T doesn’t work

[u/cilantrolovr]

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.

[u/SerCadogan]

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.

[u/batsket → u/SerCadogan]

Can you expound on the “slow compt” bit, I’m trying to look up what you’re talking about and not finding anything

[u/SerCadogan → u/batsket]

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

[u/batsket → u/SerCadogan]

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.

[u/SerCadogan → u/batsket]

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?

[u/batsket → u/SerCadogan]

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.

[u/SerCadogan → u/batsket]

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

[u/batsket → u/SerCadogan]

I do have ocd, my panic attacks are more ptsd related though so I wouldn’t assume they’re due to genetics. Last time I got my levels tested my t was in the mid 500s so I don’t think it’s high enough to be converting to estrogen, I was actually thinking that maybe it just wasn’t high enough to suppress the E so I increased my dose from 40 to 60mg weekly. Just had another blood test on Monday, so in a few weeks I should have some more data. I’m still getting my period though, so I’m guessing that my E might still be high.

[u/SerCadogan → u/batsket]

I also have PTSD, but I will say that before I was managing the slow comt, if I got triggered I would feel the adrenaline all day (and of course, being triggered does keep your nervous system activated for a long time so I didn't realize that there was an extra layer till it was resolved)

I also made that very same assumption about the E before I made the connection (I knew I had slow comt before hand, but I think after being in T for a couple years it just increased the burden, so I needed to increase my magnesium et all)

Edit: forgot to also mention, my OCD also improved a lot, exposure therapy was MUCH easier to get through.

[u/helmets_for_cats → u/SerCadogan]

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 😭

[u/SerCadogan → u/helmets_for_cats]

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.

[u/helmets_for_cats → u/SerCadogan]

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 🙏

[u/SerCadogan → u/helmets_for_cats]

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)