Quote from: Rachel Richenda on December 06, 2016, 06:35:51 PM
Those ranges seem terribly high to me?
http://emedicine.medscape.com/article/2089003-overview
Which suggests that even in Periovulatory phase the normal female range is 96-436 pg/mL
My reference range in blood results for a cis female pre-menopause is listed on the blood results at 72-1309 pmol/L
Lab ranges vary.
Am J Med. 1995 Aug;99(2):119-22."normal postmenopausal plasma concentration less than 200 pmol/L (less than 54 pg/ml); normal premenopausal physiologic ranges: luteal 368 to 1,100 pmol/L (100 – 300 pg/ml),
midcycle 785 to 1,840 pmol/L (214 – 501 pg/ml), follicular 74 to 368 pmol/L (20 – 100 pg/ml) for estradiol"
Maturitas. 2005 Apr 11;50(4):266-74."Normal concentrations obtained via a fluorometric method, vary with the phase of the woman's menstrual cycle. During the follicular phase, they range from 35 to 184 pg/mL;
during the ovulatory phase, from 191 to 540 pg/mL; and during the luteal phase, from 40 to 228 pg/mL; at menopause, the 17β-estradiol level decreases to about 35 pg/mL. »
http://www.specialtylabs.com/clients/outreach/web/site/details.asp?tid=44312&cid=301&keyword= Follicular: 21 - 251 pg/mL
Mid Cycle: 38 - 649 pg/mL Luteal: 21 - 312 pg/mL
http://www.ilexmedical.com/files/PDF/Estradiol_ARC.pdf"Normal estradiol levels are lowest at menses and into the early follicular
phase (25-75 pg/mL) and then rise in the late follicular phase
to a peak
of 200-600 pg/mL just before the LH surge, which is normally followed
immediately by ovulation. As LH peaks, estradiol begins to decrease
before rising again during the luteal phase (100-300 pg/mL)."
"If conception occurs, estradiol levels continue
to rise, reaching levels of 1,000-5,000 pg/mL during the first trimester,
5,000-15,000 pg/mL during second trimester, and 10,000-40,000 pg/mL
during third trimester. 6-8"
My lab's values:
Ovulatory: 315-1828 pmol/L (86-498 pg/ml)
Quote'A practical target for hormone therapy for transgender women (MTF) is to decrease testosterone levels to the normal female range (30–100 ng/dl) without supra- physiological levels of estradiol (<200 pg/ml) by administering an antiandrogen and estrogen.'
Levels arbitrarily chosen and without consideration for individual variation and sensitivity as well as blood measurements which aren't even accurate because they fluctuate in time.
Aust NZ J ObTtet Gvnaecol 1998. 38: 3: 45"it is difficult to define a therapeutic drug concentration (...) because
patients may vary in their oestradiol requirements (...). In addition, serum oestradiol levels may not necessarily reflect tissue oestradiol levels."
CLIMACTERIC 2005;8(Suppl 1):3–63"Even though there is a significant correlation between
the serum concentrations of estradiol and their
clinical effects, e.g. on hot flushes or bone mass,
the serum level of an individual woman does not
predict the therapeutic effect. As shown in Figure 1,
the number of hot flushes differs largely in
patients who showed identical estradiol levels
during transdermal hormone therapy1. This casts
considerable doubts on the usefulness of regular
measurements of hormone levels for the prediction
or control of a therapeutic success."
Maturitas, 12 (1990) 171-197"When the serum concentrations of natural or synthetic sex steroids are measured
at short time-intervals after administration and repeatedly during long-term
treatment, it becomes obvious that there are large intra-individual and interindividual
variations. This holds true for both the contraceptive steroids and the natural
oestrogens and does not apply solely to the oral route. Long-term studies
indicate that an important influence is exerted by predisposing factors, particularly
the metabolic capacity of the liver, on the pharmacokinetics of sex steroids.
Large variations in oestradiol and oestrone levels can be observed in an individual
woman from day to day or from hour to hour, even during transdermal therapy
with oestradiol"
QuoteI have zero levels of testosterone: 1.2 ng/dl which is 0 nmol/L following my orchiectomy
More precisely, 0.04164 nmol/L but very low indeed, 0 if we round it up. My total T level is around 8 ng/dl. I'm also post-op. Despite very low serum T levels, DHT and T levels in tissue may still be somewhat significant.
Prog Brain Res. 2010;182:321-41."after castration, the 95-97% fall in serum testosterone does not reflect the 40-50% testosterone (testo) and dihydrotestosterone (DHT) made locally in the prostate from DHEA of adrenal origin."
QuoteFeminising effects from that are clear: absence of body hair, breast growth, skin and muscles changes etc. The absence of any androgenising in my case must mean a lower input of estrogen makes complete sense. Surely?
Theoretically, makes sense but still, we can't predict in advance. You may indeed need very little E or more. Trial and error, and will be determined TOGETHER by you and your doctor.
QuoteI know every individual is different but my rising estrogen level at 577 pmol/L was making me feel ill.
Higher levels orally were making me ill. Much higher levels by injections make me feel good. Trial and error. It wasn't about the levels but had to do with something else, clearly.
QuoteWhat gets me slightly about this is the extent to which we are left to influence our physicians on the decision-taking. I know, for example, that the moment I present those results to my GP he will tell me to drop the dosage. But shouldn't it ideally be the medics guiding us, not the other way around?
I believe the ideal is a partnership between doctor and patient. My doctors have told me they learn a lot from their patients and value their feedback.
