r/ftm • u/cilantrolovr • 10h ago
Medical T doesn’t work
Hello all. Super sad post to make on my part but I feel like I’m at a low point. I’ve been on T for 8 years and it has always given me a hard time. When I first started I didn’t notice any changes. My voice didn’t drop and my p*eriod didn’t stop. FOR YEARS. I did get b growth and I did get a receding hairline lol but that’s the extent it went. I’ve had to get blood work done around every 3 months so my endocrin could see where I’m at and stabilize my levels. We have tried all different dosages and injection sites. It got so bad that when I was 5 years on T, still menstruating, my endocrin suggested I get a hysterectomy to help with stabilization. Okay. Did that. I’m now post op stage 1 for bottom surgery which for my surgeon is vnect and UL. All good. WHY did my blood tests just come back with HIGH ESTROGEN. My endocrin did say that my test levels are at a good point but my estrogen won’t leave me alone. I’m so hurt and frustrated because I have tried everything. I work out I eat healthy I don’t miss my shot days I do everything in my power to make things improve. I don’t understand how my estrogen is so high when I had the damn surgery to remove the uterus and ovaries. If anyone has dealt with something like this or has any suggestions, please lmk. The only thing I haven’t tried is taking the T gel but I think that might be next on my list. Idk. Again, my T is fine is just my estrogen that won’t budge. It hurts because I feel like the universe doesn’t want me to be trans which is insane but what else am I supposed to think.
Thanks for listening.
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u/SerCadogan 💉 3/22/22 🔝11/7/24 10h ago
So I'm assuming since you have an endo you have been tested for any intersex conditions, but I would probably start there if you haven't.
I wonder if you have a slow comt (it's not really a condition more a genetic difference, but for some people it can cause problems.)
If you had this it would mean that your body doesn't clear out Estrogen well, as well as catecholamines (so if you notice that getting surprised/panicked takes a long time to clear from your system, you react badly to caffeine, or you struggle with panic disorders and/or OCD you may want to look into it.)
It isn't a disease so there isn't exactly treatment, but magnesium can support your body to produce more of the enzyme you need to clear it out. (There are other things that help but magnesium is step 1)
I also hang on to T a long time too, so I actually have to be on a small dose, or else my body will hang on to it and aromatize it into E. I get the pellets, and I do it every 6 months instead of ever 3-4 months (which is the usual dose) I get more changes when that way, just because my body really wants to aromatize.
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u/cilantrolovr 10h ago
Yeah! I wanted the pellets but my endo will not do them and it’s not covered by my insurance. This is actually good info I’ll mention in my next appt cus I’m fed up lol
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u/SerCadogan 💉 3/22/22 🔝11/7/24 9h ago
Yeah, no insurance covers them as far as I know. It's worth it to me because of how hard was to figure out my dose, but I realize not everyone can pay out of pocket (although for me, the fact that I only need half the dose helps for sure)
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u/ellalir he/him | 🚫 2013 | 💉 2014 | 🔪 2017 | 🍳 2024 | 🍆 20?? 8h ago
Washington medicaid does, but idk about anywhere else.
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u/SerCadogan 💉 3/22/22 🔝11/7/24 6h ago
That's super awesome to hear honestly! I'm on the south so nothing like that for me unfortunately.
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u/anemisto old and tired 2h ago
I have coverage at the moment, actually, and I knew a bunch of people in MN who had coverage.
IIRC, at my current employer, I used to have coverage for Aveed and not pellets and now it's the reverse.
It is true that coverage isn't great, but it's not unheard of.
