My free and total testosterone levels are at 6ng/dL and my estradiol is at 464 pg/mL
After initially struggling to suppress my T and get my estrogen levels up looks I overshot it after switching to injections. I think the consensus is to keep estrogen at cis-woman levels which I think is 40-400.
Albeit a bit high, I'm excited to finally get here. I would like to keep it where I'm at but I'm not sure of my doctor will let me. I don't feel any issues that stand out to me so far. Is there anything I should be worried about? Would it be a bad idea to try to convince my doctor to keep me here if he wants to down titrate?
2 Comments
LegoBrickOnFire@lemmy.world · 3 pts · 354d
I was in a very similar situation until last month. If you are using injections it can be possible to be at a very high (don't ask me the level) estrogens level such that it itself suppresses the testosterone. It is said in my transfem community that it is better quality and safer transition. I am no doctor tho, I don't know. Doctors might not know neither.
Warning. Notice the different units: mol vs g
I was originally at 17nmol/L of T, and 100 pmol/L of Estradiol, before HRT. After a few months of Lucrin (antiandrogen) and one push of oestrogel, I was at 8-10 nmol/L of T, and 200 pmol/L of E. After upping my oestrogel dose to 3 push, I was finally under 2 nmol/L of T, and 500 pmol/L of E. Doses are measured 24h after gel application and 1 month after Lucrin
(I want to note that I appear to be outside of the norm for eostrogel absorbtion)
What I want to get at, is that I suspect that my anti-androgens might actually not do anything, which would be possoble but extremely rare. In this case my dosage of Estradiol might actually be enough to suppress the testosterone by itself. I still neet to run experiments to test this hypotheses.
Again, there are unit translation to make to compare to your case. But I hope my insight can be useful.
MataVatnik@lemmy.world · 2 pts · 354d
Thank you for sharing here's a conversion...
17 nmol/L --> 490 ng/dL Testosterone
100 pmol/L --> 27 pg/mL Estradiol
2 nmol/L --> 57 ng/dL Testosterone
500 pmol/L --> 136 pg/mL Estradiol
Yeah it looks like my levels a ludicrously higher by comparison.
I'm on the same camp, there is very little evidence that androgen blockers suppress Testosterone all that effectively. I'm too lazy to look it up but there is a study with a sample size of about n=50 that monitored patients T levels overtime after starting HRT, there was a huge spread on T suppression where it was essentially a coin toss, and there was very little correlation with dosage of androgen blockers.
This is also reflected with my personal experience...
I started with 1mg Finasteride, 100mg Spiro, 4mg oral Estradiol on Dec 20 2024. Bloodwork three months later (March) showed my Testosterone at 300 ng/dL (started at 400) and my estradiol levels at 40 pg/mL (20 at start). Upped my dose of oral Estradiol to 6mg oral daily. Three months later (May) my Testosterone level was still at 200 ng/dL Doctor messed up my bloodwork prescription so don't have Estradiol levels. Asked to switch to injectibles and doctor put me on 10mg Estradiol Valerate, intramuscular, one a week. Now my Testosterone is basically zero and I didn't change my androgen blockers since I stared.
To me it seems that it's pretty clear that injecting E is the most effective way to suppress testosterone. I'm surprised how little research and hard data there is on this considering how long injectibles have been around.