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[laszla]

 Hi all,
the Chelsea & Westminster clinic that ordered my blood tests aren't intending to provide feedback until late March, some 5 months after my first appointment with them a few weeks ago and I cannot live with the uncertainty.
The tests yielded these results: FSH 85 U/L; Oestradiol 112 pmol/l; testosterone 1.2; Sex Hormone binding globulin 134 nmol/L (well above the top of their range). GP ordered thyroid tests, normal.Bone scan results not available til December.

I haven't looked into these numbers in great detail but an initial search suggests that the high SHBG number might mean I'm not really absorbing the HRT I take (estrogel, utrogestan and testogel), especially the testosterone. The oestrodiol number also seems a bit low though I gather it can vary a lot over the course of the month.

I see one cause of a high SHBG is anorexia - I dont have an eating disorder but have lost about 10% of my body weight over the last year and now have a BMI of 17 (GP sent me for urgent referals for weight loss that didn't come up with anything).

My worry is that possibly because of my low weight (which I believe is the result of traumatic stress) I might not be absorbing the HRT and this scares me because of my current very shaky mental state.
I'll lose my mind if I have to wait til March for feedback. What can I do - go to a private clinic, or perhaps consult the MM doctor who provides email consultations for a charge?
Thanks for any suggestions

[CrispyChick]

Hi

I wouldn't want to comment too much as I'm not on hrt. But I have just had blood results.

I see you're worried about not absorbing testosterone. Mine just tested at 0.84...yours is significantly higher than mine...

I've not had my feedback yet.

Yes, either go private or you could see if Dr currie could advise via email. If that's your one question - do my levels show I'm absorbing enough or not...? Cavt see why not 🤷‍♀️ it won't give you a solution if you're not absorbing, but I prefer to know what's what rather than constantly searching up different scenarios.

5 months is a ridiculous wait!!!!

[laszla]

Many thanks for your thoughts Crispy. My understanding is that it is not the total testerone result that matters so much (your 0.84 and my 1.2) but rather the SHBG number because that indicates how much testosterone is bioavailable, ie how much is actually having an active effect.

As my SBGH is elevated and well over the top of the range given at Chelsea, this could mean that the bioavailability of my testosterone is low, ie not entering the tissues and providing the benefits. A bit like taking some supplements that just get peed straight out of your system.

If possible do check that SHGB result if they measured it in your tests as that would give you a fuller picture.
5 months totally ridiculous I agree and I had such high hopes for that clinic.

[Teresa]

Hi Laszla,

I can only comment on your estradiol level - it is low. It’s lower than the maximum of a post menopausal woman. I know this, because mine was 105pmo/l after three months on estradiol based HRT patch Evorel ( and Estradot first month) I was using a 50 patch which is the equivalent I believe of two doses of estragel.

I have now upped to a 75 due to my low absorption. It’s too early to notice a difference, but I am feeling better already. I do think you might not be absorbing your oestregen, based on your readings. Others have indicated it should be at least 3 or 400 or just above, though we are all different of course.

Teresa
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[Teresa]

You could try sending a question to the MM specialist - I have done this and Dr Currie does come back quickly.
How much estragel are you using?
Can you not go to your own GP for advice? as waiting until March seems very unreasonable in this situation.

Teresa
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[laszla]

Thanks so much Teresa, I hadnt found ideal ranges of estradiol so it's really useful - if disheartening - to learn Im not absorbing the hormones. I will try an email consult

[Teresa]

Hi Laszla,

I’m glad it helped. I only know the ranges, because the blood test results  on line listed them all, otherwise I wouldn’t have known. Post Menopausal women have levels anywhere under 147 Pmo/l apparently. We should be in the mid follicular stage at least which was up to 4 or 500 from memory. So even if you went into 200s you should feel better I would have thought. It might be that you need a patch instead of gel, but they should help you there.

Good luck,

Teresa
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[sheila99]

I agree oestrogen is low, I don't know about the others. I believe the level we feel good at varies between individuals which is why the nhs normally goes by symptoms. How much gel are you on? Would they let you increase it? We can absorb different types differently so it may be that would absorb more from a different type. I have heard gel is absorbed into the fat cells so possibly lack of fat is making it worse.

[laszla]

Thanks Sheila, I'm on 2 pumps of estrogel and will increase it. The GP won't advise me and the HRT clinic at Chelsea for which I mistakenly had such high hopes wont speak to me until late March so I will either need to go private which I didnt want or increase my intake and monitor myself.
I also heard the theory that fat cells increase absorption so my weight loss might well be the reason I'm absorbing so little. My elevated Sex Hormone Binding Globulin also probably means that what hormones are in my body have very little bioavailability, ie they're not reaching my cells and making me feel better.
Agree that symptoms are vital for monitoring efficacy of HRT and while I've never had the more typical symptoms, I feel terrible in terms of mental state so I will have to take some action.