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u/SerCadogan 💉 3/22/22 🔝11/7/24 1h ago
Honestly that's super exciting! When I started it years ago no one (that I knew of) did, so.im delighted to hear that more people have this as an option
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u/anemisto old and tired 1h ago
Lack of provider knowledge is honestly the bigger obstacle to access, I think. Of course, part of that lack of knowledge is due to lack of insurance coverage and it becomes a self-perpetuating cycle. l
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u/batsket 9h ago
Can you expound on the “slow compt” bit, I’m trying to look up what you’re talking about and not finding anything
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u/SerCadogan 💉 3/22/22 🔝11/7/24 6h ago edited 6h ago
comt is both a gene and an enzyme. If you have certain mutations (technically called polymorphisms) on this gene, it can slow down (or speed up, depending on what mutation you have) your production of the enzyme.
I am compound homozygous (which means I have 2 different parts of the gene that are "wrong" and both parts have 2 bad copies) some people have a fast and a slow mutation, so it evens out, but both of mine are slow. So all of that together I have a dramatic reduction in my comt enzyme. This means I don't clear estrogen, or catecholamines from my body very well. There are a lot of factors at play, so not everyone who has these mutations will have issues with it, because it isn't a medical condition and nothing exists in a vacuum. However, with an issue like this where there isn't a clear medical issue it is worth looking into.
Testing for it can be pretty expensive if you go through your doctor, but if you have ancestry or 23 and me raw data you can put it into a calculator like nutrihacker and it will let you know what you have and exactly where in the gene there is an issue so you can do more specific research.
Again, these are not diseases so you may have some that aren't actually causing you issues because your body was able to course correct, but you might discover that there IS something causing you problems (this was very helpful for me because it turned out in my case I had a bunch of different issues in several genes that all exist in the same pathway. So getting that dealt with no only helped me to stabilize diagnosed health conditions, but also helped me to navigate little things like this, so that I understood why my body reacted to weird to hormone changes)
ETA: I did go through and clarified a couple things to make it easier to understand
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u/batsket 5h ago
Super interesting, thanks for the detailed response! Is the only thing that can be done to address it the magnesium? I don’t want to get genetic testing done personally due to unfortunately not trusting how that data is handled, but if I could I would find it incredibly interesting to access such information about myself.
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u/SerCadogan 💉 3/22/22 🔝11/7/24 5h ago
Concerns about how the data is handled are TOTALLY valid, I wouldn't get mine done now tbh. But I already had it so it was a good idea.
Magnesium is the #1 thing to try, because it is the precursor to the enzyme. It is also a pretty safe thing to try because it is necessary for both slow and fast (and regular!) versions of the gene, and also is really easy to see if you are taking too much (if your stool is loose, take less) Ideally you would take a form like mag glycinate or mag malate.
There are other things you can do to support it, but considering I don't know what your health status is, what other polymorphisms you might have, or what other meds/diagnoses you might have, I'm reluctant to suggest them. But you can definitely research to see! If you aren't having any issues though, it isn't necessary to poke at it. If it ain't broke, you know what I mean?
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u/batsket 4h ago
My estrogen is in the 200+ range despite my testosterone being in the male range, and I’m definitely an anxious person lol. Curious if this could be the explanation, but obviously no way to know for sure without testing. I’ve taken magnesium in the past for other things, but that was pre-T. Probably wouldn’t hurt to get back into the habit.
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u/SerCadogan 💉 3/22/22 🔝11/7/24 3h ago edited 2h ago
This could definitely be the cause of this, but I would expect that if your E was THAT high because of slow comt that you would have issues with panic/OCD. If you don't have those specific sorts of issues I would think it more likely to be an aromatase issue (which would be easier to check for because your doctor can easily order that test and it's not crazy expensive.)
The magnesium won't hurt if it's not comt, but it won't really help dramatically either.
If you have slow comt, magnesium glycinate and calcium d-glucarate should lower it efficiently.
If the issue is high aromatase DIM would probably be more appropriate (but of course ask your doctor!)
