Hi

Searched for ages on the net but cant find anything.  Been on spiro for 4 months and premrin for 2 months. Recent blood tests have come back at 14nmol/l for T and FAI of 44. Pre HRT I was 21nmol/l for T and FAI of 63. See my doctor in April to discuss but any info would be great

Well Krissy, it does vary alot from person to person.

21 nmol/l converts to about 605. ng/dl, now that you are at 14 nmol/l that is about 405. ng/dl.
The Lab I go to state that a normal male range is 2.3 to 14.0 nmol/l. Not sure why that is
because 2.3 nmol/l would be about 66. ng/dl which is in an acceptable range for transition.

Going too low with T. will increase SHBG, causing a lesser amount of estrogens to be bio
available as they also binds to SHBG. I also use spiro and reached satisfactory T. levels in
about 6-8 months however with that said doctors vary also and maybe your doc is just being
cautious with the dosage to see how you react, which is a good thing, you and your doctor can
discuss that at your next visit as we can't discuss it here, and for good reason.

As far as the Premarin, many people who used it have had good results, I never used it so I
can't comment on its effects, but I do know that it's estrone sulfate (+ other conjugates which
effects have not been proven) and must first be converted by the sulfatase enzyme to estrone and

further converted to estradiol to have any good effect, plus with newer medications that avoid
that conversion it would be easier on your body and you can also monitor serum E2 levels (the
motherlode of Estrogens for transition).

If you get the E2 levels up enough it will also lower T levels via a feedback loop which right
now you can only calculate to a best guess based on total estrogens.

What I mentioned about estradiol and E2 levels is because it can contribute to lowering T. more
than just a little which I thought was important to your question, I am not trying to persuade
you to not use premarin as it can produce E2 but how much is the ?? part. 

FIA is just a ratio which can still be 66 or 44 or whatever whether your T. level is 600 or 60,
depending on SHBG levels.

You did manage to get your T.levels lowered by 200 ng/dl in four months which is not really a
long time assuming you are on a lower starting spiro dose. getting Your levels on track in the
first year is normal.

Keep up the good work


Nicole

Thanks Nicole. That was very helpfull.
My endo does have me on a low dose of everything as I turn 40 this year. So far all the nasties are within the normal range. So I dont think he will have problems with getting me up to the recommended doses. Its a bit disconcerting about what your lab has as the normal ranges for T as over here its 10 - 35 nmol/l
Even though Im on low doses ive been pleasantly surprized with some of the changes that are starting to happen. So I guess the key is to get T down SHBG down and E2 up.
Just did the calc for SHBG 31.8. Pre HRT was 33. Normal range 10 - 50 nmol/L

when your T drops down in female range and E goes up to female range the SHBG also goes up to keep E from over activating receptor cells. How high SHBG goes up can be somewhat controlled by T levels but is more commonly combated by HRT dosage in relation to E2 serum levels, which is complicated with premarin because your E2 level will depend on aromatase activity within your body rather than the dosage itself....If Keira where here she could really break it down for ya, she inspired me to learn what I could so that I would know what was going on with me instead of sitting there like I used to knodding my head pretending it all makes sense when the doc says that the numbers look good.

About the "normal" T range....well I asked the guy drawing the blood who was probably new to the profession as he looked very young and I caught him on the spot, so he could have thrown out any number and I would have bought into it....another good reason for learning what you can....Right!