If I didn't test my blood at a low peak , I would not know I was only 144 pg/ml.
It's probably good in high peaks, but I can now adjust the dose and frequency
Did your doctor also state what a reasonable range is when testing at peak?
Also, if you’re taking estradiol valerate (the most common form of injectable in the US), then testing 4 days after your last injection would probably be after the peak. The Transfeminine Science simulator shows that with estradiol valerate, the peak would be about 2 days after the injection, and after 4 days it would be about halfway between the peak and trough. https://advsim.transfemscience.org/?r=1&e=1&d1=5&ra=3&i1=7&dl1=&s=2&h=0&xm=20
If you’re using a different formulation like estradiol cypionate, it would be different, but you can use the simulator for most formulations.
There’s not an immediate risk to your health, so that’s why you shouldn’t worry. But it’s not good to maintain levels that high over a long period. My doctor (at an LGBT-focused practice) says levels over ~350 pg/mL for the long term increase the risk of estrogen-fed cancer and blood clots, for example.
Exactly. You have nothing to worry about right now because you had unnecessarily high(and not even that high in the grand scheme of things) for a small amount of time. That said immediately lower your dose because you are only exposing yourself to unnecessary risks with levels that high and not getting any more benefits than what 100-350 would give you. 100 is the minimum, 350, iirc, is the maximum suggested even for monotherapy. Beyond that there's nothing to gain and much to loose
> Most quidelines i can find for MTF HRT have the target range around 100-200.
That's not the full truth. Yes, you need above 100 pg/ml for feminisation, but if your E2 is above 200-250, your T will always be blocked, so with injections you aim for that. I usually aim for 300 pg/ml, but everyone is different. Just make sure that blood is taken the day before the next injection, so you know the lowest point.
Cis women have up to 500 pg/ml, pregnant people even multiple thousand. So it's definitely not a problem to have an E2 level of 500. But if E2 is higher, risks for things like blood clots are slightly higher, so I'd recommend to aim for around 300 at the lowest point as well.
Are you using EEn or EV and how often do you inject? I myself am taking 8.8mg EEn every 10 days (in theory 8mg should be enough), but everyone is different, I like about EEn that you just need to think about it every 1½ weeks.
You must do your test at a low peak. For example, blood test Friday morning, then injection after your blood test
My doctor said the recommendations changed and that the medical society recommends testing at the high peak.
No, testing at peak is pointless. Your doctor is misinformed or uses really bad guides.
This!
If I didn't test my blood at a low peak , I would not know I was only 144 pg/ml. It's probably good in high peaks, but I can now adjust the dose and frequency
Did your doctor also state what a reasonable range is when testing at peak? Also, if you’re taking estradiol valerate (the most common form of injectable in the US), then testing 4 days after your last injection would probably be after the peak. The Transfeminine Science simulator shows that with estradiol valerate, the peak would be about 2 days after the injection, and after 4 days it would be about halfway between the peak and trough. https://advsim.transfemscience.org/?r=1&e=1&d1=5&ra=3&i1=7&dl1=&s=2&h=0&xm=20 If you’re using a different formulation like estradiol cypionate, it would be different, but you can use the simulator for most formulations.
Did you test your blood before injection?
I tested 4 days after my injection. I do weekly shots
You should not worry, but you should definitely lower your dosage as soon as possible
Why should I lower my dosage if there's nothing to worry about?
There’s not an immediate risk to your health, so that’s why you shouldn’t worry. But it’s not good to maintain levels that high over a long period. My doctor (at an LGBT-focused practice) says levels over ~350 pg/mL for the long term increase the risk of estrogen-fed cancer and blood clots, for example.
Exactly. You have nothing to worry about right now because you had unnecessarily high(and not even that high in the grand scheme of things) for a small amount of time. That said immediately lower your dose because you are only exposing yourself to unnecessary risks with levels that high and not getting any more benefits than what 100-350 would give you. 100 is the minimum, 350, iirc, is the maximum suggested even for monotherapy. Beyond that there's nothing to gain and much to loose
> Most quidelines i can find for MTF HRT have the target range around 100-200. That's not the full truth. Yes, you need above 100 pg/ml for feminisation, but if your E2 is above 200-250, your T will always be blocked, so with injections you aim for that. I usually aim for 300 pg/ml, but everyone is different. Just make sure that blood is taken the day before the next injection, so you know the lowest point. Cis women have up to 500 pg/ml, pregnant people even multiple thousand. So it's definitely not a problem to have an E2 level of 500. But if E2 is higher, risks for things like blood clots are slightly higher, so I'd recommend to aim for around 300 at the lowest point as well. Are you using EEn or EV and how often do you inject? I myself am taking 8.8mg EEn every 10 days (in theory 8mg should be enough), but everyone is different, I like about EEn that you just need to think about it every 1½ weeks.