Regular blood work important-and confusing

[harley47]

I won't discuss dosages as I recall that is a 'no-no' on this forum. I sympathize with those who don't have a caring mental therapist who can get a suitable MD to accept you as a patient. Formerly I had self medicated and I don't think I hurt myself, but clearly it is best to have an MD involved in dosages and monitoring your overall health.
I think it is OK to mention Private MD labs. This firm can be found on the Internet and it offers relatively inexpensive tests to help you determine your Testosterone levels, Estrogen levels. I paid under $100. for both tests. Blood work done locally, no drama, received email with results within a week.
While this is an expense, it is important you aren't hurting yourself. My female MD lowered my Spiro as my levels were almost below an Eunuch's! my E was higher than any female-including those with childbirth stuff going on. She lowered the Estrodial.
Blood test results can, however, be very confusing-seem to see-saw a bit--using 1/2 the estrodial, levels about the same-don't know why? Cut the S by 25%, the T shot up.
I am pleased with body changes, though my MD says my breasts have likely maxed at what I call barely B's--surely enough to cost me any pool privileges.
Guess that you have to recheck every few months. My MD says it is fine to use this service--far cheaper than her lab charges.
Spiro does rob energy, male strength--but also feminizes in nice ways-I have virtually no body hair, no true 'scent' as most have-I like this. I like to have hairless legs and resent even one stray hair showing up.
Clearly meds affect one's thinking as well! I am concerned that lowered T can lead to mental losses and physical strength, but having been so unhappy for over 60 years (now 65) I prefer the positive changes.
Killing libido is a virtual certainty, but I am good with that as well.
I hope my post doesn't disturb anyone-not my intention.

[giuseppina]

If I were you, I would use an endocrinologist to help you with your bloodwork and HRT dosages, if nothing else, to maximise your safety while managing your transition. Nevertheless, it is up to your doctor to explain adequately to you what is happening and why.

[Traci Elizabeth]

You can go to safe harbor and talk about dosages and test results all night long.

[sandra-leigh]

The doctors aren't too happy about one of the readings they are seeing for me. They'll be sending me to a specialist.

Is this particular high reading of mine related to my HRT? We simply don't know yet. This particular reading is not one of the more commonly understood side effects... but the level was fine when I started and now it isn't fine. Might be unrelated and completely coincidental, might be a less-known side effect, might be a side effect of one of the other meds I'm taking...

Whether it turns out to be related or not, I can say that it would very likely not have been caught if I were not getting the regular blood tests associated with HRT. My previous doctor rarely sent me for blood tests, not even for yearly baselines.

[Kate T]

The only concerns I would have would be:
1. Are you/they collecting the blood in an appropriate manner for the test? (presumably they should be if they are doing the blood sampling but if you are doing it yourself then you would need to be offay with the various testing protocols, what tubes to store blood in, how to store etc.)
2. Similar to above if you are posting blood is it stored properly.
3. Are their test results consistant from test to test.
Someone on these forums I am sure would know more about these labs and quality control etc.
In Australia blood testing and medical stuff is a lot more regulated as a general rule. We are also lucky that many tests are covered by medicare / private health insurance so there is far less incentive to "shop around" for prices. Also prices are fairly uniform because we really only have less than half a dozen commercial pathology labs due to our population size.

[CharleneT]

Adina brings up a very good point, depending on how those samples travel, the results could be affected. I would wait for a while (let the chg in meds stablize) and then get the results repeated locally. Depending on how long you have been on HRT, having some values jump up and down is normal - at first. If it has been more than 3 months or so, then you should see and endo if you can. Not saying your doc can't take care of this, probably she can. But make sure she has a reason for what she changes ( I mean other than what you have already mentioned).



Guess that you have to recheck every few months. My MD says it is fine to use this service--far cheaper than her lab charges.
Spiro does rob energy, male strength--but also feminizes in nice ways-I have virtually no body hair, no true 'scent' as most have-I like this. I like to have hairless legs and resent even one stray hair showing up.

Since you are taking more than one drug, you cannot assume which is making a particular change. That said, Spiro does help a little with feminization, but the lions share is coming from the Estrogen. If you are also on a DHT blocker, much of the hair changes are likely controlled by it. After a few months on an AA, a DHT blocker can often take over the major work of surpressing testosterone**, with fewer side effects. That allows your doc to lower the AA dose. Ask your doc about that for the future.

Good luck !!


added later for clarification: AA's and DHT blockers don't do the same thing, but they both reduce the amount of testosterone that will affect you.

[harley47]

Hi, thanks for the post. Private MD labs is professional and license phlembotomists (sp?) draw blood. Everything is Kosher.

What I didn't maybe remark is that my Estrogen levels (on 1/2 the former dosage-per MD instructions) were HIGHER than before--they were 688pg/mL total E in April on (2x an amount --think it's a no-no to indicate dosages), then on half that sum it was 845. That doesn't follow to my layman's brain. The Totat Testosterone rose from a puny 10 ng/dl to 133--and this is higher than I'd like to have (think it should be just below 40 from what I have read online--for my purposes-clearly not to build big biceps!).
I surely appreciate the need to be under a caring MD's charge and will follow her guidance, but I believe there are members in this group are highly educated and I appreciate input. I read somewhere that excess E can actually turn to T and I sure don't want that bizarre situation.

good suggestion. My MD is a fine lady who had a significant number of Transgendered patients-but she may not be quite as up with the topic as an Endo. It is an interesting profession for an MD who performs both a prostate exam and breast exam on the same patient! thanks, H

thank you for commenting. I take the minimum amount of Finesteride for hair loss control. don't know what made my chest and body hair vanish-I think the Spiro- I will get retested in three months, then maybe just before my April physical exam. I guess all sorts of things-maybe if you ate shellfish!- can affect readings.

[CharleneT]

That is truly odd, I would ask you doc ... definitely consider a local test of the T - just to see if it was an anomaly or not. If you are taking Estrogen, Spironolactone and Finesteride, you should not have a T value that high. Well, if you have taken those drugs for more than a couple months. The hair loss is due mostly to the DHT blocker and Estrogen - they all contribute though.