't know about the E levels. I'm not even sure if he tests for them, all his focus has always been on the T numbers. Without giving away any dosage info, I don't think my E dose is particularly high. But I don't really have anything to compare that to, so I'm not sure. Gawd this is all so frustrating sometimes! :-\
Thanks for all the feedback though! It's so nice to have people to blurt all this out to who actually understand! *hugs*
-Birdie
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Quote from: Birdie on February 01, 2009, 02:32:47 AM
He said I wont experience any body changes because I'm thin (So I'm trying to put on maybe ten kilos now).
The only time that could even be remotely true is if you believe him and do nothing about it.
when I started HRT 15 mths ago I weighed 133 lbs. @ just under 5' 8". Now I weigh 126lbs.
and my height has not changed, and although I can't say that I witnessed the changes taking place
during that course of time, when I compare a then picture to a now picture the difference is night & day.
I did have to change a lot of eating habits & take a lot of walks.
Now I don't know your eating habits, but for some nice healthy weight gain the trick isn't always to eat
more and be less active, but to eat healthy foods, and perhaps a lesser helping at closer intervals.
and stay active. I am not saying go to a gym or get up and jog at 5 a.m. but the weight you would gain
by hanging in front of a TV is not at all appealing.
As for the HRT, it is the blood levels that are important, if your doc can keep them in check with a
lower dose
then there is nothing wrong with that. Doctors vary, for instance my doc had no problem giving me
Dutasteride for my hair, the hard part for me was to ask cuz of all that I have read on how doctor's
are reluctant to provide scripts for off-label use in the U.S. but when I did ask he told me he
himself used dutasteride for his hair....who knew!
if its any consolation, while you may not be reaping the benefits of stopping the T to DHT
conversion using fin/dut, you are still blocking DHT at the receptor cell with the spiro and
with your low T levels you can benefit just as well. Really when it comes down to it men
benefit from using fin/dut cuz there is no reason for them to block testosterone, just the DHT
when it comes to hair.
You would think that I would be biased about 5 AR inhibitors because I use them for my hair
but the truth is it's an obsession ::)
A big Welcome to Susan's from me. I hope you like it here and stay awhile.
*Hugs* Nicole