So as the title suggests I’m about to start DIY HRT soon, due to waiting lists for official HRT being long as hell (at least one year and I am just about to have everything to get put on the list). So I did some research on transfemscience.org and I also found someone through which I could get access to Injections (from voix Celeste) and Cyproterone Acetate (i will refer to it as CTA, because fuck that name). I will try to get Blood work done next month beforehand so that I know what my levels are, but I Am assuming, that my T shouldn’t be that high (I always struggled with building up muscle mass and dont have that much thick body hair). The expected levels for my injections have been calculated using the simulator on transfemscience.org. Here are the graphs
Currently my plan on dosage and bloodwork looks like this:
- 1: Get levels checked
- 2: Do a first injection with 5mg E and wait a week
- 3: 3 weeks with 3mg E for levels to stabilise at around 150-200 ng/ml
- 4: Get another Bloodworm done (so in total 4 weeks after the first injection)
- 5: Depending on where my T-Levels are suppress them with CTA (I have no exact clue how much I will need, but depending on how close I Am to the goal of levels below 50 ng/ml I will probably start with a small dose like 2.5 or so mg/d)
The first dose with 5mg is used as a “kick starter” because as you can see in the graphs, after one week I Am landing directly at the low of the 3mg steady state.
In terms of fine tuning I think that its probably a good idea to wait 4 weeks after changing intake to give my levels enough time to settle. This is based on the about 4 weeks it takes for the E levels to reach the steady state after starting the therapy (this can be seen in the graphs). My goal is to land within the range of about 150-200 ng/ml for E and <50 ng/ml for T. I am aiming at these levels due to these levels, at least according to the introduction for transfem HRT, having the best feminizing (my autocorrect constantly changes this to demonizing lol) effects and at the same time minimizing other risk factors like liver toxicity or blood clots. I Am healthy, so I should be fine, but better safe than sorry.
Now my additional questions:
- Is there anything that I should also get regularly checked except E and T (The introduction to transfem HRT article mentions prolactine levels and to get regular MRIs with CTA, but says, this is only needed when going above 12.5 mg/d, which has no therapeutic value, so I am not going there)?
- Is 4 weeks a good enough interval to get blood work done after adjusting intake?
- Is there anything, that I should know about in terms if the safety of injecting (apart from that I need a good enough syringe/needle)?
- Anything else that I should consider that I did not mention here?
You don’t really need cypro with injections. For most people 5mg een weekly is enough to lower T to below 50. I only need 4mg personally, but everyone is different. Also, it’s just healthier to avoid blockers if possible.
My goal is to land within the range of about 150-200 ng/ml for E … I am aiming at these levels due to these levels, at least according to the introduction for transfem HRT, having the best feminizing … effects and at the same time minimizing other risk factors like liver toxicity or blood clots.
Blockers introduce a number of other risks that will be higher than any risk from higher E. Sometimes the same risk (higher risk of blood clots). The usual goal is >100 pg/mL E and <50 ng/dL T. Whatever the lowest amount of E you can get that adequately suppresses T and is over 100 is fine. My avg is 230 pg/mL (some need closer to 300). Be aware that your E levels will vary a lot between each of your tests. My lowest was 174 and my highest was 324, all on the same dose. Those were outliers however and the variance is on average not as large as those numbers suggest. T has not varied nearly as much and has remained at around 20-30 for all of my tests. Keeping it suppressed and E above 100 is the only important thing here. There is no research that suggests that certain ranges of E are better for feminization.
You should test free T, testosterone, estradiol, FSH, LH, and SHBG. This is at least what my sexologist and GP recommended. We also did some liver tests early on. If you decide to use blockers you should absolutely get a liver test.
Here’s a good link about blood tests: https://transharmreduction.org/blood-tests Probably more reliable than my doctors who had very limited experience with HRT. It should have a page on injections also. Good resource.
I personally just use a 29G insulin syringe + needle. Can’t be switched. Works very well.
- We have a matrix if you want a rather active live chat about HRT: https://chat.blahaj.zone/c/genderverse/
- Here’s a list of DIY resources I’ve made: https://lemmy.blahaj.zone/post/19393848 It also has links on performing injections, including videos. I prefer sub-cutaneous.
Is 4 weeks a good enough interval to get blood work done after adjusting intake?
That’s about how long I would wait after adjusting, however keep in mind what I said about variance. One test might not be as representative as you think.
Edit: Oh, the videos were not linked on the resource page. They are linked here: https://lemmy.blahaj.zone/post/22251406
I received some good feedback on that post that I never implemented, but it’s still okay. Lots of links to wiser people than me.
Testing FSH and LH before HRT is a good idea. I know several people who found out that they are intersex because of weird FSH/LH levels.
+1 for monotherapy (blocking with high E), and not taking blockers
It is better to have separate needles for drawing and injecting - both to prevent a blunted or dulled needle which can cause more bruising or trauma, and also for cleanliness reasons.
I like to use Leur lock 1 mL syringes with no deadspace to prevent waste. I find 18G cores my vials, so I draw with 1 inch (25 mm) length 21G needles and inject with 1/2 inch (13 mm) length 27G needles.
I prefer a thinner needle for drawing as it’s less harsh on the rubber stopper. Since DIY vials are used for a long time I figured it would be a good thing to prioritize. But yeah you’re right about switching needles being better.
I have cored vials with 18G, but never with 21G - though my EV vials are not lasting as long as DIY vials, usually a DIY vial might be used for a whole year? Honestly that’s not the best, a vial can get contaminated, and the official medical advice is to bin vials older than a month, though I use all my vials longer than a month, I wasn’t using them for 12 months.
My current post-op dose is 2 mg EV once a week, so a 100 mg vial theoretically lasts me a little less than a year now, but back on my pre-op monotherapy doses the same vial usually lasted around 60 days.
I’ll report back if 21G cores a vial, but I have a hard time getting thinner needles to actually penetrate the rubber without bending, and of course drawing takes much longer, otherwise it seems like a good idea to protect the vial.
Some friends have had 21G eventually core their vials, but I doubt it’s assured that it will happen. There’s also techniques to mitigate the coring risk a bit, like the penetrating the rubber stopper at 45 degree thing and such.
I have heard of 21G coring vials too, so I agree it’s not a guarantee.
I do use the technique of penetrating at first at 45 degrees and with the needle pointing up, etc. - that might be part of why I have trouble with smaller gauges is that this technique damages the needles when they are too thin.
Do you just stick the smaller gauge needle straight into the rubber, then?
Yep. With a thin enough needle that technique is not required to spare the rubber stopper, and as you say the 45 degree thing tends to bend the needle (when it’s a high gauge)
Are you planning on using a separate draw and injection needle? Apart from that it looks generally good (although I don’t think the initial higher dose is necessary, it’s not necessarily harmful either). Depending on your location, I could get you in contact with some communities that could offer advice.
Are you planning on using a separate draw and injection needle?
That’s something I did not have in mind, but its a good idea. I have not bought needles and syringes yet, but will keep that in mind.
Regarding Location I’m from Germany. For anything else I would say, that its better if you hit me up on Matrix (my Account is in my Bio)
This sounds good except I’d probably try to avoid CTA by increasing the E dose instead, if this initial dosing doesn’t take care of the T on its own (and I suspect it won’t, it’s a pretty low dose)
