Hey everyone, it's been a long time since I've posted here (been lurking but quiet), but I really need some re-assurance right now.  A couple months back, after 9 months on estradiol pills, I never had an estradiol level higher than 60, in fact over the last 3 months it actually dropped into the 40's.  Meanwhile my T levels were at immeasurable levels (lab results said <2ng/dL).  Frustrated with my estradiol levels, my doctor and I discussed injections and I made the switch on February 14.

This morning I just got me most recent lab results back.  My E level was down to 6.2!!  Worse still, my T levels were back up in the mid-200's. I'm sitting here right now seriously panicking. I've never heard of E levels going down like this and the T levels rising is just too damn scary. Throughout the entire time, both on oral and injected estradiol, I've also been on the same steady dose of Spiro.  I also started Progesterone in January, I'm not sure if that could have impacted any of this.

My estradiol dosages are weekly and seem to be fairly low.  A friend of mine who is a little taller and about 15 pounds heavier is currently on more than double what I'm taking.  So I'd be shocked if this was a case of too much Estradiol. 

Has anyone else experienced something similar?  Did you find a solution? I'll be sending a message to my doctor to get her thoughts, but I could really use to hear from any of the girls here who've been down a similar road (if there are any).  Please help me out, I'm freaking out and falling into a really dark space fearing that this will just never work for me.

Hi Alyssa,

I'm not very knowledgeable on this (I have only used patches and was never on a t-blocker) but a few thoughts come to mind.  I assume your testing method is blood serum not a spit test, and curious about the timing of test after injection. 

Photos last year showing HRT progress were amazing - the softening of your face and especially eyes.  By that important measure you are succeeding, although I can understand your concern seeing the numbers. 

Kendra

I would contact your doctor for sure, that's an awfully low level.  Now of course if that was right before you injected it's possible that you just metabolize it quickly.  It would be interesting to turn you into a pincushion and take a blood draw every day for a week to get an idea of how you metabolize it.  Of course that's painful, expensive, and I'm not your doctor. (or even a doctor in the first place, but don't worry about that!)

One other thing comes to mind: was total E2 level measured or free E2?

Kendra, it is a blood test. Thanks for the comments on my progress, there has been some but there are also a number of effects I wasn't seeing. Between that and the convenience factor, I decided with my doctor to switch to the EV injections in February.

Kay, I'm not 100% sure regarding total versus free E2.  The test results don't specifically say.  It is an Estradiol 17 Beta test that they use, the reference ranges look like this:

Follicular Phase: 12.5-166.0 pg/mL
Ovulation Phase: 85.8-498.0 pg/mL
Luteal Phase: 43.8-211.0 pg/mL
Postmenopause: <54.7 pg/mL
Pregnancy (1st Trimester): 215.0-4,300.0 pg/mL

Quote from: AlyssaJ on April 02, 2018, 09:20:40 AM


Kay, I'm not 100% sure regarding total versus free E2.  The test results don't specifically say.  It is an Estradiol 17 Beta test that they use, the reference ranges look like this:

Total Estradiol, then.

AlyssaJ, I don't have an answer for that but just wanted to say that I'm glad you're back. I remember your enthusiasm a few months ago and definitely noticed your absence. Hopefully you'll stay longer this time update us on your process! I would really love to see your pics.

In the meantime, what if you increase the spiro dosage?

So the doctor thought maybe the tests were wrong, that the lab had transposed the two results, so I did new labs on Monday.  This time things looked a little better.  E was at 118, however my T was up to 271!!!  Doc wants me to stop taking the progesterone, figuring my body is metabolizing it into Testosterone at a much higher than expected rate.  I'm actually OK with this as I've gained quite a bit of weight since starting it and other than getting my libido back, have not seen much in terms of results.

The E numbers still have me concerned however.  I did my first labs on a Wednesday, 5 days after injecting my normal dose of EV and my level was very low.  The 118 number I got this week was on a Monday, only 3 days after injecting double my normal dose (yeah I was emotional after the test results and went "rogue").

So it seems clear my body is metabolizing the E rather quickly.  I'm going to be asking my doctor today to double (or more) my weekly dosage and allow me to start injecting it twice per week. I'm also planning to ask about the injection site.  I'm not finding any trans women outside of the clinic I go to that are injecting into the ventrogluteal site (the hip).

I did find this which suggests the site should be a good one, but I still wonder:

QuoteThe Ventrogluteal site provides the greatest thickness of gluteal muscle (consisting of both the gluteus medius and gluteus minimus), is free of penetrating nerves and blood vessels, and has a narrower layer of fat of consistent thinness than is present in the dorsogluteal.

So I've got my appointment this afternoon, I'll let y'all know what comes of that.

Quote from: AlyssaJ on April 04, 2018, 09:54:32 AM
Doc wants me to stop taking the progesterone, figuring my body is metabolizing it into Testosterone at a much higher than expected rate

Studies have shown this does not happen, even on high doses of oral progesterone but perhaps, YMMV. I was on a high dose of P and my T was very, very low, around 3-9 ng/dl. More likely, IMHO (I'm not a doctor), estradiol is low and therefore, testosterone is not suppressed enough.

QuoteThe E numbers still have me concerned however.

They do seem low, considering you doubled dose and drew blood 3 days after. Something strange is going on...hope you figure it out with your doctor.

QuoteI'm not finding any trans women outside of the clinic I go to that are injecting into the ventrogluteal site (the hip).

Wondering about that too, whether dorsogluteal, if your doctor allows, might be better.

The next time you get a blood test, ask the doctor to run both Total Estrogen and Estradiol. Something that shouldn't happen with injections but happens with pills is Estradiol is converted to Estrone and both test should tell you if this is the case. If your body isn't doing the conversion, then it would be interesting to know where all that Estradiol is going.