So this is less a question about anything, and more something that I'm happy about and just wanted to share :-). So I posted a while back when I first started HRT. I'm pre-diabetic and see a very well reputed endocrinologist for diabetes. Anyway, when I was going to first start HRT I asked if he treats Trans patients as well, and he said yes. So I figured it'd be nice to use an Endo who can keep an eye on the whole picture. So at my first appt he prescribed me a super super low dose of estrogen and no T-Blockers. When I asked about it he said that often he finds T-blockers to be unnecessary and that often estrogen alone is enough to suppress testosterone. So I went, okay, I'm slightly dubious BUT he's probably just starting me on low dose to get me acclimated and then I'll see where my levels are at at my follow up. So I go to my follow up, and he hands me a new prescription... For the same low dose of estrogen only I had been getting. Now, I know HRT is a slow process, but literally NOTHING had happened over the first 3 months. So I asked him where my levels were at. He pulls them up (and is seeming to be reading them for the first time) and my testosterone was slightly HIGHER than it had been three months ago, and my estrogen was a little elevated but not much. So I said, well then if my testosterone isn't suppressing with E alone, shouldn't we add T-Blockers? And he goes, and I quote, "Well the actual numbers of your hormone levels are irrelevant." Then he hands me a prescription for a SLIGHTLY higher dose of estrogen and sends me on my way.

So needless to say, I walked out, and I called a different endocrinologist that had been referred to me that is a specialist in trans HRT (and is also trans herself) and set up an appointment with her. At that appointment, she literally laughed when I told her what I was on. She said that's the dosage that they give post op women as a maintenance or is used only for pre-op trans women who have an underlying intersex disorder and whose T levels are already negligible. Anyway, she took some blood and gave me a Spiro prescription. She said for the next two weeks take the Spiro and continue taking the E that the other endo had prescribed. Then we will follow up in two weeks, go through my blood work thoroughly, and discuss the various and more tailored to me and my goals methods of HRT that we can do. I felt like she was so much more attentive to my needs, also asked really insightful questions about my transition goals, etc.  So I'm feeling WAY better andI will have a completely new prescription in two weeks :-). Here's to hoping this actually gets physical changes going!

Now that sounds like you made a great decision! I can just imagine that you left your appointment with a skip in your step! I am on spiro alone, and will be for another month. At that time I will have another blood test and hopefully add low dosage E to my meds.

Thanks! Yeah, I feel SOOOOO much better :-). And you'll be through that month before you know it!

Just goes to show that not all endocrinologists or doctors treating TS patients are competent. Always remain critical and use your common sense. Just as you shouldn't trust what you read on this forum or any forum, question things at all times, the same applies when you read studies or get advice from doctors. The more you are informed, the better.

Quote from: KayXo on March 10, 2015, 01:34:44 PM
Just goes to show that not all endocrinologists or doctors treating TS patients are competent. Always remain critical and use your common sense. Just as you shouldn't trust what you read on this forum or any forum, question things at all times, the same applies when you read studies or get advice from doctors. The more you are informed, the better.

Yup! I just couldn't believe the first one ACTUALLY said "The numbers are irrelevant." He also said he never ever prescribes anything more than a small dose of estrogen only in pill form... Apparently even if that's not enough or not doing what it's supposed to. I already have a nice placebo affect from adding in the anti-androgen O:-).

In contrast, my endo specializes in trangender patients and I get blood tests done every time I visit him. He definitely treats blood levels as important, and I'm very happy with how he works.

My doctors don't look at E or T levels as they don't consider them important. I agree. What's more important is how I feel and feminization. What dose produces good results and when the dose is found, we stick with that dose.