I'm curious about how frequently it is best to take sublingual estradiol? My doctor instructed me to take my full days dose at once, but everything I've seen regarding the sublingual route seems to conclude that spacing multiple doses throughout the day is better for the stability of levels, but oral administration is fine to take it all at once. Thoughts & experiences?

If I was prescribed more than one pill a day I would space them out as that is usually how the doctor would say to take them regardless if taking orally or sublingually. At this point I take only one and do so sub buccally  between the cheek and upper gum above the eye tooth.

  Hugs,
   Jeanette

From what I have seen, Sublingual and oral is best delivered in equally spaced dosages. With Sublingual even a small dosage can spike close to 1000 pg/ml and anything over that has no additional benefit. Spacing the dosage keeps levels under the cap giving you more effective levels over time. In my case, I take my medication once a day (one tablet a day) and about 32 hours latter (when my blood is drawn) my levels have dropped to about 50 pg/ml. If my last pill was only 20 hours ago, my levels would have been higher. By the way, all that estradiol wasn't lost. Because of the way my body works, it was converted to estrone and is converted back to estradiol as needed. My total estrogen levels are over 700 pg/ml so it's all there, just not in the most desirable forum.

I would try to review with your doctor to see about spacing it out. Most people I know on HRT have it spaced out 2-3 times a day. Now, we can't really give medical advice because that is for your doctor, but it is worth finding out.

Thanks for the advice & information everyone. My daily dose is actually two pills, so splitting it up shouldn't be any trouble at all. My doctor is supposed to give me a call to follow up on my first appointment sometime this week; I'll address it with him then!

Estradiol taken sublingualy,  will peak in about 15 minutes and the blood levels will taper off for the next several hours. 12 hours later, you will only have a small fraction of the estradiol left in your blood system.

If you want optimal blood levels, then twice a day is just fine. But keep in mind, blood levels are not that important in the feminizing effects of estrogen therapy. What is important is getting to an adequate peak and doing this daily for many months.  I started with twice a day dosing to get things moving fast. Now I take my estradiol once a day mainly for convenience.

Quote from: Dena on April 22, 2017, 06:54:32 PMWith Sublingual even a small dosage can spike close to 1000 pg/ml and anything over that has no additional benefit.

What are you basing yourself on to say that anything over 1,000 doesn't have any additional benefit? Studies?

QuoteBecause of the way my body works, it was converted to estrone and is converted back to estradiol as needed.

Estradiol is converted to estrone in all human bodies and especially when taken orally, due to gut and liver metabolization. The conversion back to estradiol is small relative to the other way around, confirmed by studies. This is why you have so little estradiol relative to estrone even when taken sublingually. Some of it is inevitably swallowed too as is confirmed by the fact that your estrone is so much higher. On injections, my estradiol levels are consistently twice as high as those of estrone.

Quote from: Dani on April 23, 2017, 07:37:03 AM
Estradiol taken sublingualy,  will peak in about 15 minutes

In one study where estradiol was administered sublingually, levels were tested 10, 20, 40, and 60 minutes after administration. Levels were 234±56, 468±115, 1980±456, and 2124±568 pmol/L, respectively. So that the peak was reached at 60 minutes.