Hi!  I am new to this forum, this is my first post (of hopefully many in the future!).  I would like to start by introducing myself. My name is Kim.  I am a 48 yo transgender woman.  I am in the USA in the Ann Arbor, MI area. I have been seeing a therapist for the last few months to discuss transitioning.  I have an appt with an endocrinologist in two months (August 15th) to start HRT.  I am anxious and excited for that day to come and wish I could make it sooner.  In the mean time, trying to be positive, I'd like to do whatever I can to be prepared for HRT in terms of diet and exercise.  The trouble is, I'm not really sure what that means. 

Should I just try to be healthy in general (eat right, get sleep, get some exercise)?  Should I be aggressively trying to lose weight prior to HRT and then try to add it when I am on HRT?  Should I be trying to build /maintain some muscle, knowing that I will likely lose it later, to prepare for a good female body tone in the future (maybe like chest muscle)?

I don't really exercise right now, but I do try to eat "somewhat" healthy.  I am about 5'8" or 5"9" and about 155-160 lbs (reasonable slim for a guy, but not really skinny).

Once I start HRT, should I try to eat extra fat to help develop my new hips and chest? If so, are there certain types of fat, like fish, that would be better? Or does eating extra fat just sound like a bad idea?

When I see the endocrinologist, are there certain questions I should make sure to ask? Should I be asking for a certain dosing level or type of hormone that is more effective than others?

Thanks!
Kim

Just exercise, eat healthy and drink plenty of water. I think it is far better to just be reasonably healthy than trying to do anything really aggressive to lose or gain weight. 

My experience has been so far that fat will migrate when it wants to, and the type of fat or even type of diet I eat hasn't really seemed to have much impact on that. The only thing that really seemed to matter was the only thing that seemed to matter before the amount of calories I burn, versus the amount I eat....Though HRT did reduce the amount I burned at rest by a fair margin so I have had to really cut down consumption and increase exercise to continue my very moderate weight loss.

What I did, and it may be a fun thing to do, is get a measuring tape and a ledger book (or anything really) and keep track of your measurements on HRT. This not only lets me track my progress on HRT but it let me ditch the scale altogether. I don't at all worry about weight, I worry about size after all, I lose weight to look good and fit into more clothes not to satisfy an arbitrary number on a scale. I take measurements and photos about once a week, and it really made me appreciate how much more effective bicalutamide was than spironolactone for me, whereas if I hadn't been taking measurements I wouldn't really have been able to quantify the difference.

I would make sure to ask the endo exactly how to take the medication. Especially if they want you to take anything sublingually (under the tongue) as the dosage is vastly different from swallowing a pill. If it were me I would request bio-identical hormones where available as well, as they tend to have less side effects associated with them (i.e. medroxyprogesterone vs micronized progesterone). Just my two cents on what to ask of the Endo.

A big warm welcome to the family Kim! First congrats on your appointment. I know it seems like forever, but once it gets here things will go fast. Your weight sounds good to me and should not be a problem. I changed my eating patterns a lot going from fast food all the time to salads and leaner meats. The one thing that helped me most was stopping sodas and going to water all the time. In my experience you should go to more of a cardio workout and not heavy lifts. It does take a while for us older members to respond to HRT so don't get disappointed if muscle does not fly off or breast's grow overnight. Do not eat extra fat as it will not help at all. This will take a while so be patient. My first HRT Endo appointment was only to gather medical history and blood testing. Don't be too surprised if you leave empty handed that day. Usually prescriptions are given after blood test results come back. HRT is serious business so they want to see where your body is at level wise and health wise before starting you out. Hang in there though and things will get moving. It seemed like it took forever to get on HRT, but now I am already planning SRS. 


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Quote from: Jessica Merriman on June 17, 2014, 09:38:52 AM
My first HRT Endo appointment was only to gather medical history and blood testing. Don't be too surprised if you leave empty handed that day. Usually prescriptions are given after blood test results come back. HRT is serious business so they want to see where your body is at level wise and health wise before starting you out.

