#also my FSH and estradiol were within limits on my blood tests but I was on a combined pill until two weeks ago so

[twilit-tragedy]

Got blood tests and a gyno ultrasound done yesterday and yikes! I'm just barely not anemic anymore, despite the iron supplements. I got high cholesterol out of nowhere, a severe vitD deficiency and my ovaries look like a battlefield but "not concerning", apparently. Bruh.

[effemimaniac]

I realized something quite weird and interesting yesterday, related to my transition...

so, I was looking at reference ranges for hormone blood tests, and looking at my past results, and I realized something that I hadn't noticed before... so like, the whole time I've been on HRT I've had weirdly low E2 levels, it's annoying. I just can't seem to get decent levels on oral or sublingual. But, only yesterday did I realize that with the first blood test I had while on HRT, at like the 2 or 3 month point, my estradiol level was actually below the male reference range... kind of odd, considering I had pretty quick development of breast buds and other changes!

Still now, ~9 months in, my levels are low, and within most male reference ranges, but I think my development has been pretty good?

I guess it's true that suppression of T is the more important part, or perhaps that other levels (like LH, FSH, SHBG etc.) are more important than we usually give them credit for? Or probably just that levels and ranges aren't a one size fits all thing, and different levels will mean vastly different things for different bodies lol

(more rambling and specifics under the cut)

I live somewhere that uses molarity (pmol/L and nmol/L) rather than mass (pg/mL and ng/dL) so I'm just going to use those units for simplicity. The male reference range of E2 sometimes doesn't have a minimum value, but typically it does, somewhere between 50 to 100 pmol/L. The maximum is usually around 200. my baseline hormone levels pre-HRT were:

T - 16 nmol/L

E2 - <18 pmol/L (below detection limit, so actual level could be anywhere from 0-18)

Then I started HRT with 1mg oral E.V. and 12.5mg CPA daily for the first six weeks, increasing to 2mg oral E.V. after that. I had this test I think about a month or maybe slightly less time after upping to 2mg:

T - 0.81 nmol/L

E2 - 39 pmol/L

^within that time I had already seen a good degree of feminization, despite still being below the 50 pmol/L reference male minimum, and ofc nowhere near any female reference range.

After that blood test, naturally my doctor increased my dose to 4mg. I had a blood test while on 4mg but can't seem to find the data anywhere. IIRC it was about twice the level of the last test, at like 60 pmol/L or something? It was still below the target range so my doctor increased my dose to 6mg. I also switched to taking the pills sublingually before my dose was increased. So, after like a month or so on 6mg sublingual I had another blood test:

T - 0.5 nmol/L

E2 - 167 pmol/L

It's much much better, which I attribute in part to switching to sublingual administration, but still not nearly to target. my doctor is iffy about raising my dose higher, so she said to stay on the same dose and get another blood test, and if levels haven't improved then maybe it can be raised to 8mg. But, I personally decided I'm going to switch to DIY injections. I'm just waiting on the vials to arrive in the post lol. I really wonder why my levels seem to be so low... metabolism maybe?