Hey guys.  So my endo wants me to start T on a really low dose and slowly work our way up.  I mean slowly.  Are the risks of just starting on a regular dose all that much? Like to be worth going so slow?  He mumbled something about acne and that was it.  I've been waiting for 8 months now to start, I don't want to have to wait so much longer to see changes happen if I don't have to.

Quote from: Evan of Spades on August 08, 2014, 01:59:54 PM
Hey guys.  So my endo wants me to start T on a really low dose and slowly work our way up.  I mean slowly.  Are the risks of just starting on a regular dose all that much? Like to be worth going so slow?  He mumbled something about acne and that was it.  I've been waiting for 8 months now to start, I don't want to have to wait so much longer to see changes happen if I don't have to.

Everyone processes medications differently.

So most take the process as needed.

Acne, increase libido, mood swings, penis enlargement (clitoris). hair growth on face, deepening of voice, loss of scalp hair (mpb), fat moving to more male location, increased muscle mass, stop menstrual cycle and others.

So yes those are some of the joys of T.

I seen my husband through every one of them so far.

Hugs

How low and how slow? I started on a really low dose. My doctor increased it three months later. The risks you and your endo should be looking out for are liver issues, cancer of the female organs and on a lesser note breast cancer, heart attack and stroke, acne, male pattern baldness, mood swings. Hormones are not to be played around with. There might be more. Anyone feel free to add to this list. But I think I got the major ones.

I don't mean risks of T, I know that there are risks that go with T.  I just mean the risks involved with taking a higher dose right away vs going slowly.  Like, are you more likely to develop problems like serious acne by going to a higher dose right away vs taking it slow, that kinda thing.  I'm mostly concerned that my voice is going to take a year to start dropping at the rate he's going to have me going, I don't want to wait that long, especially when I know other guys have started at a higher dose with their voices starting to drop 2 or so months in.  Also having to wait for shark week to finish, I dunno.  They seemed totally fine starting at a high dose, but I'm asking in case I'm missing something here.  Or does everyone start at a low dose and I just didn't know it or do you still see good changes happening at a low dose (like voice dropping).  Also worried that weight distribution is not going to go to the proper areas because I need to gain weight but refuse to gain it if it's going to my hips and butt. I'm really underweight right now.

Chipper that's interesting. So you found your changes went along the normal timeline despite starting at a lower dose?

My doctor did some quick blood work, said I was healthy as a horse and gave me a dose that seems reasonable to me. I don't have anything to compare it to but I'd say it's in the mid to high range at least, because my voice was dropping pretty quickly at months two and three and at six months I'm halfway into growing a beard. I haven't developed any particular problems associated with T yet, like acne or balding.

I found this page saying most people can start at full dosage
http://transhealth.ucsf.edu/trans?page=protocol-hormones

But it is very common to start low and increase gradually. Personally I started at a very low dosage and my doctor never put me on the full reference dosage.
You can let your doctor know if you think your dosage is not sufficient. They tend to listen to you because they don't want you to be desperate and seek hormones from other sources.

If you went onto a full dose and suddenly had liver complications of kidney failure, then you can bet you'd be taken straight off T and it would be pretty hard to convince a doctor to put you back on it, especially if they're not dealing with trans* guys often.  So it's better to ramp up.  No, I don't think that it will take a year for you to see changes.  Some guys don't even take "a full dose" and have changes just fine. 

As long as your levels are in the normal male reference range - it doesn't matter what the dosage is.  That's why some doctors prefer to ramp up - start off low, gradually increase to see at what dosage your levels fall into male range.

Generally, I'd say there "could be" risks associated with blasting yourself with a full dose right away if neither you nor your doctor know how your body is going to react to it.  I'm sure it's uncommon, but there's always a possibility.

My endocrinologist had no qualms about starting me off full dose, when I brought up the idea of a lower dose initially he told me there wasn't really any point. I ended up on a lower dose anyway because my body didn't absorb gel very well, once I switched to injections I was on full dose.

To be perfectly honest I just don't think we know enough about the hormones to understand fully what the best practices are. I think that the most important thing is to make the effort to get your bloodwork done regularly and check in with your doctor (advice that I personally need to follow better, but yeah lol).

There aren't enough studies but different doctors will give different prescriptions and they'll all have some reason behind it. If you're really that unhappy about starting low, talk to your doctor or get a second opinion.

Ok all good points.  I appreciate everyone's input, thanks all!  And the first-hand experience there Chipper, makes me very hopeful and you make a good point, less is often more in this kinda thing.  I think, after listening to what everyone is saying here, I might ask for a slightly higher dose than what he's planning.  If he insists I suppose I'll let him have his way. I'll let him know my concerns and see how things go from there.  Thank you everyone!