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My endocrinologist is either a dip or just isn't taking me seriously. The doses he prescribes me are far too low to do anything at all! It has been many months that I have been on such low doses and any time I try to talk him into raising them, he goes on and on for a half hour about the dangers of higher doses. I've done my research and he knows this. Im willing to take that risk and he knows this too. How do I get my stubborn endocrinologist to raise my dosage?
He currently has me on a mere 2mg oral estrodiol and a useless 50mg of Spironolactone. My blood tests show that these doses are doing almost nothing, so there IS proof on paper.
What do I do?
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(07-09-2016, 10:53 PM)GamerGuy Wrote: My endocrinologist is either a dip or just isn't taking me seriously. The doses he prescribes me are far too low to do anything at all! It has been many months that I have been on such low doses and any time I try to talk him into raising them, he goes on and on for a half hour about the dangers of higher doses. I've done my research and he knows this. Im willing to take that risk and he knows this too. How do I get my stubborn endocrinologist to raise my dosage?
He currently has me on a mere 2mg oral estrodiol and a useless 50mg of Spironolactone. My blood tests show that these doses are doing almost nothing, so there IS proof on paper.
What do I do?
Ask him to refer you to another endo. That would the first thing I would do. If that don't get him off his arse, then you find a different one on your own.
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2nd opinion. In my case my Psyciatrist perscribed meds. He is a Nurologist too. He monotors everything so I dont get toxic levels. He saved my life.
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(07-09-2016, 10:53 PM)GamerGuy Wrote: My endocrinologist is either a dip or just isn't taking me seriously. The doses he prescribes me are far too low to do anything at all! It has been many months that I have been on such low doses and any time I try to talk him into raising them, he goes on and on for a half hour about the dangers of higher doses. I've done my research and he knows this. Im willing to take that risk and he knows this too. How do I get my stubborn endocrinologist to raise my dosage?
He currently has me on a mere 2mg oral estrodiol and a useless 50mg of Spironolactone. My blood tests show that these doses are doing almost nothing, so there IS proof on paper.
What do I do?
I would just ask to see another endo. Or slap him with a cucumber and say can you not read the results these are not native female results...
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(07-09-2016, 10:53 PM)GamerGuy Wrote: My endocrinologist is either a dip or just isn't taking me seriously. The doses he prescribes me are far too low to do anything at all! It has been many months that I have been on such low doses and any time I try to talk him into raising them, he goes on and on for a half hour about the dangers of higher doses. I've done my research and he knows this. Im willing to take that risk and he knows this too. How do I get my stubborn endocrinologist to raise my dosage?
He currently has me on a mere 2mg oral estrodiol and a useless 50mg of Spironolactone. My blood tests show that these doses are doing almost nothing, so there IS proof on paper.
What do I do?
As others have noted, drop him and find somebody who actually wants to help. In the mean time, don't swallow the tablet, let it desolve under your tongue for as long as you can, then spit it out, do not swallow. Take 1mg Reishi 3 times a day. That should help for now.
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08-09-2016, 01:46 AM
(This post was last modified: 08-09-2016, 01:47 AM by
Skye is on fire.)
(07-09-2016, 10:53 PM)GamerGuy Wrote: My endocrinologist is either a dip or just isn't taking me seriously. The doses he prescribes me are far too low to do anything at all! It has been many months that I have been on such low doses and any time I try to talk him into raising them, he goes on and on for a half hour about the dangers of higher doses. I've done my research and he knows this. Im willing to take that risk and he knows this too. How do I get my stubborn endocrinologist to raise my dosage?
He currently has me on a mere 2mg oral estrodiol and a useless 50mg of Spironolactone. My blood tests show that these doses are doing almost nothing, so there IS proof on paper.
What do I do?
My doctor started me off on this exact dose for the first five months which allowed my body to gradually start the change. After five months, he doubled my doses for the last 6 months. My numbers came bac great on the T, but slightly lower than I want on my E. I will ask him to up my E dose when I see him. But if your endo isnt willing to do this, then yeah, shop around for another. My doc isn't an endo. He just does this for trans people.
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Sorry to hear you're having so much trouble. If memory serves me correctly you didn't have a whole lot of options. So you may unfortunately be stuck in a bad situation. I hope that is not the case and you have other options. If not, work with him as much as you can and try not to be confrontational. Unfortunately some specialists can be a bit egotistical and don't appreciate being told how to do their job.
So have a bit of patience, work with him as best you can, if their are alternative endos, I would start seeing about switching to one that is more helpful to your needs as others have already stated. Best of luck!!
P.S.
You should stop by the new chatroom sometime and catchup.
