The world according to Sarah

[Devlyn ✅]

4 mg here. E=196 and T=53 (US units).

[Lori Dee ✅]

On pills or patches, I only got above 100pmol/l three times in four years.
After many and quite heated discussions, I was switched to injections.

Pills get processed through the liver first, reducing their effectiveness and affecting blood clotting.
Patches need to be absorbed through the skin into the underlying layers of fat. I don't know if it was because they weren't penetrating my skin, poor product quality, or what, but they didn't work. I was wearing three patches at a time and changing weekly patches twice a week. No help.

Now that I am injecting directly into the fatty tissue, my levels have improved. I am less convinced by the "everybody's different" theme than by the "every medication is different " theme. That seems more prevalent, especially with generic products. Too much profit and not enough quality.

[Stottie Girl]

OK I'm confused then, are we all talking about the same units here? pmol/L? I take my estrofem pills orally in the morning and the evening. But I take them sublingually. The bloods were taken about 6 hours after I took the pills. Does this sound like I'm doing something different? That reading does sound very high compared to everyone else.

Are we allowed to talk about this stuff in such detail by the way? I thought it was frowned upon?

[Devlyn ✅]

Here's the site policy:

Discussing hormone replacement therapy responsibly: Offer support and share experiences, but avoid giving medical advice. Encourage seeking professional medical guidance, especially for topics as serious as hormone therapy. — [TOS 6]

In a nutshell, you can state your dosage, but don't tell someone else what they should take.

[Devlyn ✅]

Also, most US people aren't given their levels in EU measurements, and vice versa.

[Stottie Girl]

Also, most US people aren't given their levels in EU measurements, and vice versa.

Ah right so we are comparing apples and oranges. That's more reassuring.

[Devlyn ✅]

There are online calculators.

[Lori Dee ✅]

Also note that sublingual bypasses the liver on the first pass, so it avoids those issues.

[Charlotte Kitty ✅]

Bloods are normally taken in the trough so just before your next dose ideally. But thats not always practical. Sublingually will give a large spike. But as you're splitting dose then 6 hours doesn't seem too bad a reference.

Whatever happens it seems it works for you!

[Lori Dee ✅]

Also, most US people aren't given their levels in EU measurements, and vice versa.

Ah, yes. My typo.

In the U.S., it is pg/mL.
International Unit: Picomoles per liter (pmol/L) is often used outside the U.S.
(Multiply pg/mL by 3.67 to convert to pmol/L)

My bad.

[Stottie Girl]

Ah, yes. My typo.

In the U.S., it is pg/mL.
International Unit: Picomoles per liter (pmol/L) is often used outside the U.S.
(Multiply pg/mL by 3.67 to convert to pmol/L)

My bad.

OK so I am 336 pg/mL in US money. Does that sound more normal then?

[Lori Dee ✅]

OK so I am 336 pg/mL in US money. Does that sound more normal then?

Yes. Definitely.

My doctors wanted me around 200, but I convinced them that 250 was better. My labs and others report that hovering around 250 on injections is typical.

At peak, they will be higher a day or two after injection, then fall to their trough reading the day before injections.

I have seen other readings higher and have had two readings at 400 over the last couple of labs. I think you are in good shape.

[Charlotte Kitty ✅]

Highest I've ever had at trough is 400pmol/l. That's within in the wpath range but nowhere near the ranges you both have. Should i have been ignoring wpath and going over the upper limit? That's probably why feminization has failed. Hopefully injected will have me at a over 1000pmol most of the time!

[Lori Dee ✅]

Hopefully injected will have me at a over 1000pmol most of the time!

Since you are changing how the meds are introduced to the body, don't change the dose for two or three labs. Look at what they show. Note whether they were peak, trough, or mid-cycle. That will give you a better idea of where your levels sit. Then slightly adjust from there. You don't want to make big changes.

Hormones work together and affect one another. A change in one can affect the others. And not just T and E. There are many others as well. Make small changes, then let the body settle into that. Then get labs to see what happened. Then adjust again, or maintain if they are in the correct range.

[KathyLauren]

My doctor aims for an E level of 200-600 pmol/l.  (That is 54-163 pg/ml, US units.)  I have been outside that range a couple of times, but mostly I am in the middle of it.  My dosage and levels have been pretty consistent for nearly 10 years.  I am very happy with my results in breast development, fat redistribution, body hair, and facial changes, as well as regulation of dysphoria.  In fact, I am planning to get my bust measured again soon, because the girls have grown in the past few years since I was last measured.

[KristaFairchild]

I was on a 0.1 mg patch for three days and got tested as sort of a baseline. It was 95 pg/ml.

I'll get another blood test at about four months and I'm hoping for good results. I am fortunate to have very little body fat Where I am attaching the patch so maybe that is helping. Or maybe I'm just lucky. 

Injecting would be my worst nightmare. 

[Lori Dee ✅]

I'll get another blood test at about four months and I'm hoping for good results. I am fortunate to have very little body fat Where I am attaching the patch so maybe that is helping. Or maybe I'm just lucky. 

Krista,

Actually, the opposite is true. The patches should be placed over fatty tissue. The hormone leaches through the skin and is stored in the fat. The body pulls from that storehouse as needed to increase your serum levels.

Check the paperwork packaged with the patches; it should show the best locations.

I had suggested to my Endo that I place them on my thighs, but she said there wasn't enough fat there. The usual places are the abdomen below the navel or on the upper buttocks. I found the upper buttocks skin flexed too much as I bent over, causing clothing to rub and peel the edges. The lower abdomen worked well.

[KristaFairchild]

Krista,

Actually, the opposite is true. The patches should be placed over fatty tissue. The hormone leaches through the skin and is stored in the fat. The body pulls from that storehouse as needed to increase your serum levels.

Check the paperwork packaged with the patches; it should show the best locations.

I had suggested to my Endo that I place them on my thighs, but she said there wasn't enough fat there. The usual places are the abdomen below the navel or on the upper buttocks. I found the upper buttocks skin flexed too much as I bent over, causing clothing to rub and peel the edges. The lower abdomen worked well.

Yes, I may phrase that wrong. I put it on fatty tissue, but there's just not a lot of fat there. I've had the same problem with anything on my rear end; it tends to peel off. 

[Stottie Girl]

Yes, I may phrase that wrong. I put it on fatty tissue, but there's just not a lot of fat there. I've had the same problem with anything on my rear end; it tends to peel off.

That's why patches are a big no no for me. Nothing stays stuck to my skin for long. clothes will end up ripping off the patches before long.

I've ordered some transdermal gel to give that a try instead of the pills as it is likely that is what I will be switched to when I finally get to see and endo and go legit. The plus is that the gel is noticably cheaper than the pills!

[Charlotte Kitty ✅]

I found gel to be far more expensive than pills. Was paying $2.50 for 28 pills and $10 for a bottle of gel. The stuff I used was 0.75mg per pump. At 1.5mg would last 28 days.