Thanks Jessica!  I appreciate the welcome.  I understand about HRT being serious business.  That's why I've not tried to get them myself outside of a prescription.  Still, I am hopeful that I will get started at the first appt.  The endo I will be seeing was recommended by my therapist.  She said that he typically will provide a prescription at the first appt, but will tell you not to take anything until you have your blood drawn (which can be done in the next building over).  However, your comment makes me think that I might try calling the endo's office and see if I can get an order for the blood draw a couple weeks before my appt.  That would make the results available prior to my first appt.

Quote from: Hikari on June 17, 2014, 09:36:44 AM
Just exercise, eat healthy and drink plenty of water. I think it is far better to just be reasonably healthy than trying to do anything really aggressive to lose or gain weight. 

My experience has been so far that fat will migrate when it wants to, and the type of fat or even type of diet I eat hasn't really seemed to have much impact on that. The only thing that really seemed to matter was the only thing that seemed to matter before the amount of calories I burn, versus the amount I eat....Though HRT did reduce the amount I burned at rest by a fair margin so I have had to really cut down consumption and increase exercise to continue my very moderate weight loss.

Thanks Hikari, that seems like a very reasonable approach! I think I will try to start walking regularly and build up from there if I need to.

Quote from: Hikari on June 17, 2014, 09:36:44 AM
What I did, and it may be a fun thing to do, is get a measuring tape and a ledger book (or anything really) and keep track of your measurements on HRT. This not only lets me track my progress on HRT but it let me ditch the scale altogether. I don't at all worry about weight, I worry about size after all, I lose weight to look good and fit into more clothes not to satisfy an arbitrary number on a scale. I take measurements and photos about once a week, and it really made me appreciate how much more effective bicalutamide was than spironolactone for me, whereas if I hadn't been taking measurements I wouldn't really have been able to quantify the difference.

I would make sure to ask the endo exactly how to take the medication. Especially if they want you to take anything sublingually (under the tongue) as the dosage is vastly different from swallowing a pill. If it were me I would request bio-identical hormones where available as well, as they tend to have less side effects associated with them (i.e. medroxyprogesterone vs micronized progesterone). Just my two cents on what to ask of the Endo.

I like that idea!  I had thought about taking pictures of myself each week, but hadn't thought about a ledger or journal for measurements.

How did you learn about bicalutamide?  I never heard of it.  I expect to be put on spiro.  I didn't know there was another option.

I will ask about the bio-identical hormones.  I had heard that the plant-based estrogen is safer than the horse-derived, but had not heard of the bio-identical versions.

Thanks,
Kim

Kim,

Congrats! You are on your way. I started HRT a little more than 4 months ago. I was wanting things to progress as quick as possible too and was thinking I was going to walk out of Dr's office with prescriptions in hand. For me it didn't work that way and I am sure for lots of others that are going through this as well. I was thinking I would get my female pills. Wrong!!!! I first was prescribed a T blocker. I was on those for a month and back to Dr. He then prescribed a low dose of Estrogen. I have been on that for 3 months plus. Oh yeah I am 54 years old. We have additional risks for being in the older age group. Those of us that are in the older age group have a greater chance for heart attacks, strokes, blood clots and so on!!!!.  Last month Dr started me on spiro. Spiro is another T blocker. I had to get more blood work to make sure spiro didn't increase potassium levels to high. Two weeks ago and after additional blood work Dr increased Estrogen and spiro. I now don't go back for next check up in  2 months. When I first got started I was really bothered that my Dr didn't know what he was doing. But looking back on it He knew exactly what he was doing. Progress for me has been amazing. I am sure I am not the first to say or think this. If there was a magic pill that could change us overnight. We would have taken it. But It doesn't work that way.

Best of luck! Hugs and Kisses.

Gretchen

I just had my first appointment with natural path on last Thursday she did physical exam talk and bloodwork should have HRT and blockers today or tomorrow all the best you need to do what is right for you not other peoples opinions waiting is the hardest keep us posted