I'm concerned about my hormones dosage and effects

[Michelle789]

I've been on hormones for almost three months, in fact it will be three months on Saturday. I seem to be getting some good progress. I have been feeling way better the past few months. My breasts have been feeling sore since late August. I have taken pictures of myself and seen my face gradually soften over the past three months, and I have posted some of these pics on SH. My body odor changed sometime in mid-August.

I had a blood test taken on September 18, and on October 1, I met my doctor to review the results. I told him about the results I am achieving, and he also reviewed the lab results and as of the 9/18 blood test my hormone levels were exactly half way between male and female. He told me that I was getting better than average results, and that I had the option to stay on the same spiro dosage or to double my spiro dosage.

He initially prescribed me only half the normal dosage for spiro, and the full estradiol dosage that he normally gives transwomen. His protocol is to only prescribe half the spiro dosage and then to increase as necessary.

I chose to keep my spiro dosage the same. He told me that I can call him and have him double my spiro dosage at any time.

Lately I noticed a few weird things.

1. When I woke up on Monday morning, I noticed that my body odor seemed to be more like it was pre HRT. I haven't noticed this feeling since then.

2. On Monday morning, I felt like my body had that greasy feeling I used to have before I started HRT.

3. Then just now, I notice that my breasts no longer feel sore. Even yesterday they felt sore.


However, I'm still feeling great, as I have been the past three months.

Has anyone had this happen to them? Is this normal? Am I just overthinking it? Or is it time to call the doctor and have him increase my spiro dosage?

[LeaP]

Take a shower? (kidding!)

Different doctors, different philosophies. But it's pretty common to ramp Spiro up over time as needed. I'm guessing this doc's approach is knock down T levels over time via estradiol, only increasing the Spiro if needed. That can work (depending on the individual) but it usually takes more E and for a longer period than would be required otherwise. Does he have any special concerns for you with Spiro? Most doctors try to balance anti-androgens and estradiol in a combination therapy because the latter is considered the riskier of the two.

Soreness comes and goes. A change in a single day is not significant! Feeling great is not only good in itself, it is an important clinical indication. Something is SERIOUSLY out of whack if you start feeling weird and it persists. If you feel good, levels are likely reasonable and there is likely room for adjustments. Start thinking long-term, however - months and years. A good way to level set your perspective is to orient your thinking around your blood test schedule. It should be minimally everly 6 months at this point. 3 would be even better for the 1st year, but again, different doctors, different philosophies. If you sweat over one day to the next, you will drive yourself crazy.

[Ashley D.]

Your only at three months.
Don't sweet the little thing
No pun intended
You will go back and forth with things for the first six month to a year. Listen to your doctor if he said you coud go up on spiro and you comfortable with that do it.
My T is unreadabl in most my test. And I'm doing great.

[MarieTS]

Michelle, at only three months you are doing
great. My endo initially increased spiro and then brought it down. It did its joqb and am mostly just on estradiol now.
Enjoy the ride!

[Jorja]

Something else to keep in mind here,Michelle. The original intended use of spiro was to help control blood pressure. To low blood pressure is just as bad as too high blood pressure. Your doctor will need to adjust the spiro from time to time to keep you in a good bp range.

[DebbieL]

Michelle,

At only 3 months, you are likely to have fluctuations. Your body will try to counter the T-Blocking effects by producing testosterone in spite of the medication. Mine actually went up after about 6 months. I had a normal low T - around 100 and at 6 months it went up to 140. At this the doctor increased my Spiro dose.

It's important to follow your doctor's advice and suggestions, and to keep him informed. You should take your blood pressure at least once a week. The doctor will also check your blood for signs of kidney and liver problems.

I started with a very low dose initially, and then he doubled my spiro and estro. By then I had gotten off my heart and blood pressure medicine because the spiro was having the same therapeutic effect. The higher doses were also theraputic for me. My blood pressure was actually in a very healthy range, and my heart rate was consistent and a very healthy pace.

At the next labs, he was concerned at one of my kidney indicators, but it was because I was late getting started on my 2 hour drive to my appointment and decided not to drink anything so I wouldn't have to stop for a restroom break.

Now my prolactin levels are slightly high for a woman, and my testosterone levels are about normal for a woman.

Your doctor will check blood levels for several things. He needs to check liver, kidney, thyroid, and also needs to check for indications of blood clots.

Normally the doctor will be a bit conservative, so he wouldn't be suggesting more spiro unless he thought you could take it safely.

I have heard, in a TS support group, of someone who had their dose increased and was suffering from dizziness and fatigue, because her blood pressure was too low, and her heart rate was too low. They actually had to take her off the spiro to get her stabilized, then resumed with a lower dose.

There are other drugs that can be used, but those are among the safest.

By the end of 1 year I was 38-B and by the end of year 2 I am 38-D, or 40-C. I'm actually surprised at how much benefit I'm getting, and that growth has continued for this long. Sometimes, slow growth is good growth. It looks like I won't need BA or FFS, but I probably will need vocal chord work. I still sing baritone. I've lost almost an octave from the bottom, but not that much off the top. I also need to lose more weight, which is harder to do with female metabolism.