I went in for my 3 month checkup today. Months ago, I had my peak levels measured and last week I had my trough levels measured. My trough was measured in Total Estradiol this time, which was 703. However my peak was measured in E2 (Estradiol only) at 1424! All of my other things (Complete Blood Count and Comprehensive Metabolic Panel) checked out fine, T was at 13, Prolactin was elevated but still normal at 20.3.

I'm wondering what my trough really boils down to. 703 seems very high also, but it's all 3. Obviously my meds need to be altered. The doctor doesn't know what to make of it all, as he wasn't the doctor seeing me on my last visit and the other doctor isn't there anymore. He told me to come in for another lab tomorrow to check E2, but he didn't alter my meds.

On a footnote, everybody has been saying I've been getting better results by the month. I guess so with E levels that high... It's crazy, last time I had blood drawn my E was at 72. My estradiol levels jumped 20 times as high as it was in 3 months.

Did you change the deliver method of the estrogen (i.e. pills to injections), or added additional E sources, like gels?

I switched to 2 week injections in January and my first test after that (March) showed that my trough E was at 72. They moved me to a 1 week dose that was less in the syringe (but more if you add the 2 weeks) in March. 2 weeks after that, my E2 tested out to be 1424 at peak, and my trough total estrogens tested out to be 702 a couple months later (8 days after injection).

I had blood drawn today to see what my E2 level is at trough. The funny thing is that my doctor didn't even change my dose...

That's not all that high depending on your age group.

My endo likes to keep me around 500-700. I'm on implants so it is constant at that level.

She is VERY experienced in TG endocrinology.

Really, I've always heard 200-300 is optimal at the high range. But no matter what, I think a peak of 1424 is a little much, lol! That's second trimester range...

If you mean between 700-1400 pg/ml... That is very high. The units of measure are important because the US uses a different system (English Units) of measure vs. metric used everywhere else.

I'd first get retested because labs do make errors all the time. Next, I'd recommend having your thyroid checked. Get a full thyroid panel to check T3 &T4 (total + free), T3 uptake, and Thyroxine (TSH) levels. Your doc will probably lower your E dosage in the mean time.

Yes, pg/ml. Sorry for the confusion. When last checked, my TSH was at .6 or so. I wonder if I've reached the point of permanent chemical castration and that's why a little change went a LONG way.

Quote from: Alainaluvsu on June 05, 2013, 10:17:27 AM
Yes, pg/ml. Sorry for the confusion. When last checked, my TSH was at .6 or so. I wonder if I've reached the point of permanent chemical castration and that's why a little change went a LONG way.

Are you taking an androgen-blocker like Spiro also... or just E alone?

Yes, I'm taking Spiro... a full dose of it. I want off of it, seeing as my T has never tested above 25 and some of my blood work indicates mild dehydration from time to time.

Well... if not a lab error... it sounds like it's time to cut back on the E dosage. Is it Estradiol Valerate you are taking? That seems to be the most often used E injectable.

Yes, and the blood was taken 6 hours after injection. She wanted to get an idea of my peak. The 702 number was taken 8 days after injection, so I have no doubt that the 1424 number is true.

The strange thing is my CMP AND the CBC results showed even more mid range normal results on many of my stats. So the liver isn't breaking its neck trying to process this stuff at least.

Quote from: Alainaluvsu on June 05, 2013, 01:17:02 PM
Yes, and the blood was taken 6 hours after injection. She wanted to get an idea of my peak. The 702 number was taken 8 days after injection, so I have no doubt that the 1424 number is true.

The strange thing is my CMP AND the CBC results showed even more mid range normal results on many of my stats. So the liver isn't breaking its neck trying to process this stuff at least.

Interesting. The only thing that sort of sticks out is only waiting 6 hours to take blood for testing. 12 hours after medicating is usually what most docs recommend. But 702 pg/ml of E... 8 days after injecting... is pretty shocking. You could either reduce the dosage and stay at injecting every 2 weeks... or just keep the same dosage, bump only inject every 4 weeks. I'd probably go with the 2 week option as it will keep things more level.

E makes me really energetic for lack of a better description... at 700 I'd be bouncing off the walls... literally.

I was on a slightly higher dose for every 2 weeks and my E was only at 72 on the 14th day, but my T was still suppressed at 9. That's what has me wondering what's going on more than anything. Perhaps my metabolism / liver is extremely rapid?  But why didn't my T spike even a little when E was at 72? I was keeping the same routine for 2 months before getting tested. I'm thinking the doctor should drop it about 33% per dose but keep it at every week.

The lack of T is killing my energy, personally. And with E around 1400 once a week, I get emotional over the slightest things. People on here say they can't wait to feel emotions... yall, it's got a dark side to it.

Did you ever have any strange/unexplained E spikes when taking it orally?

Also, after a period (depends on the person 1-2 years), T production from the testes maybe permanently stopped forever. The low energy and libido decrease are why some postops take a T supplement... Usually in gel form. Postop now, my T level is between 20-28 ng/dl.

I'd think ll that extra E would give you plenty of energy. I guess it varies by person.

Actually yes.

2 months in (original dose) - 175
5 months in (original dose) - 722
7 months in (66% of original dose) - 89
9 months in (83% of original dose) - 112
12 months in (original dose) - 230
16 months in (original dose)  - 135

Could be your body just adjusting to the changes. Also, the standard E2 test we all get is total E2... it doesn't give us the breakdown of free + total like the T tests do. There is a free E2 test, but it is rarely asked for. Normal free estradiol levels in cis-females ranges from .6-7.0 pg/ml... no idea what a good range for MTFs is... but it should be around there. There could be a huge surplus floating around free and unbound to receptors.

Well with levels above 1400, I'm sure there is a bunch! It'd be hard to fathom my body is using all that estrogen.