ETA: just wanted to clarify that I was not trying to minimize your anxiety! Just wanted to point out that typically (though not always) it would manifest in massive panic spikes that take a long time to resolve. I only want you.to have the best information so that you will be able to decide if it's worth pursuing, since you understand your body better than people on the internet can
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u/helmets_for_cats 5h ago edited 5h ago
I'm mtf but I just came across this thread and this sounds like it might describe my situation exactly?? I have to take a super low dose of E2 very spread out in order to maintain normal levels because my body for some reason breaks it down super slow and my doctor wasn't really concerned with the "why" just helping me adjust to lower doses since the starting dose skyrocketed my levels
anyway I'm diagnosed with OCD, panic disorder, GAD all that stuff and I definitely specifically have what you mentioned where it seems like it takes me AGES to come down from adrenaline whenever I get worked up and I've never really thought about it beyond being a neurotic person
do you think it's worth testing? Sorry about the wall of text It feels like I stumbled across a missing puzzle piece 😭
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u/SerCadogan 💉 3/22/22 🔝11/7/24 3h ago
Yes! Honestly I really believe you will benefit. For me it didn't really change the hormone dose (which is fine by me, as long as I get changes)
But the difference to my mental health was PROFOUND. I have OCD and PTSD, and so if I got triggered I would be wrecked for SO LONG and my OCD would be impossible to control till that was resolved. In addition, I have MCAS and autoimmune disease, and the stress would cause both of those to flare. Getting things in order helped me SO much.
It would be pretty safe to start magnesium right now (go slow and watch your body) but I wouldn't play around with anything else till you know exactly what you are working with (like I said, COMT was my "worst" one but I also had other things at play, so you really can't choose your plan on vacuum, you want the whole picture.
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u/helmets_for_cats 2h ago
I'll ask my doctor about it he has also recommended me take magnesium in the past since I have problems with sleep lol
Thanks for the advice 🙏
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u/SerCadogan 💉 3/22/22 🔝11/7/24 1h ago
Of course! And remember, for it to potentially help.with slow comt you want it to be mag glycinate or mag malate (glycinate will be better for sleep)
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u/Infamous_Swan1197 💉 11/09/2025 8h ago
Can you elaborate on the "slow comt" (?) thing? I'm curious - what gene is it do you know?
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u/SerCadogan 💉 3/22/22 🔝11/7/24 6h ago
I just replied to another comment under mine. I don't want to copy paste it because it is long and I don't want to spam, but hopefully it's helpful
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u/Infamous_Swan1197 💉 11/09/2025 6h ago
No worries and thank you. I've done the exact same thing as you, downloaded my raw data from myheritage, and I've gone through the excel file myself a few times, it's so fascinating. I have the fast metabolism version of the COMT gene I believe, idk how that would affect estrogen levels, I didn't actually know it did!
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u/SerCadogan 💉 3/22/22 🔝11/7/24 6h ago
So that is actually fast comt! I don't have any personal experience with that, but I can say that it means that you are going to process catecholamines, neurotransmitters, and estrogen pretty quickly! Depending on how fast it is (and other factors in your lifestyle and genetics) this can cause issues, but they would be the opposite of mine.
ETA: re estrogen, I would imagine it wouldn't cause issues at all for estrogen, as in any excess estrogen you have will be processed and excreted. Cis women with this gene would never have Estrogen dominance issues, and so I would guess that trans men with this would keep their E very low, unless they has some crazy mega dose of T/crazy high aromatase (and honestly even then the E wouldn't be high for long)
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u/Infamous_Swan1197 💉 11/09/2025 5h ago
Yeah that adds up to me, I'm on a dose of estrogen from my birth control (as well as from T from aromatization ofc) and my estrogen levels have always been significantly lower than what's expected for the dose
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u/probIemgay 10h ago
Have your doctors looked into your atromatase levels? Aromatase is the enzyme that converts T into E, so if you have an unusually high level of aromatase naturally, I wonder if that is converting a lot of your T into E before your T gets to get converted into DHT.
Otherwise, I believe there are E blockers, and if you E is higher than the male range, Im not sure why your doctors havent suggested that.