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GG, how long have you been at this dosage??
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(07-09-2016, 10:53 PM)GamerGuy Wrote: My endocrinologist is either a dip or just isn't taking me seriously. The doses he prescribes me are far too low to do anything at all! It has been many months that I have been on such low doses and any time I try to talk him into raising them, he goes on and on for a half hour about the dangers of higher doses. I've done my research and he knows this. Im willing to take that risk and he knows this too. How do I get my stubborn endocrinologist to raise my dosage?
He currently has me on a mere 2mg oral estrodiol and a useless 50mg of Spironolactone. My blood tests show that these doses are doing almost nothing, so there IS proof on paper.
What do I do?
Gamer,
The proof of what my HRT plan is doing comes from seeing my lab test results, I don't know of any other proof that would be of significance to that, imo. I will just say my doc started me on 2 mg of oral estradiol & 50 mg spirolactone too, soooo, those dosages are not a shocker tbh. Everyone metabolizes differently as we well know, however, from those two dosages my Estradiol came back 2-3x higher than normal female range at +600 pg/mL and 25 ng/dL total testosterone. Within 4 months I was increased to 4 mg E2 and 100 spiro which usually puts me @ +800 pg/mL E2 and roughly zero total testosterone (.8 ng/dL).
The thing is, I think HRT dosages are low overall too, but........I've done 6-8 mg E2 and my lab test results where lower & 500 pg/mL, so go figure, though I felt no different on the higher amount.
I prefer sublingual delivery of oral E2, it dissolves completely, I also split (not spit) the dosage and spread the delivery time.......and on an empty stomach. The spiro is taken at a separate time....(every 4 -6 hrs) since that's about its half life.
Hang in there.
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My 2 cents, for what it is worth.
I have marginal faith in doctors as a whole. There is a reason they call medicine an "art" and doctors "practice".
Let's talk about endocrinologists. In general they deal with natal males and females attempting to establish and maintain "normal" hormonal function. Their training is focused on how the male/female body is supposed to funtion given the parts and wiring we are born with.
Now introduce Trans people like us. Right off the bat we are asking them to do something that could be interpreted to violate their ethical code to "do no harm". We are asking them to rewire our endocrine system to override what nature gave us to do the things we need it to do to make us one with ourselves. So we have one strike against us before we walk in the door.
Then there is the research or lack their of, of what is needed to do what we are asking of them. Essentially, there is no long term scientific studies to establish drug therapy regimes to act as a basis for establishing doses of estrogen, progesterone, spirolactone and the other drugs that make up a transition regime. Face it, the Trans community, which i consider myself part of, is so small that we are not considered large enough to be considered a minority. There is not enough of us to establish a statistically significant pool of test patients to establish meaningful transition drug therapies based on science. Therefore endos are trying to fit a square peg in a round whole by force feeding us drug cocktails based on natal female information without totally integrating the impact of the male systems that need to override to get there. In essence, they are guessing based upon anecdotal evidence. And if the Endo does not specialize or have a significant number of trans patients, the guess is even larger and their desire to truly help you get to where you want to be is is minimal at best.
The only good thing medical doctors bring to the table is their magic pad, that allows them to write prescriptions to get the hormones and anti adrogens we need to make us whole.
The good news is that the collective knowledge on this board and others like it provide a wealth of knowledge that can be used as a basis for self medicating.
Before i get bashed for advocating using drug therapies without medical supervision, look at all the all of the NBE users who are, let's say, less than honest with their doctors about their use of NBE. ALL drug therapies were originally based on herbal therapies that were established via anecdotal evidence over time. Eastern medicine still relies on herbal medicines and there is a growing community in the west that are converting to a more natural path.
Let me get back on track.
As a group we are relatively educated, and what we do not have in formal education whe make up for with common sense and the ability to reason then think through a problem. We know what the baseline doses are for pharma used for transitioning. We know our own bodies, what feels right, what feels wrong. We have access to inexpensive blood tests that can be done discretely without insurance companies or significant others knowing. we know what normal levels of the various tests should be. All the Endo does is look at the same information we have access to and adjust the meds accordingly. Doing something we can do ourselves. If something is out of the ordinary, change your meds to see if that addresses the issue. That is all the doctor is going to do, with the aid of his magic prescription pad.
Bottom line is to take control of your transition. If your Endo is a moron, either change endos or take take over and self medicate and do the appropriate blood work to monitor the effects. IT IS YOUR BODY, TAKE CONTROL.
I know there are people who are going to bash me as a loon. But I am a big girl who has taken responsiblity for my life and health.
Peace, and love you all
Christina