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So, I've done a blood test a few days ago, got the outcome. I think @will_steal_your_username@lemmy.blahaj.zone would be interested to hear about this.
I'm posting it publicly and transparently so if others have similar issues, they can see whether it might be the same underlying issue.
Total T is in nmol/L; free T and E are in pmol/L. Pre-HRT was 2 weeks before starting. The (almost) 1 year-mark is from a few days ago.
Situation - Total T - Free T - Estradiol
Pre-HRT: 15.8 - 358.9 - 125
5 mo: 0.978 - 30.5 - 175
1 year: 0.223 - 4.8 - <91.8
Other hormones haven't changed much. I had a little prolactin before, SHBG went from 25 to 10 to 25, strangely, but that's all.
This confirms my suspicions: somehow, despite upping my E doses to three, I have lower E. Far too low, even. I don't think even upping to 4 doses will work for the Lenzetto spray, so I'll plan on switching to gel. Or maybe I should consider DIY'ing needles after all...
Now, I had the blood test in the midday, and I usually take E in the late evening. So my levels may have been a bit lower, but still.
Conclusion: T sufficently nuked and at cis woman levels, but E needs to be amped by a ton. This also explains why my tits havent grown enough >:(
That sucks, may your E rise high and your boobs grow large ๐
Yep, this sucks. At least T is suppressed fairly well. Go boobs and hips!
I'm also considering other methods in case, like injections that you rec'd. Which injection method should I Iook for, in those cases?
Injections aren't available via the official route here (only gel, spray, pills, and patches afaik), but have to be DIY'd.
Let me refer you to a friend of mine: https://tube.blahaj.zone/w/1PcND2ahHpQC51HMGr7RLD
Basically if you want a smaller less scary looking needle pick subcutaneous, but pick intramuscular to lessen the odds that you'll experience any allergic reactions. It's not uncommon for the outer skin to react a bit to some of the ingredients in injections. I picked subq and it has worked really well for me, so maybe try that first and then go for intra if you do experience a reaction. If you're very comfortable with needles just go for intramuscular from the get go.
I used to find needles really scary but have grown to get a bit more used to them. I still don't like them, but maybe I should consider them.
Thanks for the guide! I will def try this out if I'm going for needles. My GP is really chill so if I'll do needles, I'll ask him to supervise the first try.
I definitely recommend injections. I have a moderate to severe needle phobia and still chose to inject my estrogen.
Jorunn is right, subq injections are the way to go - you can use very thin and short needles that are often painless when injecting. It's still a mental hurdle, I'm not going to lie, but injections are just the best and most reliable method for getting estrogen (esp. pre-op).
I have a write-up of tips that I developed to help me overcome my needle phobia:
https://lemmyverse.link/lem.lemmy.blahaj.zone/post/27953271
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The timing of the test with respect to when your most recent dose of E was administered is pretty significant. I'm on tablets and have strict instructions from my endocrinologist to get my blood tested 4 hours after taking my tablets.
My friend has the same situ, and she forgot to do the 4 hours thing, and her levels showed horrendously low since it had been 14+hrs since her last dose. She redid the test as she should have, and her levels were very normal.
Just in case you want to get more accuracy on your results because it can be quite a big deal
Edit, to be clear: the 4 hours instructions are for me and my doctor. What I am saying is you should be taking your test at a consistent time from/to your next dose
Your endos instructions aren't good unless you're also taking pills every four hours. You should be taking the blood tests when your levels are at their lowest, right before your next test. Maybe less important on blockers, but still
Edit: To elaborate it might be perfectly fine if your endo is good and they take it into account that it's not at trough, so definitively do as they say
why is it beneficial to test when levels are lowest / at trough? I think Will Powers gave some kind of reasoning that didn't fully make sense to me, but it seemed like he was saying at trough you can see how much is actually retained by the cells vs just free-floating in the blood from the initial injection, basically earlier in the cycle you're more likely to have unreliably high levels because the depot release of estrogen can be unreliable or inconsistent?
I ask because my newest provider wants me to get blood tested "mid cycle" (on a 7 day cycle, that means at 3 - 4 days after injection ... which is when I theoretically should be peaking?). I'm not sure what the rationale is either way, tbh.
I thought it was for the uncertainty margin, but your reasoning makes sense too.
I updated my post to clarify I wasn't advising them to follow my endo's instructions
However you do have me curious.
I'm on blockers so my T is below what the test will measure, sufficiently nuked.
My E most recently was at 484 pmol/L, and not at trough as you mention. What are ladies usually aiming for at trough?
360ish to 740ish+. 360+ with blockers and then often you need 740+ to block testosterone without a blocker
Thanks, I am actually due a review with my endo so I've raised it just to be sure
Also I will say, for DIY, it's very freeing to be able to adjust your own dosages. I have to question why they've allowed you to have such low estradiol levels for an entire year.
They actually upped my dose from two to three before, but somehow the levels are lower, which I don't know why.
Maybe it's the measurement time, but that should generally not affect too much, no?
With things like gel and sprays hours do matter because of the half life, but isn't late evening after midday? Blood tests are ideally at your lowest usual levels, right before your next dose. We call this trough.
I usually do it around 18-22 o' clock. The blood test was at 12 the next day.
Then your blood test was higher than trough
Were you applying all the spray doses at the same time each day? Ideally you space each spritz across the day. F.ex you might do one spritz at 7 in the morning and then one at 7 at night, or three spritzes with 8ish hours between them.
Ahh, I do all three at once a day. I use Lenzetto 1.53 mg/dose. No, I kind of variate, I've a bit of an irregular mind. A few months ago I used to do it more consistently between 18-20 o' clock, but it's a bit more erratic now.
How about for now, until I switch to gel/needles, I'll try 4 spritzes, 2 around 7:30, and 2 around 19:30?
That sounds good! Twice a day would be a big upgrade. I think the half life is such that once a day is never sufficient unless you take sky high doses which would be uncomfortable for other reasons. I don't remember the half life at the top of my head but it's two digit and measured in hours, and not days like with injections