Quote from: EmmaMcAllister on May 31, 2016, 12:08:35 PM
So, my doctor cut my dose in half, as I expected he would. Beyond my estradiol levels, he was concerned about my hemoglobin. So, back to once a day, retest in a few weeks.
Hemoglobin levels are lower in females and may drop a little when on estrogen. Best to compare your levels to female levels.
Quote from: Richenda on June 01, 2016, 11:21:42 PM
Neither statement is factually correct.
Oral vs sublingual has different effects if this admittedly small double blind study is correct: http://www.sciencedirect.com/science/article/pii/S0029784496005133
"Results:
Sublingual administration resulted in rapid absorption with significantly higher E2 levels than did comparable oral dosing. Estrone levels did not vary with route of administration but correlated with the dosage administered. Estrone sulfate levels correlated with the dosage administratered and also tended to be higher with sublingual administration. Sublingual administration resulted in a significantly lower E1 to E2 ratio during the 24 hours than did oral administration.
Conclusion:
Sublingual administration of micronized 17β-estradiol results in a rapid, burst-like absorption into the systemic circulation, yielding high E2 levels that fall rapidly over the first 6 hours."
I don't dispute the fact that E taken sublingually yields significantly higher levels, I've read this study and many more like these. But, in my case and in the case of others (but not all transwomen), physically and psychologically speaking (regardless of levels in the blood at any point in time), results were similar, whether oral or sublingual. That's all I'm saying. So, for me, I just took it orally and saw no point in taking it sublingually. Bio-identical, I consider, based on several studies, to be quite safe, even when taken orally so from that standpoint as well, saw no significant advantage taking it sublingually.
QuoteThe valerate version of estradiol is different. It binds to a carbonyl to create an ester of estradiol. As a result it creates a prodrug which is much more benign and not easily absorbed or reactive. So this radically slows down absorption, which leaves it in the system longer https://en.wikipedia.org/wiki/Estradiol_valerate
They state "especially when given in an oil solution via intramuscular injection". Also,
Maturitas. 1982 Dec;4(4):315-24."After oral or parenteral administration, oestradiol valerate, the synthesis compound contained in various commercially available preparations, is completely converted into the natural substances 17 beta-oestradiol and valeric acid. The 17 beta-oestradiol produced on cleavage of the ester behaves in the organism like the endogenous steroid hormone. Oestradiol valerate and 17 beta-oestradiol are virtually dose-equivalent. No differences in the spectrum of action of the oestrogen and its ester have been found either in animal experiments or man.
The pharmacokinetic behaviour and the biotransformation of the 17 beta-oestradiol originating from oestradiol valerate are no different from those of natural 17 beta-oestradiol."
Arzneimittelforschung. 1998 Sep;48(9):941-7."A randomized, single-dose cross-over study in 32 postmenopausal women was performed to demonstrate bioequivalence of two estradiol valerate containing formulations"
"The terminal elimination half-life of estradiol was calculated at 16.9 +/- 6.0 h (Test) and 15.0 +/- 4.8 h (Reference), that of free estrone at 16.3 h (Test) and 13.5 h (Reference)"
Vs.
https://en.wikipedia.org/wiki/Estradiolbiological half-life is stated to be 13-17 hours.
In the end, the difference
when taken orally between E2 and EV, if any, is minimal. A study states lower estrone levels with EV and another slightly lower estradiol levels.
