Hi girls.  Need a little advice about low level estrogen injections and how to handle the Endocrinologist.  Sorry if this is a little long, but the background is needed if you don't know about me. 

Just got the latest blood work results and Serum Estradiol went from 153 to 152 pg/ml.  This is really just the same number because of error percentages, but it makes me feel that the 20% increase in my dose ten weeks ago was absolutely useless.  I'm well below what other girls are getting and it just feels like I'm being left behind.  Plus the Endo has no idea how this makes me feel.

The problem is that the Endo may not even understand that I'm transitioning to SRS in the future.   During the first appointment he asked a couple important questions about what I saw in my future, and of course I screwed up the answers.   At that point my relationship with my wife was a disaster, and I was doing everything I could to save our marriage.  So with a brief explanation I told him that my marriage had to be saved, and I wasn't sure what my plans were.  But I added that there would ultimately be a point of satisfaction in life.  So he started me on the second lowest dose possible using a patch, and only the Spiro was kept at a suitable level.  Even after everything was fully explained to him three weeks later when he switched me to injections, the dose was kept far lower than any girl I've talked to.  So now with the injection increased by 20% in December it's still only about a third of what others get, and it's depressing. 

My Gender Therapist has been out on sick leave for three months, and will be for at least another month and a half.  Since there's no other person for the Endo to consult about my mental state He's not going to believe me when we discuss things during an appointment on Tuesday.  Yes, I could get an update by visiting the psychiatrist who helped me from the end of June until the long-term therapy was set up in September.  But she's in Oakland and has an incredible backlog of patients so she can't see me for a month, and would need a couple sessions to catch up.  So without seeing my therapist for such a long time the Endo has no current psychological profile for me.  And of course, if I go to a therapist outside my healthcare system the Endo may drop me entirely.

My healthcare system has nowhere else to go other than Sacramento, Oakland or SF.  And that would mean starting over again.  This is really F'd up because I'm also heading for Michigan in two months and wont return until late August or September.  The Endo was going to try and set a self injection schedule for the time away from California, and I hate to jeopardize that.  But somethings gotta give.

In total, I have no idea how to handle this situation, and I'm sorry to bother you girls again.  But there's a need to vent, and I have to get some sort of advice.  I know a lot of you may feel my levels are perfectly fine, and I've heard it all before.  But I don't understand why the Endo wont raise the levels more, except that he's questioning my transition.

Kathy

First of all it's the numbers, not the dose, that count. 150+ is perfectly fine. Most of my bloodwork I've received had me UNDER 150 and I still developed quite well. I think the trick is to kill the T production. Is your T suppressed?

Secondly, from my own personal experience and talking to many trans friends, E levels spike in the first 6 months or so after starting E. After that, the same dose doesn't spike levels as high.

For example, when I started, my first test in was at 2 months and my E was normal (175). So I stayed at the same dose. At the 5 month mark, I was at 722, which is ridiculously high, so my dose was cut 33%. The next test, my E was at 88, so eventually I was brought back up to my regular dose. I have not yet gone above 230 since.

Another example: a friend of mine started on a low dose. Her first test came to about 250ish. The doctor was okay with that so she was kept on that dose. At the 9th month, she dropped to 95.

I think the body learns to break down E after a while. On top of that, one of my theories is since the body is creating new receptors for the hormone, maybe more of the hormone is required in the blood to feed the receptors. That would explain why perhaps a higher dose is required to get the same result you had a couple months ago.

Quote from: Alainaluvsu on March 03, 2013, 10:11:01 AM
...Is your T suppressed?

Secondly, from my own personal experience and talking to many trans friends, E levels spike in the first 6 months ......

....... maybe more of the hormone is required in the blood to feed the receptors. That would explain why perhaps a higher dose is required to get the same result you had a couple months ago.

Thank you Alaina.

My T was 202 in June, then 4 in September and 4 again in December.  No information for T this month until Tues when I see the Endo.  Hoping the T level doesn't go up again.


The E levels went from 65 in June to 308 in September.  Then Kaiser got me fully squared away, and I wisely ended everthing else I was taking as over-the-counter and self medication.  So the E dropped to 153 in Dec and 152 now.

Yes, I believe we girls do slowly adjusts to the E available in the blood as the receptors begin to process it, and our livers manage to clean or pass on the E.   But it seems like the receptor thing would explain the valleys and spikes a lot more.  Anyway, I figured I'll be having another set of tests while in Michigan this summer, but if the doses are changed I'll be buying my own at Walmart or Walgreens since Kaiser won't mail them out of state.

I'm still wondering what to do about a therapist, and it looks like I'll have to set up something wth the psychiatrist in Oakland for at least two sessions next month.  Plus need to figure out something for Michigan because there's only one therapist within 100 miles, and he's affiliated with a group that's partly funded by a Church.  Needless to say I've been warned about him so it should be fun.   

Hugs.
Kathy