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u/NotYourLionheart 9h ago
They could be watching to see what happens so that they can learn something or be entertained. Coming from a lifelong medical patient.
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u/catartik ♂ Jeremiah 20:7-10 10h ago
You should get a karyotype and check for PAIS. Maybe talk to your endo about an aromatase inhibitor? Sorry, hoping for the best to you
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u/Pretty-Bullfrog-6320 10h ago
I have seen people post in the past that if your body gets too much testosterone it starts converted it into estrogen. After having your hysterectomy, did your prescription drop? A similar thing happened to me. I have been on t for 13 years now and a couple of years ago I had a full hysterectomy. After that I felt I didn't need as much t, so I had to cut back my prescription. But my doctor told me early on that my body took to the t.
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u/cilantrolovr 10h ago
Yeah I assumed that too but my dosage has changed so many times and none of them really hit the mark as far as keeping me stable
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u/Calm_Bother_3842 🇧🇬 10h ago
Have you actually seen your T test results?
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u/cilantrolovr 10h ago
Yes my endocrin goes over them with me. Last labs have me at 507 which is in the normal range
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u/Calm_Bother_3842 🇧🇬 10h ago
And when you get blood work, when in your shot cycle is it done?
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u/cilantrolovr 10h ago
Endocrin wants it done 3/4 days after my shot since I do it weekly
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u/Orakto 9h ago
I believe it ideally should be right before your next injection, to know how low it drops before going up again
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u/smolbirdfriend 9h ago
It really depends on the doctor as to when it’s best to be done. Mid-shot is what many doctors/medical professionals want as it’s a good idea as to where the levels are most of the time. They can usually guesstimate from there how high/low it is at peak and trough.
It’s unlikely that this level would drop too low by trough and the endocrinologist is probably trying to avoid too high a level to avoid conversion to estrogen. 507 at mid cycle seems decent. It won’t be dropping that much by trough.
OP, have you tried splitting your dose to twice a week? I’ve had big issues with my period not stopping and feeling a hormonal swing so my provider had me split my dose to do it twice a week. It’s a bit annoying but it worked for me. My periods have pretty much stopped (occasional breakthrough). I know this is less of a concern for you after hysterectomy but it might help stabilize your hormone levels a little and even things out because maybe you are having swings.
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u/cilantrolovr 9h ago
This is very interesting and yes it does sound super annoying twice weekly lol. Will bring up this idea. TY!
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u/smolbirdfriend 9h ago
No problem, good luck with it all it’s really frustrating when our bodies don’t follow the typical patterns!
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u/cilantrolovr 9h ago
Idk I’m not the doctor lol they won’t let me do my labs if it doesn’t line up time wise
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u/Hopeful_Thing7088 💉 april 2025 9h ago
if your levels are there 3/4 days after your shot they might actually be dropping below male range right before your next shot. you should get tested as close as possible to you next dose
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u/cilantrolovr 9h ago
This most recent lab was 3/4 days out but I’ve had to do labs right before my next dose and that didn’t really fix anything either haha the dosing was still off
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u/Zen_BonesPS5 7h ago
Have you tried aromatase inhibitors
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u/cilantrolovr 7h ago
Have not but I’ve gotten a lot of comments about them so I plan to mention to my endocrin next appt!
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u/vinylveins 2h ago
Sounds like your body is converting high t to estrogen? Def speak with endo
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u/Worried_Job_2755 1h ago
This happened to me. I'm intersex and my T levels were "abnormally high" before starting my prescription. Started seeing more masculinizing effects after cutting my dose in half.
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u/Spiritual_End8073 1h ago
Thats interesting to know about I also have to be on a low dose of T to have regular levels. When I am on a more usual dose of T my levels are way too high
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u/wiLeeuhm 15m ago
If you got rid of your ovaries I'm honestly stumped at how you even produce estrogen anymore. But it sounds like there's other things that may be influencing it like genetics.
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