I will be going on HRT pretty soon. However I have some other health issues - gout, high blood pressure, diabetes (not bad, but managed) and cholesterol. I'm controlling the gout, BP and cholesterol with meds and it is working out well. Diabetes I've lost weight and with  exercise I keep my hbA1C in a healthy range.

However a new twist has been thrown my way. Thanks to insurance issues I am losing my wonderful family doctor. I mean this man is amazing, he turned my life completely around by addressing all of my health issues and he really does seem to care. Before I saw him, apart from the dysphoria I was a sick wreck 6-7 days per week, hurting in every joint and my head wanted to explode. He did what others failed to do and for that I'm thankful. But alas I'm losing him.  I need one that is in network because he went out of network and I don't want to pay $200+ a visit since I have insurance and I should really be paying $15 copay.

However since I'm going on HRT, my meds and healthcare will be interacting. I will probably be off the BP meds since spiro will be doing the same thing.

So how does this work exactly? Do they like talk to each other, or will my endo be taking over some of my primary care functions in this regard? Do I kill two birds with one stone and get a GP who will do the HRT endo stuff for me?

I initially bypassed the nightmare of getting two doctors to communicate by having my endo act as my primary. 

If you are diabetic, you probably could kill two birds with one stone by doing the same.  Sending diabetics to an endo is recommended by most providers anyway.   

I heard from a doctor that he cured his diabetes, high BP just by cutting down carbs and replacing them with more fat, including saturated. He also lost weight...added bonus. He is now much healthier. His name is Jay Wortman, you can find the video on Youtube.

My diabetes is "cured" because I exercise and diet. But make no mistake, if I go off the diet and get lazy, it will come roaring back. I have tried to stay off metformin for now because of what I heard it does to your metabolism (slows it down). But since I started taking statins for the cholesterol it seems to have upped my hbA1C a bit so my last doc said I needed to get on metformin.

However I've heard that metformin also helps with fat redistribution so it may not be so bad after all... and some MtFs get it prescribed off label for that purpose? Of course I would be using it for its intended use but if that's a nice side effect, hey, I'll take it.


BTW that diet you're referring to seems similar to Atkins. I tried it years ago. Was never really a fan. I did lose some but I found that simply reducing portions works as well.

Well an update. I have my 1st appointment with the endo in less than a month. I am very excited.

Also they are going to be my primary care so they can take care of my other issues as well.

I just went to my endo for the first time today. I gave her my paperwork and I think it sped up the process. She said she's concerned about my triglycerides and the fact that my high blood pressure med was incompatible with either the hormone or the AA I don't remember which. So she switched the med. So while they haven't communicated, they are "working together" through me.

Quote from: awilliams1701 on November 24, 2014, 07:23:23 PM
I just went to my endo for the first time today. I gave her my paperwork and I think it sped up the process. She said she's concerned about my triglycerides and the fact that my high blood pressure med was incompatible with either the hormone or the AA I don't remember which. So she switched the med. So while they haven't communicated, they are "working together" through me.

I fully expect to be placed on a different med for blood pressure. In fact they might replace my med with spiro which would work out well.

So did you walk out with a script for HRT or just the Bp meds?

I see a nuro (epilepsy), two Dr's for HRT (it is the same clinic, so if I need a refill and one is not there I can see the other Dr) and a G.P. The neuro and the Dr's ask me what medication I am taking, who I am seeing (medically) and when my last seizure was everytime I see them. They have also hinted they are in contact with each other

Both actually. I'm not sure if it was because I presented her with bloodwork or if she was going to start me on HRT anyway. I felt a placebo effect almost instantly. Once I realized that 2 minutes was too fast for a pill that wore off. I'm not sure if I'm having a decent mind day (my mind goes crazy all the time and sometimes its worse than others) or if I'm getting preliminary effects after a day. Either way my mind is semi calm and I hope it goes to completely calm. I hope it brings order to chaos.

Quote from: ImagineKate on November 24, 2014, 07:25:41 PM
I fully expect to be placed on a different med for blood pressure. In fact they might replace my med with spiro which would work out well.

So did you walk out with a script for HRT or just the Bp meds?

I found out that the nurse practitioner I'm going to be seeing for the initial visit is openly trans. That is pretty awesome. I will be totally at ease as I planned to go dressed up anyway. Just a few days away. I'm sooooooooooo excited.

Quote from: awilliams1701 on November 25, 2014, 03:41:32 PM
Both actually. I'm not sure if it was because I presented her with bloodwork or if she was going to start me on HRT anyway. I felt a placebo effect almost instantly. Once I realized that 2 minutes was too fast for a pill that wore off. I'm not sure if I'm having a decent mind day (my mind goes crazy all the time and sometimes its worse than others) or if I'm getting preliminary effects after a day. Either way my mind is semi calm and I hope it goes to completely calm. I hope it brings order to chaos.

So I posted in the other thread but I should put it here for reference. Basically my trans care provider is my primary now. I get everything from them now including care for the cardiovascular issues, diabetes and of course HRT. They did adjust my bp med and took away one half and added spiro. I was taking a combo and they switched that to just an ACE inhibitor with spiro. Blood pressure is consistently 120/80 or thereabouts now except if I forget to take my meds.

HRT they put me on a moderate dose because I had blood work from previous where I was taking low dose E only for a couple months and it was fine, liver and kidneys OK. I get blood work next visit in 2 weeks. They are particularly interested in triglycerides and A1C.

The cool thing is that since it integrates with primary my insurance pays it all with just a small copay. The prescription plan does not pay for E but they didn't for my wife either nor will the plan from my job. No worries the initial was about $40 at Duane reade and I'm going to switch to Walmart where I can buy their $4 generics instead. They do pay for spiro and finasteride if I wanted it. I may go on metformin for the diabetes but it has a nice side effect of helping fat redistribution.

Talking to other places that do informed consent in NYC they seem to follow this too in that they can and prefer to take over your primary care in addition to your transitioning needs.


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I hope someday my primary GP will take over since I have to go all the way to atlanta. However since I'm just starting out I'm ok with the current arrangement.