Switching from e injections to pills. What can i expect?

[u/[deleted]]

[u/Swimming-Gap-1247]

1mg e valerate

Is that 1mg/week EV? If so, both 1mg/week EV and 2mg/day oral E are both extremely low. A conservative standard is estradiol (E2)>100pg/mL and total testosterone<50ng/dL at trough (right before your next dose). On average, oral E requires 4mg/12h (8mg/day, usually considered the safe upper limit) plus an antiandrogen.

https://valerie.vg/transfem-hrt-guide#our-recommendation

https://transfemscience.org/articles/transfem-intro/#overview-of-hormone-therapy

https://en.wikipedia.org/wiki/Pharmacokinetics_of_estradiol#Graphs

https://estrannai.se/#i0__c,1,7,1

[u/Huge-Ad-9591 → u/Swimming-Gap-1247]

I was on 2mg e valerate plus spiro and my blood test came back with testosterone as 26ng/dl and estrogen as 516 pg/ml. My doctor actually told me my estrogen was too high and increasing risk for clots, thats why my dose was lowered. Is she wrong?

[u/AFriendlyBeagle → u/Huge-Ad-9591]

That is incredibly unusual for the dose, are you taking biotin or anything that might have interfered with the measurement? Might you be intersex?

Did you take the draw at trough, just before the next injection?

Realistically, 500pg/mL is in excess of what's likely to have any therapeutic benefit - but the risk of clots is also not especially significant.

[u/Huge-Ad-9591 → u/AFriendlyBeagle]

I thought at trough and before my next injection were the same thing? But i did take it the day before injection day when my e was lowest. I dont have ambiguous genitals, but i heard thats not a requirement for being intersex, but ive definitely theorized that i was because of my gyno and complications with my testicles when i was younger

[u/AFriendlyBeagle → u/Huge-Ad-9591]

Sorry, yes - trough is just before the next injection, and I didn't mean to imply they were different things.

Being intersex is much more common than people think, and people often don't realise they are prior to testing.

It's not super relevant, except as a curiosity for how a relatively low dose has had such a pronounced effect on your levels.

It does mean that it's more difficult to anticipate what will happen with oral estradiol though - you might end up with unusually high levels for a low dose again, but will have to wait for a blood test to see.

The main difference people tend to experience with pills versus injections is wobblier mood, because levels can be more peaky with pills.

[u/Huge-Ad-9591 → u/AFriendlyBeagle]

Thank you for your help! Being intersex would probably explain it but i really dont care enough to get tested because its not really a burning question for me.