Quote from: Dena on May 18, 2016, 04:59:18 PM
I am going to throw my hat into the ring on this one because some of the talk is apples and oranges. From 1977 to 2006 I was on Premarin mostly on a quarter dose but up to a transition dosage for a few years. I suspect at peak dosage my estradiol might have reached 25 pg/ml and total estrogen around 1400 but the levels were never tested.
Premarin also contain equine estrogens that have an estrogenic effect in your body, test does not account for this. Total estrogen is the sum of estrone and estradiol. Premarin consists of mostly estrone (around 50%) and very little 17 beta estradiol (less than 1%). It contains a little 17-alpha estradiol (around 3-4%) which is less potent than the beta version.
This is the list of the three most abundant estrogens in Premarin:
Estrone (49%)
Equilin (23%)
17alpha-dihydroequilin (13.5%)
QuoteYesterday I had my doctors appointment and my estradiol is 51 with a total estrogen of 733 on my first test. I suspect most of the total estrogen was made up of estriol which is almost useless as far as transitioning is concerned. The person monitoring my treatment figures a total estrogen level of 300 is all us older girls need.
Total estrogen does NOT include estriol, only estrone and estradiol.
http://www.mayomedicallaboratories.com/test-catalog/Clinical+and+Interpretive/84230"Serial specimens must be drawn over several days to evaluate baseline and
peak total estrogen (E1 + E2) levels."
E1 is estrone, E2 is estradiol, E3 is estriol.
You are most likely taking estradiol ORALLY since your estrone is much higher. Figures vary according to route of administration. By injection, estradiol is about twice as much as estrone which approximates women's normal physiological ratio before menopause. After menopause, estrone is twice as much.
What each person needs varies, in my opinion and can be determined on the basis of how well the person is responding.
QuoteOK, I can understand if you had a high dosage of estradiol when you are young, there might be a point in life were you should enter the menopause range of 15 to 60 ph/ml of estradiol BUT I HAVE NEVER LEFT THE MENOPAUSAL RANGE. This may also explain my rather boyish build and some what masculine face. The last 3 months were on about a half transition dosage but she was more that willing to write my next prescription for a quarter transition dosage. I am beginning to wonder why I have spent $600 getting back on HRT when the doctors are doing there best to make it not work!
You need to see a more informed and competent doctor. She is probably worried about health risks with higher levels not understanding that levels are not an accurate gauge but rather the type of estrogen and route and that all the health risks found were in women taking non bio-identical estrogens.
Quote from: Rachel Lynn on May 18, 2016, 07:14:40 PM
Where I go they do not monitor E; they monitor T. They ask how I feel and go from there ( they see 1800 trans). The IM dose they prescribe is on a 14 day cycle. I am on the same amount of E as a 25 year old but on a 10 day cycle. I had to promise no smoking, alcohol or drugs and exercise every day in order for him to lower the cycle time.
Doctor worries about higher estrogen levels non-orally when that fear is really unfounded. But, all good advice nonetheless.
Prostate 1989;14(4):389-95
Estrogen therapy and liver function--metabolic effects of oral and parenteral
administration."Oral estrogen therapy for prostatic cancer is clinically effective
but also accompanied by severe cardiovascular side effects.
Hypertension, venous thromboembolism, and other cardiovascular
disorders are associated with alterations in liver metabolism. The
impact of exogenous estrogens on the liver is dependent on the route
of administration and the type and dose of estrogen. Oral
administration of synthetic estrogens has profound effects on
liver-derived plasma proteins, coagulation factors, lipoproteins, and
triglycerides, whereas
parenteral administration of native estradiol
has very little influence on these aspects of liver function."
Think of pregnant women with extremely high levels and VERY low risk OR men with prostate cancer who are old, who had high levels and nonetheless, did not have increased complications, rather their cardiovascular health suggested improvement.
Br J Obstet Gynaecol. 1990 Oct;97(10):917-21."There is some anxiety about the possible harmful sequelae of supraphysiological estradiol levels but no data are currently available to show any deleterious effects of these levels on coagulation factors, blood pressure, glucose tolerance or the occurrences of endometrial or breast cancer (Hammond et al. 1974; Thom et id. 1978; Studd B Thom 1981; Armstrong 1988)."
QuoteFemale range for T is 36-150 ng/dl but woman do not have a prostrate to convert T to DHT.
Range varies by lab. I have seen as low as 2 ng/dl. Women have other tissues with high concentration of 5 alpha reductase like scalp, liver, etc where T can be converted to DHT. Estrogen appears to reduce concentration of this enzyme.
