Back in January, after 9 months oral estradiol, I switched to IM injections.  Yesterday, when my first set of blood work came back since the switch, the estrogen levels reported had dropped significantly (almost to male norms).  Has anyone had similar experiences or heard of this before?  Just a little (lot?) worried that I am not getting what I need.

(And did I mention I'm impatiently waiting for my chosen surgeon to get back to me to confirm/deny/schedule?!)

-=Angela=-

I've seen this happen if the blood work was done right before the next injection when injections are done every two weeks. Estrogen levels are always the highest around 48 hours after an injection. Talk to your doctor about using the same amount but less strength, but double the frequency so that your Estrogen levels are more even.

Welcome to Susan's

As stated, keep in mind when your blood draw was in the IM cycle. It definitely warrants a chat with your doctor.  I know that after my switch from pills to IM my T went from 26-35 NG/DL to below 20 (lowest the test goes). My doctor does not test for E.

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The blood draw was on day 9 of a 2 week cycle.  It was as close to midpoint (per the doctor's request) as I could get given scheduling.

Are you on estradiol cypionate (EC) by any chance?? Since levels may be low on that but estradiol cypionate also exerts estrogenic activity which is ignored by blood test.

If you are on estradiol valerate (EV), depends what dose you are on and usually levels drop significantly after 7 days, sometimes earlier in individuals who metabolize their hormones fast. So 9 days, on a low dose, this could well explain why you are seeing these results. Perhaps, test again 2-3 days after? Levels fluctuate quite a bit on EV. 

The important thing though is how you feel and physical results (i.e. body changes).

Valerate.  I will test again once my OB/GYN is back from her vacation, so maybe next week?

I don't really feel different I guess, but the changeover was 3 months ago.  I feel like I'm finally getting the hang of the injections and they aren't hurting like they did initially.  I don't want to chase a number, but...

Numbers fluctuate a lot on injections. They typically go way up the first 2-3 days and then, there is a drop after 7-8 days. You could test again on day 2 or 3. Also, be sure the valerate is injected into the muscle and not into fat...this is why the needle needs to be long, usually 1.5 inches. Is the source you're getting E. Valerate from reliable? Depends on the dose too, if dose is VERY low, numbers would be low after 9 days. Please don't state dose on here.

Yes, I've been very careful not to specify dose.  My pharmacy is Strohecker's in Portland.  Though this is my first time ordering from them, my doctor uses them with her FtM patients very frequently.  It doesn't discount the possibility of a bad vial of course, but it seems unlikely.

The 1.5 needles better be getting into muscle. 

Like I said, maybe ask your doctor if it is possible to have blood drawn on the 2nd or 3rd day after injections and see what comes out of that. Keep us informed.

Quote from: Angelsfury on April 21, 2015, 10:03:56 PM
Yes, I've been very careful not to specify dose.  My pharmacy is Strohecker's in Portland.  Though this is my first time ordering from them, my doctor uses them with her FtM patients very frequently.  It doesn't discount the possibility of a bad vial of course, but it seems unlikely.

The 1.5 needles better be getting into muscle. 

Hi just wondering what concentration of EV your using, 20mg/ml or 40mg/ml from Strohecker's???

Ive been using the 20mg/ml EV from them because Delestrogen has been unavailable at that concentration for about 6 months now but the last time I asked my pharmacy about it a couple of weeks ago they said they could get it again.... I just started a new vial but when that's gone Im going back on Delestrogen.... Maybe Im wrong but I feel like the Delestrogen worked better for me.... The compounded stuff just doesn't seem as potent to me and my feminization feels like its not as good as it was

Im looking forward to trying the Delestrogen again because my insurance refuses to cover any compounded meds but they should cover the Delestrogen   Im not sure you know this but I was told its important to roll the vial to make sure its mixed well from Strohecker's.... I do that now but I never did it with the Delestrogen because it never occurred to me and nobody ever mentioned it.... I guess I could see the possibility of getting a stronger dosage from the first few shots if it was stored standing up and not mixed... Of course that would also potentially give a weak dosage towards the last of the vial...

I can't imagine going 9 days or longer between shots, the longest Ive tried is a week and the last two days sucked before my shot   I just reduce the dosage and inject every 5 days and that seems to work well for me.... Ive never been tested for levels on the compounded stuff but Im interested in seeing your lab results on day 2-4 after a shot... Of course your level should be "high" even on a modest dosage when the E peaks... Hopefully your doc would know that and not flip out....

You never did mention how you feel on the shots VS the pills???

I will say dose is low, but so was the oral beforehand.

Eva, thanks for the tip on rolling the vial, probably before each injection.  Even though the EV should be pretty well distributed, gravity works, and it could have an effect.

As to how do I feel? 
Physically I don't really feel much different, though much of my bandiwdth is taken up by unrelated back pain.
Emotionally/psychologically, I'm having a very rough time right now having separated from partner, in the process of selling the house, and then filing for divorce.  And waiting for the surgeon.

There are so many negative things going on in my life, trying to differentiate what is a physical reaction to the hormones (or lack thereof) and what is everything else is bordering on impossible right now.

I will say though that several simple stupid things at work yesterday made me want to rage, and that is pretty unusual for me.  Followed by tears at home (partner related).

Oh, and for reference, T levels actually fell in the most recent bloodwork, though they've pretty much always run a little high compared to others on similar regimens of Spironolactone and Finasteride.

Got more blood work done this week and fast results.  It appears that, yes, I am getting plenty of Estrogen.  I scheduled the blood draw specifically to get a peak value, and it came back appropriately high (similar to peak monthly estrogen levels of cis women).

The original test may still have been a fluke, or I may just move it through my system very quickly, it's impossible to tell at this point.  I'll have a better idea during my usual quarterly blood test in June.

As you suggested Sydney, once I get some smaller syringes, I will begin taking half the dose each week instead of every other week in hopes of evening out the levels, at least a little bit.

Suffice to say, I'm glad I had the retest done (even if it freaked my Dre. out a little bit - she didn't know it would be peak value).  And with word about surgery this week, this puts me in a much better mental place.